Archived: Drs Hegde & Jude's Practice

Updated 22 January 2015

Drs Hegde and Jude’s Practice is one of three practices based in the Riverside Centre for Health in the Dingle area of Liverpool. There is also a branch service based in the Picton area of Liverpool at Picton Neighbourhood Health and Children’s Centre. The practice registered with CQC to provide primary care services, which include access to GPs, minor surgery, family planning, ante and post natal care. The practice treats patients of all ages and provides a range of medical services. The staff team includes two GP partners, five salaried GPs, two regular locum GPs, three practice nurses, a healthcare assistant and administrative and reception staff. Both sites have core staff with some staff working across both sites.

Both sites are open Monday to Friday from 8.00am/8.30am until 6.30pm. Both sites offer extended hours consultations until 8pm on Mondays. Patients can book appointments in person and by telephone. Patients can book on the day or in advance, home visits are offered to housebound and terminally ill patients and telephone consultations are available. When the practice is closed patients access the GP out-of-hours provider UC24.

The practice is part of NHS Liverpool Clinical Commissioning Group. It is responsible for providing primary care services to approximately 9,400 patients. The practice is situated in an economically deprived area of the city. 24.2% of the practice population are under 18 years of age. 58.9% of the practice population have a long standing health condition. The practice has a GMS contract.

The Riverside and Picton sites share a building with other GP practices and with a number of community services such as chiropody, physiotherapy, health trainer service and counselling services. There is also a private pharmacy located within the buildings.

Updated 22 January 2015

Letter from the Chief Inspector of General Practice

This is the report of findings from our inspection of Drs Hegde and Jude’s Practice. Drs Hegde and Jude’s Practice is registered with the Care Quality Commission to provide primary care services.

We undertook a planned, comprehensive inspection on 1 October 2014 at the practice location in the Riverside Centre for Health and we also visited the branch location at the Picton Neighbourhood Health and Children's Centre. We spoke with patients, staff and the practice management team.

The practice was rated as Good. An effective, responsive and well- led service was provided that met the needs of the population it served.

Our key findings were as follows:

• There were systems in place to protect patients from avoidable harm, such as from the risks associated with medicines and cross infection.
• Patients care needs were assessed and care and treatment was being considered in line with best practice national guidelines. Staff were proactive in promoting good health and referrals were made to other agencies to ensure patients received the treatments they needed.
• Feedback from patients showed they were overall happy with the care given by all staff. They felt listened to, treated with dignity and respect and had confidence in the GPs and nurses. 
• The practice planned its services to meet the differing needs of patients. The appointment system in place allowed good access to the service.
• The practice had a clear vision and set of values which were understood by staff and publicised for patients. There was a clear leadership structure in place. Quality and performance were monitored, risks were identified and managed.

The provider should:

• Consider carrying out regular infection control audits.
• Consider having the same range of medication available to be used in an emergency at both surgeries.
• Consider responding to the actions arising from all significant events in a timely manner.
• Consider carrying out drills to test out the accessibility of emergency equipment and staff response times.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 January 2015

The practice is rated as good for the population group of people 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) and hypertension. This information was reflected in the services provided, for example, reviews of conditions and treatment, screening programmes and vaccination programmes. We found staff had a programme in place to make sure no patient missed their regular reviews for long term conditions. Staff were skilled and regularly updated in specialist areas which helped them ensure best practice guidance was always being considered.

Updated 22 January 2015

The practice is rated as good for the population group of families, children and young people. There were screening and vaccination programmes which were managed effectively to support patients and the needs of families. For example, appointments for new patients were offered alongside vaccination appointments. The practice monitored any non-attendance of babies and children at vaccination clinics and worked with the health visiting service to follow up any concerns. All of the staff were very responsive to parents’ concerns and ensured parents could readily bring children who appeared unwell into the practice to be seen. Staff were knowledgeable about child protection and a GP took the lead for safeguarding. Staff put alerts onto the patient’s electronic record when safeguarding concerns were raised. Regular meetings were held within the practice to ensure the staff team were aware of any children who were at risk of abuse and to review if all necessary GP services had been provided.

Updated 22 January 2015

The practice is rated as good for the care of older people. The practice was knowledgeable about the number and health needs of older patients using the service. They kept up to date registers of patients’ health conditions and information was held to alert staff if a patient was housebound.  They used this information to provide services in the most appropriate way and in a timely manner. The practice ensured each person who was over the age of 75 had a named GP. Medication reviews were completed with all patients over the age of 75. We found the practice worked well with other agencies and health providers to provide support and access specialist help when needed.

Updated 22 January 2015

The practice is rated as good for the population group of the working-age people (including those recently retired and students). We found the practice had a range of appointments available including pre-bookable, on the day and telephone consultations. Staff told us they would try to accommodate patients who were working to have early or late appointments wherever possible. Patients were also able to book a consultation with a GP through the extended hours service. This was available from 6.30pm to 8.00pm during the week and on Saturday mornings. Patients unable to attend during the normal opening hours were able to book in advance to be seen at the ‘extended hours’ service run at both sites until 8pm on Mondays. During periods of high patient demand, such as for flu vaccinations the practice opened on a Saturday morning.

Updated 22 January 2015

The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). Staff we spoke with were knowledgeable about the annual reviews available for patients experiencing poor mental health. GPs worked with other services to review care, implement new care pathways and share care with specialist teams. The practice maintained a register of patients who experienced mental health problems. The register supported clinical staff to offer patients an annual appointment for a health check and a medication review. The practice had information for patients in the waiting areas to inform them of other services available. For example, for patients who may experience depression or those who would benefit from counselling services for bereavement.

Updated 22 January 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable. 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 of patients with a learning disability and annual health care reviews were provided to these patients. Staff told us they would ensure homeless people received urgent and necessary care. They were also aware of the GP practice in the Clinical Commissioning Group (CCG) that took the lead for managing homeless patients’ long term care and referred patients on appropriately. Asylum seekers were registered with the practice and there was information for staff to refer to around initial screening examinations that were undertaken by another service provider. Staff were knowledgeable about safeguarding vulnerable adults. They had access to the practice’s policy and procedures and had received training in this.