Ellergreen Medical Centre

Updated 26 July 2016

Ellergreen Medical Centre is situated in a deprived area of Liverpool. There were 12,236 patients on the practice list at the time of our inspection.

The practice is managed by seven GP partners. There are also two salaried GPs. There is a nurse practitioner, three practice nurses and a healthcare assistant. Members of clinical staff are supported by the practice manager and an assistant manager, reception and administration staff.

The practice is open 8am to 6.30pm every weekday. Patients requiring a GP outside of normal working hours are advised to contact the GP out of hours service by calling the 111 service.

The practice has a General Medical Services (GMS) contract and had an enhanced services contract which includes the delivery of childhood vaccinations. 

Updated 26 July 2016

Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection of this practice on 12 November 2015. Breaches of legal requirements were found. After the comprehensive inspection, the practice wrote to us to say what they would do to meet legal requirements in relation to Regulations:

• Regulation 15 HSCA (Regulated Activities) Regulations 2014 Safety and suitability of premises.
• Regulation 17 HSCA (Regulated Activities) Regulations 2014 Good governance.

We undertook this focused inspection on the 28 June 2016 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements and issues identified in the previous report. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Ellergreen Medical Centre on our website at www.cqc.org.uk.

Overall the practice is rated as good.

Our key findings were:

The practice had addressed the breaches of regulations and other issues identified during the previous inspection and made many improvements including:

• New systems to ensure they were meeting Health and Safety legislation to ensure the safety of both patients and staff. Risk assessments for health and safety had been carried out and action had been taken against the risks identified such as gas, electrical and fire safety.
• New systems to follow national guidelines for the cleaning of premises. There was monitoring of cleaning for the premises and clinical equipment and cleaning equipment had been renewed.
• There was now a formalised practice plan and all staff were involved in discussions about policies and protocols at protected learning events.
• The training matrix had been renewed and kept updated on a monthly basis which made it clear when staff training was due. All staff had received training relevant to their role and additional training had been attended for example, computer training.
• The practice had employed a pharmacist who was helping the practice address the high level of hypnotic medication prescribing. The practice had managed to reduce antibiotic prescribing rates by 6.8%. The practice had introduced monitoring systems for uncollected prescriptions.
• The practice had employed an information facilitator who had renewed the recall system and who liaised with the local mental health team to help ensure annual physical health checks for all patients experiencing poor mental health were completed and correctly recorded.
• The practice was carrying out a rolling programme of GP and nurses’ consultation audits to ensure all clinicians are following appropriate guidance in relation to treatment and medical record keeping.
• The practice had sought other ways of gaining patient feedback and had also conducted a staff survey.
• The practice had considered further ways to improve patient satisfaction with regards to making appointments and looked at tackling the high patient fail to attend rate for appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 26 July 2016

The practice is rated as good for providing services to patients with long term conditions.

At our previous inspection, the practice was rated requires improvement for safety and for well-led. The concerns which led to these ratings applied to everyone using the practice, including this population group. At this inspection, the practice was now rated as good for providing safe and well led services and the rating for this population group has been revised accordingly.

The practice had registers in place for several long term conditions including diabetes and asthma. All patients on the register had a diary date for a review appointment and were followed up if they did not attend. The practice took part in telehealth schemes to help with the monitoring of patient’s conditions at home such as monitoring blood pressure.

Updated 26 July 2016

The practice is rated as good for providing services to families, children and young people.

At our previous inspection, the practice was rated requires improvement for safety and for well-led. The concerns which led to these ratings applied to everyone using the practice, including this population group. At this inspection, the practice was now rated as good for providing safe and well led services and the rating for this population group has been revised accordingly.

There were systems in place 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 A&E attendances. The practice regularly liaised with health visitors. The practice was part of pilot projects in the area to work with paediatricians and respiratory nurses to improve care provided to children.

Updated 26 July 2016

The practice is rated as good for providing services to older people.

At our previous inspection, the practice was rated requires improvement for safety and for well-led. The concerns which led to these ratings applied to everyone using the practice, including this population group. At this inspection, the practice was now rated as good for providing safe and well led services and the rating for this population group has been revised accordingly.

The practice offered proactive, personalised care to meet the needs of the older people in its population and offered home visits and nursing home visits. The practice participated in meetings with other healthcare professionals to discuss any concerns. There was a named GP for the over 75s. 

Updated 26 July 2016

The practice is rated as good for providing services to working age people.

At our previous inspection, the practice was rated requires improvement for safety and for well-led. The concerns which led to these ratings applied to everyone using the practice, including this population group. At this inspection, the practice was now rated as good for providing safe and well led services and the rating for this population group has been revised accordingly.

The needs of this population group had been identified and the practice had adjusted the services it offered to ensure these were accessible. For example, the practice offered online appointment bookings and prescription ordering. In response to patient feedback, the practice offered 15 minute pre-bookable appointments in the afternoon.

Updated 26 July 2016

The practice is rated as good for providing services to patients experiencing poor mental health.

At our previous inspection, the practice was rated requires improvement for safety and for well-led. The concerns which led to these ratings applied to everyone using the practice, including this population group. At this inspection, the practice was now rated as good for providing safe and well led services and the rating for this population group has been revised accordingly.

At our previous inspection we also identified that patients experiencing poor mental health received an invitation for an annual physical health check. At this inspection we found the practice had employed an information facilitator who liaised with the local mental health team to help ensure annual physical health checks for all patients experiencing poor mental health were completed and correctly recorded.

The practice had identified that the practice population had high levels of stress and depression. The practice engaged with the local mental health team and also had counsellors and Citizens Advice Bureau on site. All staff had received dementia awareness training.

Updated 26 July 2016

The practice is rated as good for providing services to patients whose circumstances may make them vulnerable.

At our previous inspection, the practice was rated requires improvement for safety and for well-led. The concerns which led to these ratings applied to everyone using the practice, including this population group. At this inspection, the practice was now rated as good for providing safe and well led services and the rating for this population group has been revised accordingly.

The practice held a register of patients living in vulnerable circumstances including those with a learning disability. It had carried out annual health checks and longer appointments were available for people with a learning disability. The practice worked with the local learning disabilities team to check patients on their register. The practice held a weekly Addaction clinic for patients with substance misuse problems.