Bridge Road Medical Centre

Updated 15 June 2016

Bridge Road Medical Centre is based in the Litherland area of Liverpool and falls within South Sefton Clinical Commissioning Group (CCG). The medical centre is run by a partnership made up of four GPs, three male and one female. The partnership GPs are supported by two salaried GPs, two practice nurses and a healthcare assistant. The practice is a teaching practice, hosting GP up to two GP registrars at a time.

The practice premises were purpose built in 1989. There are 10 consulting rooms, one of which is set up and used as a treatment room. All patient facilities and consulting rooms are on the ground floor, including two patient toilets, one of which is fitted with baby change facilities. Both toilets are accessible to wheelchair users. There is some car parking available but spaces are limited. There is one, clearly marked disabled parking space.

The combined clinical sessions of all the GPs equates to 4.38 working time equivalent GPs, excluding the working time of the GP Registrar at the practice. The combined clinical sessions of the two practice nurses equates to 1.43 working time equivalent nurses. The hours of the health care assistant (HCA) are not included in this figure.

The practice offers 478 face to face GP appointments each week; approximately 54% of these are pre-bookable, up to two weeks in advance. GPs also offer 54 pre-bookable telephone consultations each week. Any patients who are unable to secure an appointment, and who need to be seen on the day, will be seen as an emergency at the end of each clinical session.

Other health professionals visit the practice on a regular basis, delivering clinics jointly with GPs, for example, health visitors and GPs run the weekly mother and baby clinic. The midwife visits and delivers an ante-natal clinic every week.

The practice is open from 8.30am to 6.30pm Monday to Friday. GP surgery times are from 8.40am until 11am or 11.45am each morning, and from 2pm or 2.30pm to either 5pm or 5.20pm each afternoon.

Nurse clinics are offered daily, and times vary; generally nurse appointments are available from 9am to 12pm each morning and from 2pm to 5.15pm each afternoon. The practice does not offer any extended hours surgeries.

All services are delivered under a General Medical Services contract. Out of hours services are delivered by a different provider. When the surgery is closed, patients are diverted to the NHS 111 service. If patients need the services of a GP they are referred by NHS111 to the locally appointed out of hours service provider Go to Doc.

Updated 15 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bridge Road Medical Centre on 18 May 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.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect.
• 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 commented that trying to get through to the practice by phone was difficult and that they found this frustrating.
• Patients said they could make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice acted positively in response to feedback from patients and staff.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvements are:

Having a failsafe system in place in relation to cytology screening;

Upgrading or making improvements to the telephone system to address complaints by patients that they cannot get through to the practice by phone.

Providing some extended hours opening for patients with work or caring commitments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 June 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.

• Patients who failed to attend appointments were contacted by phone and/or sent reminder letters up to three times before being classified as declining treatment.

• Longer appointments and home visits were available when needed.

• All these 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.

• Indicators for the care of diabetic patients were in line with local and national averages.

Updated 15 June 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 in line with or slightly below local and national averages.

• 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 25-65 whose notes record that a cervical screening test has been performed in the last five years, was 80% compared to the local clinical commissioning group (CCG) average of 82% and national average 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 15 June 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.

• Practice nurses and health care assistants visited housebound patients to deliver health care such as annual flu jabs, or to deliver shingles or other immunisations.

• The practice had identified those patients at risk of unplanned hospital admission and had agreed care plans in place for these patients.

• The practice was involved in work to identify those patients at risk of frailty; this will enable clinicians to tailor a package of healthcare support that assists those patients in staying well at home.

Updated 15 June 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.

• Feedback in the last National Patient GP Survey (published January 2016), showed 88% of patients said the last appointment they got was convenient for them.

• The practice GPs triaged calls of those patients who could not book an appointment and would see these patients on the day if necessary.

• The practice typically provided 54 telephone appointments each week.

• The practice had identified patients who were also carers; these patients were offered a double appointment if they needed it, to ensure they had enough time to discuss their health needs.

Updated 15 June 2016

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

• The percentage of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months was 90%, which is higher than the national average of 84% and the CCG average of 82%.

• 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 15 June 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.

• 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.

• The practice lead on safeguarding worked on a weekly basis with health visitors and midwives to ensure that all updates on safeguarded patients were shared.