Dingle Park Practice

Updated 27 April 2018

Dingle Park Practice is one of three practices located in the Riverside Centre for Health in a deprived area of Liverpool. The practice list size had increased by 10% over the past three years to approximately 4,900 patients at the time of our inspection and the majority (80%) were white British.

The staff team includes four GP partners, two salaried GPs, one assistant practitioner, two practice nurses and a healthcare assistant, a practice manager, an office manager and administrative and reception staff. The practice is a GP training practice and has a GP registrar working for them as part of their training and development in general practice.

Dingle Park Practice has a General Medical Services contract (GMS). The practice is part of NHS Liverpool Clinical Commissioning Group (CCG). Dingle Park Practice is the only practice commissioned to provide phlebotomy as part of the citywide community service (alongside Liverpool Community Health and the Royal Liverpool and Broadgreen University Hospitals Trust.)

The practice is open 8am to 6.30pm Monday to Friday. Patients accessed the Out-of-Hours GP service by calling NHS 111.

Updated 27 April 2018

This practice is rated as Good overall. (Previous inspection 15 October 2014– Good overall)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Dingle Park Practice on 16 March 2018 as part of our routine inspection programme.

At this inspection we found:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.

• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Care Quality Commission (CQC) comment cards reviewed indicated that patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. The practice constantly sought ways to improve the quality of care and actively monitored complaints, incidents, audits and survey results.
• Results from the national GP patient survey from July 2017 showed that patient’s satisfaction with the service and how they could access care and treatment was much higher compared to local and national averages. For example, 97% of patients who responded would recommend this surgery to someone new to the area (CCG average 80%; national average 77%).
• There was a clear leadership structure and the practice was well organised. Staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour.

We saw areas of outstanding practice:

• The practice had identified previous immunisation uptake rates for children were low and had taken a proactive approach to tackle this by employing an additional member of staff-a child immuniser, improved the recall and alert system and ensured GPs had access to vaccinations to increase opportunistic vaccinations. This had resulted in a significant improvement and uptakes were 97%.
• The practice proactively supported patients to lead healthier lives. They had held a health awareness review week in 2015 when a variety of supporting agencies had been invited into the practice to help patients with their lifestyle to promote healthy living or address any social needs. This had been well received and the practice was planning a further event running for three weeks in April 2018.

The areas where the provider should make improvements are:

• Review the system for ensuring all patient group directives for the administration of vaccinations are kept up to date.
• Review the prescribing policies so as to include information to staff for how to manage uncollected prescriptions.
• Review the patient information literature to include details of who patients can contact as an alternative to the practice if they wished to make a complaint.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 5 February 2015

The practice is rated as good for the population group of people with long term conditions. The practice had assessed the needs of its patient population and as a result a practice nurse was employed to work mainly with housebound patients to ensure they received the care they needed around chronic disease management. 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. Regular chronic disease management meetings were held to enable clinical staff to discuss patients with complex needs, keep up to date with changes to protocols and seek advice from colleagues.

Updated 5 February 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, a weekly clinic was run which combined immunisations and routine child health screening. Eight week baby checks and post-natal checks were also combined for the benefit of patients. 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. 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 with the health visiting service to discuss any children who were at risk of abuse and to review if all necessary GP services had been provided.

Updated 5 February 2015

The practice is rated as good for the care of older people. The practice had assessed the needs of its patient population and as a result a practice nurse was employed to work mainly with housebound patients to ensure pro-active care of older people who were housebound. 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. All nursing home and housebound patients also had a named GP. Patients over 75 received an annual health check. We found the practice worked well with other agencies and health providers to provide support and access specialist help when needed. A dedicated phone line was available at the practice for health care professionals to contact a GP to assist with communication and improve patient safety.

Updated 5 February 2015

The practice is rated as good for the population group of 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. Appointments could be booked and repeat prescriptions ordered on line. The need for extended hours service had been reviewed through surveys and was being monitored through patient and staff feedback. Well man and well woman checks were being offered to patients to promote patient well-being and prevent any health concerns.

Updated 5 February 2015

The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). 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 poor mental health. The register supported clinical staff to offer patients an annual appointment for a health check and a medication review. The Quality Outcomes Framework (QOF) indicated that the practice was meeting its targets for annual reviews of people experiencing poor mental health. The practice referred patients to appropriate services such as psychiatry and counselling services. Referrals were made to Child and Adolescent Mental Health Services (CAHMS) to support younger patients. 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 5 February 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. The practice worked with Addaction to support patients to overcome their problems with drugs and alcohol by prescribing any medication required and carrying out health screening and any necessary health interventions. Staff were knowledgeable about safeguarding vulnerable adults. They had access to the practice’s policy and procedures and had received training in this.