GP Practice at Riverside

Updated 12 August 2021

GP Practice at Riverside is located in Liverpool at:

Riverside Centre for Health

Park Street

Liverpool

Merseyside

L8 6QP

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services, treatment of disease, disorder or injury and surgical procedures. The practice is one of several practices operated by the provider.

The practice is situated within the Liverpool Clinical Commissioning Group (CCG) and delivers General Medical Services (GMS) to a patient population of about 2,300. The practice is part of a wider network of GP practices.

Information published by Public Health England shows that deprivation within the practice population group is in the lowest decile (one of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is approximately 78% White, 5% Asian, 6% Black, 5% Mixed, and 5% Other.

At GP Practice at Riverside there are two long-term locum GPs and a further locum GP. There is also a paramedic and an assistant nurse practitioner. Locum GPs, salaried advanced nurse practitioners and practice nurses who work at the providers other practices also work at GP Practice at Riverside. The provider also employs other clinicians who work across all the practices they operate, this includes a pharmacist, pharmacy technician and two mental health practitioners. The clinical staff at GP Practice at Riverside are supported by administration and management staff.

Due to the enhanced infection prevention and control measures put in place since the pandemic and in line with the national guidance, most GP appointments were telephone consultations. If the GP needs to see a patient face-to-face then the patient is offered a choice of either the main GP location or the branch surgery. When the surgery is closed patients are directed to NHS 111 and NHS walk in centres. Patients are advised to dial 999 in the case of an emergency.

Updated 12 August 2021

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at GP Practice at Riverside on 3 May 2017. The overall rating for the practice was good but the practice was rated as requires improvement for ensuring safe services. The full comprehensive report on the May 2017 inspection can be found by selecting the ‘all reports’ link for GP Practice at Riverside on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 6 February 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 3 May 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as Good.

Our key findings were as follows:

• The registered provider had reviewed the overall governance structure of the practice including staff roles and communications. New team and operational meetings were taking place. Key senior team members had developed leadership roles to support governance arrangements.

• Clearer systems were in place to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes. Risk assessments, monitoring and audit systems were improved to mitigate safety risks, in particular with regard to safety alerts and guidance, staffing, emergency medication and prescriptions and safety of the premises and equipment.

• Practice specific policies and standard operating procedures were available to all staff.

• There were clear methods of communication across the staff team. Records showed that regular meetings were carried out as part of the quality improvement process to improve the service and patient care.

• New systems and monitoring responsibilities had been put into place to ensure that records relating to the practice, including policies, staff recruitment and training documentation were completed. A staff training matrix was used by the practice to monitor staff training.

• A complaints policy and procedure was in place and information was available to help patients understand the complaints procedure and how they could expect their complaint to be dealt with.

• An improved system for cascading NICE guidelines and patient safety alerts had been put in place.

• New procedures were in place to monitor the emergency medicines, doctors’ bags and emergency equipment.

In addition the provider should:

• Review how information collected by the practice could improve the support available for carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 4 September 2017

The practice is rated as good for the care of people with long-term conditions.

The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs. All these patients had a named GP and there was a system to recall patients for a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. The practice held information about the prevalence of specific long term conditions within its patient population. This included conditions such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. The information was used to target service provision, for example to ensure patients who required regular checks received these. There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health. Practice nurses held dedicated lead roles for chronic disease management. As part of this they provided regular, structured reviews of patients’ health. The practice held regular multi-disciplinary meetings to discuss patients with complex needs and patients receiving end of life care. Longer appointments and home visits were available for patients with long term conditions when these were required. Patients with multiple long term conditions could be offered a single appointment to avoid multiple visits to the surgery.

Updated 4 September 2017

The practice is rated as good for the care of families, children and young people.

Staff were aware of safeguarding matters related to children and how to respond to these. We found the practice had regular safeguarding meetings with all professionals to discuss patients at risks and any developments to this. From the sample of documented examples we reviewed we found there were systems to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of accident and emergency department (A&E) attendances. A GP was the designated lead for child protection. The practice employed an Immunisation Nurse to maintain and improve standard childhood immunisations. The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications. The premises were suitable for children and babies and baby changing facilities were available.

Updated 4 September 2017

The practice is rated as good for the care of older people.

The practice offered proactive, personalised care and treatment to meet the needs of the older people in its population. Up to date registers of patients with a range of health conditions (including conditions common in older people) were maintained and these were used to plan reviews of health care and to offer services such as vaccinations for flu. Nationally reported data showed that outcomes for patients for conditions commonly found in older people were similar to or in some cases better than local and national averages. General Practitioners carried out regular visits to a local care home to assess and review patients’ needs and to prevent unplanned hospital admissions. Home visits and urgent appointments were provided for patients with enhanced needs. The practice used the ‘Gold Standard Framework’ (this is a systematic evidence based approach to improving the support and palliative care of patients nearing the end of their life) to ensure patients received appropriate care. Where older patients had complex needs, the practice shared summary care records with local care services.

Updated 4 September 2017

The practice is rated as good for the care of working-age people (including those recently retired and students).

The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group. The practice had a website as well as noticeboards in reception advertising services to patients. Telephone consultations were provided and patients therefore did not always have to attend the practice in person. Extended hours appointments were not available. The practice provided a full range of health promotion and screening that reflected the needs of this age group. The practice was proactive in offering online services including the booking of appointments and requests for repeat prescriptions. Electronic prescribing was also provided.

Updated 4 September 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

The practice held a register of patients experiencing poor mental health and these patients were offered at least an annual review of their physical and mental health. The practice referred patients to appropriate services such as psychiatry and counselling services. The practice regularly worked with multi-disciplinary teams including in the case management of patients experiencing poor mental health. Staff interviewed had a good understanding of how to support patients with mental health needs and dementia. A system was in place to follow up patients who had attended accident and emergency and this included where people had been experiencing poor mental health. Processes were in place to prompt patients for medicines reviews at intervals suitable to the medication they were prescribed. Patients experiencing poor mental health were informed about how to access various support groups and voluntary organisations. GPs carried out at least weekly visits to a care home for people living with dementia and care planning was carried out to support these patients.

Updated 4 September 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

The practice held a register of patients living in vulnerable circumstances in order to provide the services patients required. For example, a register of people who had a learning disability was maintained to ensure patients were provided with an annual health check and to ensure longer appointments were provided for patients who required these. End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable. The practice worked with relevant health and social care professionals in the case management of vulnerable people. Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours. Information and advice was available about how patients could access a range of support groups and voluntary organisations.