The Hollies Also known as The Hollies Family Surgery

Updated 7 March 2017

The Hollies is a GP partnership practice, based in a residential area of Formby, Liverpool. The practice is located in a former domestic property which has been extended and developed over time to provide GP consulting and treatment facilities. The practice is led by three GP partners, one male and two female, supported by a salaried GP. The clinical team is complemented by two practice nurses (female) and two health care assistants (female). The practice administrative team is led by a practice manager who oversees the work of five administrative and reception staff. The practice is registered to deliver three regulated activities, diagnostic and screening procedures; treatment of disease, disorder and injury; maternity and midwifery services. Those patients requiring family planning services or surgical procedures are referred to other services locally by the GPs at the practice. All services are delivered under a PMS contract. The practice list size is approximately 4,900 patients.

All parts of the practice are located on the ground floor; the practice had been adapted over time to be wheelchair accessible. Doorways were also wide enough for pram and pushchair access. The practice has four GP consulting rooms, two clinical treatment rooms, two dedicated office areas and a meeting room. There are separate staff and patient toilet facilities. The patient toilets have baby changing facilities. The practice offers any breast feeding parents the use of a room for their comfort and privacy. There is limited car parking outside the practice; there are no parking bays specifically reserved for use by disabled patients.

The practice is open from 8am to 6.30pm each weekday, with later opening until 7.30pm on Tuesday and on Thursday, when extended hours surgeries are offered. Appointments are available from 8.30am to 11.50am each morning and from 2.30pm to 6.10pm each afternoon. Later appointments are available in the the two extended hours surgeries each Tuesday and Thursday evening with the last bookable appointment being at 7.15pm.

Outside these hours, patients contacting the surgery are diverted to NHS 111 who handle calls and refer those patients in need of a GP, to the locally appointed out of hours service provider Go to Doc.

Updated 7 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Hollies Surgery, on 13 April 2016. The overall rating for the practice was ‘Good’. The practice were found to be requiring improvement in one area, covered by the key question of ‘Safe’ The full comprehensive report on the April 2016 inspection can be found by selecting the ‘all reports’ link for The Hollies on our website at www.cqc.org.uk.

This inspection was an announced focused follow-up inspection carried out on 1 February 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 13 April 2016. This report covers our findings in relation to those requirements.

Overall the practice is now rated as Good

Our key findings were as follows:

• All significant events are formally reported, recorded, investigated and findings shared with all staff, including clinicians who may not be working at the practice any more, but who were working at the practice at the time of an incident.

• Formal patient specific directions are now in place. These cover medicines administered by nurses and health care assistants, that are not covered by patient group directions, for example, Vitamin B injections.

• A system for dealing with information requests from multi-agency safeguarding hubs and child protection teams has been put in place. We saw that staff were aware of this system and how it should be used by the practice.

• Staff recruitment checks were in place and copies of these checks were held by the practice.

In addition the provider should:

• Progress the correct registration of the partnership with CQC, including removal of those partners who no longer work at the practice.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 10 May 2016

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

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

• Nursing hours had reduced at the practice. To address this, delivery of prescribed care was being done by health care assistants, for example delivery of vitamin B injections.

• Indicators for care of diabetes patients showed the practice performance was in line with national averages.

• Longer appointments and home visits were available when needed.

• All patients had a named GP and 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.

Updated 10 May 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.

• The practice had not met all requests for safeguarding reports, by safeguarding review boards. This could impact on the outcome of such meetings and on patients concerned.

• Immunisation rates were relatively high for all standard childhood immunisations.

• 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.

• Data showed the practice results for cytology screening were similar to those nationally: The percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding five years, was 79% compared to the national rate of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

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

Updated 10 May 2016

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

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

• Winter planning arrangements were made every year to ensure the practice could meet the needs of the growing elderly population on the patient list.

• One of the GP’s leads on care of frail elderly patients and works with other surgeries to ensure proactive services meet the needs of this population group.

Updated 10 May 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 had ring-fenced appointments within its extended hours surgeries, for cytology screening for women with work or caring responsibilities, to further increase uptake of screening.

• 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 GPs offered extended hours surgeries on two evenings each week to help meet the needs of working patients.

Updated 10 May 2016

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

• 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 targeted areas for improvement in the management of patients experiencing poor mental health. Figures available demonstrated that progress was being made.

• 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 10 May 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 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.