The Village Medical Centre

Updated 12 May 2016

The Village Medical Centre is registered with the Care Quality Commission to provide primary care services. It provides GP services for approximately 7500 patients living in Wirral. The practice is situated in a purpose built health centre. The practice has three male GPs and four female GPs, a practice manager, practice nurses, administration and reception staff. The Village Medical Centre holds a Primary Medical Services (PMS) contract with NHS England.

The practice is open: Monday to Friday 8am – 6.30pm and remains open over lunchtime.

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 the Wallasey area of Wirral. The practice population is made up of a slightly higher than average elderly population with 31% of the population aged over 65 years old. Fifty four percent of the patient population has a long standing health condition and there is a lower than national average number of unemployed patients (1.7%).

The practice does not provide out of hours services. When the surgery is closed patients are directed to the local out of hour’s service provider (Wirral GP Out of Hours service) via NHS 111 for help. Information regarding out of hours services is available on the website and on the telephone message.

Updated 12 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Village Medical Centre on 8 December 2015 and at this time the practice was rated overall as good. However breaches of a legal requirement were also found. After the comprehensive inspection the practice wrote to us and told us that they would take action to meet the following legal requirements set out in the Health and Social Care Act (HSCA) 2008:

Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2010, Safe care and treatment.

On 13 April 2016 we carried out a focused review of this service under section 60 of the Health and Social care Act 2008 as part of our regulatory functions. The review was carried out to check whether the provider had completed the improvements needed and identified during the comprehensive review on 8 December 2015. This report only covers our findings in relation to those requirements. The report from our last comprehensive inspection can be read by selecting the ‘all reports’ link for The Village Medical Centre on our website at cqc.org.uk

The findings of this review were as follows:

• The practice had addressed the issues identified during the previous inspection.

• Effective systems were now in place to ensure accurate recording of medicine fridge temperatures and to ensure the correct procedures were followed if the temperatures fall outside of the required range for temperature sensitive medicines.

• Staff had received training in safe storage of temperature sensitive medicines.

• Effective systems were now in place to monitor the fridge recordings to ensure medicines were stored safely.

• Other recommended actions had been taken to improve care and services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 January 2016

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

• The practice maintained and monitored registers of patients with long term conditions for example cardiovascular disease, diabetes, chronic obstructive pulmonary disease and heart failure. These registers enabled the practice to monitor and review patients with long term conditions effectively. Clinical staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority through the risk stratification tool. (Stratifying patients accordingly aids the delivery of good long term conditions management. By using a risk prediction approach it is possible to identify those people who are the most regular users of hospital services (and are at risk of re-admissions), then stratify them according to complexity of need and commission cost effective interventions to meet those needs.)

• Performance indicators for management of diabetes were at or above national average.

• The percentage of patients in the defined clinical risk groups who received a seasonal flu vaccination was higher than the national average.

• Routine longer appointments and home visits were available.

• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. Systems ensure patient recalls are highlighted.

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

Updated 21 January 2016

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

• There was a clinical lead for child safeguarding

• There were systems in place to identify, prioritise and follow up vulnerable 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 and who did not attend for appointments.

• Immunisation rates were high for all standard childhood immunisations with the majority of immunisations uptake for 2 years and under at 100% and those for five years old ranging from 85% to 100%.

• 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.

• The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding five years was above the national average at 82%.

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

• We saw good examples of joint working with midwives, health visitors and school nurses, for example antenatal midwifery care and post-natal child surveillance was offered within the practice and monthly meetings took place with the health visitor to discuss any SG concerns)

Updated 21 January 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. There was a named GP for older patients.

• The percentage of people aged 65 or over who received a seasonal flu vaccination was higher than the national average.

• It was responsive to the needs of older people, and offered home visits (including to their patients in care homes) and urgent appointments for those with enhanced needs. It followed up all hospital admissions of over 75year olds within 72 hours of discharge from hospital.

• The practice worked with the multi-disciplinary teams in the care of older vulnerable patients.

Updated 21 January 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 the practice offered morning and evening appointments, face to face or via the telephone.

• 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.

• They offered a number of specialist in house clinics such as musculoskeletal opinions, joint injections and minor surgery.

• They offered a number of additional in house services including counselling, physiotherapy and phlebotomy.

Updated 21 January 2016

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

• The practice had a mental health and dementia lead. They carried out memory testing for dementia on site at the practice and were able to signpost patients experiencing poor mental health to access various support groups and voluntary organisations.

• It carried out advance care planning for patients with dementia and 95% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months.

• 100% of people experiencing poor mental health had a comprehensive, documented care plan in place.

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

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

• It 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 people with mental health needs and dementia.

• All patients with poor mental health were given extended appointments.

Updated 21 January 2016

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

• The practice had a clinical safeguarding adults lead and a register of vulnerable adults was held. Regular discussions around adult safeguarding concerns took place at clinical and multi-disciplinary meetings

• Vulnerable adults had an alert on their records so that staff were aware and could prioritise them if they requested an appointment.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

• It offered longer appointments for people with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• It had told vulnerable patients about how to access various support groups and voluntary organisations.

• Staff were familiar with patients from this group and knew and understood family dynamics.

• 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.