Dr J O'Donnell's Practice

Updated 10 August 2016

Dr J O'Donnell's Practice, known locally as Valley Medical Centre is responsible for providing primary care services to approximately 8000 patients. The practice has a General Medical Services (GMS) contract and offers a range of enhanced services such as flu and shingles vaccinations, unplanned admissions and timely diagnosis of dementia. The number of patients with a long standing health condition is about average when compared to other practices nationally. The practice has four GP partners, three salaried GPs, two practice nurses, a health care assistant, administration and reception staff and a practice manager. The practice is a training practice with GP specialist trainees and they also teach University medical students.

The practice is open from 7.45am to 6.30pm Monday to Friday with extended hours to 8pm on a Tuesday evening. Patients can book appointments in person, via the telephone or online. The practice provides telephone consultations, pre-bookable consultations, urgent consultations and home visits. The practice treats patients of all ages and provides a range of primary medical services. Home visits and telephone consultations are available for patients who required them, including housebound patients and older patients. There are also arrangements to ensure patients receive urgent medical assistance out of hours when the practice is closed.

The practice is part of the Liverpool Clinical Commissioning group. The Belle Vale neighbourhood where the practice is placed, is the ninth most deprived in the city. In addition it is estimated that the average household income is significantly lower than both the Liverpool and national averages. Unemployment is significantly higher than the city rate and 7.6% of the population is long term sick or disabled. People living in more deprived areas tend to have greater need for health services. The population is older than the city average with almost a quarter (23%) aged between 40-54 years. There are fewer children aged 0-4 and proportionately more people aged 85 plus.

Updated 10 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr J O'Donnell's Practice on 6 July 2016. Overall the practice is rated as good.

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.We saw good evidence of improving the service by learning from adverse events and errors. Improvements were evidentwhen patient complaints had been made.

• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice.

• Feedback from patients about their care was consistently positive.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG). For example the PPG made the suggestion that GPs availability should be added to the practice website to help patients when making appointments and this was carried out.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• The practice actively reviewed complaints and how they were managed and responded to, and made improvements as a result.

• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.

• The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw areas of outstanding practice including:

• We heard that the practice had a high number of older patients within their community. The practice manager reviewed this population to try and identify those older people who might be a risk of being socially isolated and as a result lonely. Working with the practice PPG they set up a friendship group offering social events such as afternoon tea in the practice with an opportunity to meet new people. These social events included a Christmas party with every person attending receiving a present. At Easter another event was organsied for people to come together for social activities such as bingo. All staff participated in these events and some transported patients to and from the practice in their own cars where patients did not have their own transport. The practice believes there to be many benefits to these befriending events, including improving access and awareness of health services available at their own practice.

However there were areas of practice where the provider should make improvements. The provider should:

• Develop a protocol or procedure for the safe transport, storage and administration of vaccines in the community setting.

• Review the use of a staff incident book to record events described as minor in nature.

• Ensure that information for staff about any relevant physical or mental health conditions is collected as part of the recruitment process.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 August 2016

The practice is rated as good for the care 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), cardio vascular disease and hypertension. This information was reflected in the services provided, for example, reviews of conditions and treatment, screening programmes and vaccination programmes. The practice had a system in place to make sure no patient missed their regular reviews for long term conditions. The clinical staff took the lead for different long term conditions and kept up to date in their specialist areas.

The practice had multi-disciplinary meetings to discuss the needs of palliative care patients and patients with complex needs. The practice worked with other agencies and health providers to provide support and access specialist help when needed. The practice referred patients who were over 18 and with long term health conditions to a well-being co-ordinator for support with social issues that were having a detrimental impact upon their lives. The practice provided support and information to patients to encourage them to manage their long term conditions and provided care plans to patients to assist with this.

Updated 10 August 2016

The practice is rated as good for the care of families, children and young people. Child health surveillance and immunisation clinics were provided. Appointments for young children were prioritised. The staff we spoke with had appropriate knowledge about child protection and how to report any concerns. The safeguarding lead staff liaised with the health visiting service, school nurses and midwife to discuss any concerns about children and how they could be best supported. The practice provided a comprehensive and confidential sexual health and contraceptive service delivering the full range of contraceptive services.

Updated 10 August 2016

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. We saw outstanding care and kindness given to older people who had been identified as being socially isolated and possibly at risk of loneliness. Working with the PPG they set up a friendship group offering social events such as afternoon tea in the practice with an opportunity to meet new people. The practice had named GPs for all patients and also specifically for those over the age of 75 years. The practice offered a variety of health checks for older people specifically memory screening and osteoporosis risk assessments.

Updated 10 August 2016

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 an active website, Facebook and Twitter pages as well as noticeboards in reception advertising services to patients. The practice had a high population of students and in order to reduce some of the anxiety and stress felt when the student moved away from home, the practice team attended the university on the weekend the students first arrived. At this meeting practice staff were available to provide student information packs, immunisations previously missed and to talk to both the students and their parents.

Updated 10 August 2016

The practice is rated good for the care of people experiencing poor mental health (including people with dementia). The practice maintained a register of patients receiving support with their mental health. Patients experiencing poor mental health were offered an annual review. The practice worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The practice carried out assessments of patients at risk of dementia to encourage early diagnosis and access to support, this included opportunistic assessments. The practice referred patients to appropriate services such as psychiatry and counselling services. The practice had information in the waiting areas about services available for patients with poor mental health. For example, services for patients who may experience depression. Clinical and non-clinical staff had undertaken training in dementia to ensure all were able to appropriately support patients.

Updated 10 August 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable. Patients’ electronic records contained alerts for staff regarding patients requiring additional assistance. For example, if a patient had a learning disability to enable appropriate support to be provided. There was a recall system to ensure patients with a learning disability received an annual health check. The staff we spoke with had appropriate knowledge about adult safeguarding and how to report any concerns. Services for carers were publicised and a record was kept of carers to ensure they had access to appropriate services. The practice referred patients to local health and social care services for support, such as drug and alcohol services and to the wellbeing coordinator. The practice worked with the Citizen Advice Bureau to improve outcomes for some patients who are suffering from anxiety relating to financial or employment difficulties.  These patients were provided with advice from benefits advisers and debt counsellors to help address their problems.