Dr J A Topping and Partners Also known as Greenbank Drive Surgery

Updated 31 March 2016

Drs B D O'Connor & J A Topping (known locally as Greenbank Drive Surgery ) is registered with the Care Quality Commission to provide primary care services. The practice provides GP services for 4573 patients living in the centre of Liverpool which has a higher than average level of deprivation. The practice has three GP partners, both male and female and is a training practice for trainee GPs. The practice had two practice nurses, a practice manager, and administration and reception staff. The practice holds a General Medical Services (GMS) contract with NHS England.

The practice is open 8am - 6.30pm on weekdays. Morning surgeries operate on an open-access system starting at 9am. Any patient arrived by 10am is guaranteed to have a doctor’s consultation that morning. Afternoon appointments are pre-bookable between 3.30pm and 6.20pm daily. There are also urgent appointment slots reserved for emergencies on a daily basis in the afternoon. There are bookable nurse appointments offered throughout the day. The practice treats patients of all ages and provides a range of primary medical services. The practice is part of Liverpool Clinical Commissioning Group (CCG). The practice population has a higher than national average patient group aged 25 to 45 years. The practice provides a service for temporary patients who are staying in the city as short stay asylum seekers.

Updated 31 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs B D O'Connor & J A Topping, known locally as Greenbank Drive Surgery On the 21 January 2016. Overall the practice is rated as good.

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

• Systems were in place to ensure incidents and significant events were identified, investigated and reported. All staff were aware of what constituted a significant event and they fulfilled their responsibilities to raise concerns and to report incidents. Information about safety was recorded, monitored and appropriately reviewed.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• 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 readily available in document form for patients. Clear complaint procedures were in place,monitored and reviewed.

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

• There were sufficient numbers of staff with the right competence, knowledge, skills, qualifications to meet the needs of patients.

• 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. Monitoring systems were in place.

There were areas where the provider could make improvements and they should:

• According to current external guidance and national standards, practices should be encouraged to have defibrillators.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 31 March 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. The practice had recently started working alongside a specialist diabetic nurse to monitor the care given to these patients. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. 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. This includes access to a health trainer who runs clinics at the practice on a weekly basis.

Updated 31 March 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 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. 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.

Updated 31 March 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. The practice had taken part in both the Dementia Enhanced Service offering dementia screening and the Avoiding Unplanned Admissions Direct Enhanced Service mainly focusing on older patients. Recently the practice held a coffee morning for Macmillan Cancer Care raising money and reaching out to patients who may be more vulnerable and isolated.

Updated 31 March 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 reflected the needs for this age group.

Updated 31 March 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). All of the patients experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It 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. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff received training on how to care for people with mental health needs and dementia. The practice had a good working relationship with the local Mental Health Liaison Nurse, validating the disease registers and providing physical health checks. Recently two medical students at the practice had produced a leaflet signposting patients to the available resources for common mental health conditions. This was regularly given out by doctors in consultations and copies were available in both waiting rooms.

Updated 31 March 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, travellers and those with a learning disability. It had carried out annual health checks for people with a learning disability and 95% of these patients had received a follow-up. It offered longer appointments for people with a learning disability.

The practice had a moderately-sized population of asylum seekers on their registered list. Staff understood the difficulties this vulnerable population group can face and they made it a priority to provide a compassionate, open and non-judgmental environment for these patients. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. 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.