Longview Medical Centre

Updated 8 March 2017

Longview Medical Centre is based in a purpose built facility in a residential area of Knowsley close to local amenities. The practice is based in a more deprived area when compared to other practices nationally. The male life expectancy for the area is 76 years compared with the CCG averages of 77 years and the National average of 79 years. The female life expectancy for the area is 81 years compared with the CCG averages of 81 years and the National average of 83 years. There were 4030 patients on the practice list.

The practice has two GP partners (one female, one male) and a permanent salaried GP who is currently on maternity leave. Long term locum GPs are booked when needed. The practice has two practice nurses, a practice manager, and five reception and administration staff. The practice also hosts trainee doctors on placement.

The practice is open Monday to Friday from 8am to 6.30pm and each Monday it offers extended opening hours from 6.30pm to 8pm. Patients requiring GP services outside of normal working hours are diverted by phone to NHS 111. Calls are triaged and patients referred on to the local out of hour’s provider for Knowsley, Urgent Care 24 (UC24).

The practice has a Personal Medical Services (PMS) contract. In addition the practice carried out enhanced services such as joint injections.

Updated 8 March 2017

We carried out an announced comprehensive inspection at Longview Medical Centre on the 19th January 2016. Overall the practice is rated as good.

Our key findings were as follows:

• Some aspects of managing safety needed further review. The systems in place for monitoring equipment and medicines showed that some equipment had not been checked and was out of date. Some staff did not know how to operate their emergency call system in the event of needing help and were unsure where emergency equipment and medications were stored. There was an inconsistency to the auditing and checking of these facilities, some had regular checks, while some audits had not been carried out routinely and did not include the oxygen or defibrillator.

• Governance systems lacked clarity for some staff.

• Repeat prescribing was well managed and the practice contributed to regular audits performed by CCG medicines management teams.

• The practice had a system in place to report, record and investigate significant events. However some events had not been recorded and shared with the team which limited learning from all events.

• Staff files lacked evidence of necessary checks required to show safe recruitment and selection procedures. Some files lacked any evidence of Disclosure and Barring Services (DBS) check. (These checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable.)

• The practice had a safeguard lead and staff were aware of how to report safeguarding concerns. However some staff lacked clarity in how children at risk were reviewed within the practice.

• The clinical staff proactively sought to educate patients to improve their lifestyles by regularly inviting patients for health assessments.

• Staff had been supported in accessing training to meet their needs. Staff retention at the practice was good offering great stability and continuity of care to patients.
• We saw some complaints were well managed however staff had not documented verbal complaints. The complaints policy was in need of being updated to include advice on how patients could escalate their complaint if required.
• Appointments were well managed. Review of appointment availability week by week showed the practice consistently met patient demand for GP appointments. The practice regularly offered in excess of the basic numbers required which enabled patients to always access appointments when needed.
• The practice was clean and tidy. The practice had good facilities in a purpose built building with access for patients with disabilities.
• Patients spoke highly about the practice and the whole staff team. They said they were treated with compassion, dignity and respect and felt involved in their care and decisions about their treatment.
• The practice has a Patient Participation Group (PPG) who met with the practice staff throughout the year. They made suggestions throughout the year to help improve the service provided by the practice.

There were areas of practice where the provider must make improvements. The provider must;

• Take action to ensure its recruitment policy, procedures and arrangements are improved to ensure necessary employment checks are in place for all staff and the required information in respect of workers is held. (Reg 19 Schedule 3).

• The systems in place for monitoring equipment and medicines should be improved to ensure continuous safety checks. Risk assessments must be up to date and show what actions are taken to reduce risks. (Reg 12)

There were areas of practice where the provider should make improvements: The provider should:

• Ensure all significant events are reported, recorded and investigated and findings shared with staff to promote learning.

• Review with all staff how children at risk were monitored within the practice.

• Ensure all patient complaints including verbal complaints are recorded and investigated in line with the complaint policy. The policy should be updated to include details on how patients can escalate their concerns if required.

• Review governance arrangements with all staff including systems for assessing and monitoring risks and the quality of the service provision.

Letter from the Chief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 April 2016

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

The practice held information about the prevalence of specific long term conditions within its patient population such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. This information was reflected in the services provided, for example, regular reviews of long term conditions with the practice nurse, treatment and screening programmes. The practice offered timely appointments for these patients to check that their health and medication needs were being met.

Updated 13 April 2016

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

Immunisation rates were comparable with local CCG averages for standard childhood immunisations. Staff had received safeguarding training. Staff had appropriate knowledge about child protection and they had access to policies and procedures for safeguarding. One GP took the lead for safeguarding. Staff put alerts onto patient’s electronic records when safeguarding concerns were raised. Urgent access appointments were available for children. The practice had a private room with baby changing facilities and welcomed patients who wished to breast feed.  Community midwives were based at the same premises and we saw that good working relationships contributed to the standard of care, treatment and support of this population group.

Updated 13 April 2016

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

Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice kept up to date registers of patients’ health conditions. The practice had identified patients who were at risk of unplanned hospital admissions and supported these patients to stay well at home, avoiding unplanned hospital admission.

Updated 13 April 2016

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

The practice was proactive in offering a range of services that reflect the needs of this age group including: on-line prescription ordering, the extended hours surgery each Monday, telephone consultations, electronic prescribing and appointment bookings. Health checks were offered to patients who were over 40 years of age to promote patient well-being and address any health concerns.

Updated 13 April 2016

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

The practice had a nominated GP lead for mental health. The practice maintained a register of patients who experienced poor mental health in order to regularly review their needs and carry out annual health checks and updates to their care plan. The practice staff liaised with other healthcare professionals to engage with these patients to ensure they attended reviews. Clinicians made referrals to the local memory clinic for accurate diagnosis of dementia. Staff demonstrated a good understanding of issues around patient consent however not all staff had received updated training in the Mental Capacity Act 2005.

Updated 13 April 2016

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

Staff had received training in safeguarding vulnerable adults and they had access to the practice safeguarding policy and procedures. Staff were aware of their responsibilities to raise any safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours. Staff used translation services to assist patients who did not have English as their first language. The practice was aware of patients in vulnerable circumstances and ensured they had appropriate access to health care to meet their needs. For example, a register was maintained for patients with a learning disability and annual health care reviews were provided to these patients.