St Georges Medical Centre

Updated 18 July 2016

St George’s Medical Centre is registered with the Care Quality Commission to provide primary care services. The practice provides GP services for approximately 9,600 patients living in Wirral and is situated in a purpose built medical centre. The practice has three female GPs, five male GPs, five practice nurses, two healthcare assistant, administration and reception staff and a practice management team. It is a teaching/training practice and occasionally has medical students and GP trainees working at the practice. St George’s Medical Centre holds a Personal Medical Services (PMS) contract with NHS England.

The practice is open Monday – Thursday 8am – 7pm and Friday 8am – 6.30pm. On Thursdays appointments are available from 7.30am.

Telephone lines are open 8.30am - 6.30pm.

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.

The practice is part of Wirral Clinical Commissioning Group (CCG) and is situated in a less affluent area. The practice population is made up of around national average population groups with 38% of the population under 18 years old and 28% of the population aged over 65 years old. Fifty seven percent of the patient population has a long standing health condition and there is around the national and CCG average number of unemployed patients. Life expectancy for both males and females is slightly lower than the CCG and national average.

The practice does not provide out of hours services. When the surgery is closed (after 6.30pm weekdays and at weekends) patients are directed to the GP out of hours service provider (NHS 111). Information regarding out of hours services was displayed on the website and in the practice information leaflet.

Updated 18 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at St George’s Medical Centre on 14 June 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. Safety alerts were received and acted upon.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Staff had been trained to deal with medical emergencies and emergency medicines and equipment were available.
• Infection control procedures were in place.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they could make appointments easily and urgent appointments were available the same day for all children and those patients who needed them.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• Staff were supervised, felt involved and worked as a team.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Review the system for reporting out of range drug fridge temperatures to include documenting the reason and risk assessments when storage is deemed safe.

• Review the uniform policy for clinical staff to include suitable attire that promotes infection prevention and control.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 July 2016

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

• Nursing staff and GPs had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance indicators for patients with long term conditions were around or above the CCG and National average. For example:

  The percentage of patients on the diabetes register, who had an influenza immunisation in the preceding 1 August to 31 March (2014/2015) was 98%. The CCG average was 95% and the national average was 94%.

  The percentage of patients with cardio pulmonary obstructive disease (COPD) who had a review undertaken including an assessment of breathlessness using the Medical Research Council dyspnoea scale in the preceding 12 months was comparable to the CCG and national averages at 92%

• Longer appointments and home visits were available when needed.

• All these patients had a structured annual review to check their health and medicines needs were being met.

• For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• Medical records for vulnerable patients with long term conditions were highlighted so that all staff knew their needs and arranged appointments and care accordingly.

Updated 18 July 2016

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

• 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.

• Immunisation rates were relatively good for all standard childhood immunisations with immunisations uptake for all children aged five and under around 90%.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• Unwell children were always offered same day/urgent appointments.

• The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding five years was around the national average at 79%.

• Appointments were available outside of school hours.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 18 July 2016

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

The practice had an elderly population around the national and local clinical commissioning group (CCG) average number of elderly patients with 28% over the age of 65. 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 avoiding unplanned hospital admissions, dementia, nursing and residential care home support and end of life care.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• Nationally reported data showed that outcomes for patients for conditions commonly found in older people were good. For example the percentage of patients with hypertension in whom the last blood pressure reading was 150/90mmHg or less was 83% and around the CCG and national average. Whilst the percentage of patients with atrial fibrillation treated with anticoagulation or anti platelet therapy was 98% and around the CCG and national average.

• All the older patients had a named GP who coordinated their care.

The practice had a GP lead for elderly care who liaised with the local elderly care network in caring for patients.

Updated 18 July 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.

• For example, it offered online bookings of appointments and prescription requests and offered evening appointments and telephone consultations. Appointments could be pre booked or booked on the day and emergency appointments were also available daily for those in need and all children.

• It offered early morning (from 7.30am) appointments.

• 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 for example NHS health checks for those aged 40 to 75 years old.

• 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.

Updated 18 July 2016

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

• 81% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months which is comparable to the national average.

• 91% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the preceding 12 months which is above the national average

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 18 July 2016

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

• The practice held a register of patients living in vulnerable circumstances including homeless people, those in ‘safe houses’ and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.