Ainsdale Village Surgery

Updated 28 February 2017

Ainsdale Village Surgery is located in a residential area close to Southport, Merseyside and falls within Southport and Formby Clinical Commissioning Group (CCG). The practice is run by two female GP partners, supported by a salaried GP who works one morning each week, and a nursing team made up of an advanced nurse prescriber, a practice nurse and a phlebotomist. The practice manager leads a team of six reception and administrative staff.

The practice is a training practice hosting foundation year two medical students (FY2), and is an accredited GP training practice. The practice has hosted GP registrars from August 2016. Services are delivered under a General Medical Services (GMS) contract. The practice has approximately 3,000 patients.

The practice is open between 8am and 6.30pm Monday to Friday, with an extended hours surgery offered on Tuesday evening from 6.30pm to 8pm. The time of surgeries are staggered throughout the day to provide cover through the morning and afternoon. All surgery times are given on the practice website and updated as required.

The practice does not provide weekend surgeries. Patients requiring GP services out of hours are directed to the NHS111 service. Patients who are assessed as needing to see a GP, are directed to a designated provider for the Merseyside area, Go to Doc. 

Updated 28 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ainsdale Village Surgery on

15 October 2015. The overall rating for the practice was good. However, the practice was rated as requires improvement on the key question of well-led. This was because we found the practice had not updated its registration to reflect that they were delivering family planning services. The full comprehensive report on the October 2015 inspection can be found by selecting the ‘all reports’ link for Ainsdale Village Surgery on our website at www.cqc.org.uk.

This follow-up inspection was a focused desk based review, carried out on 24 January 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

15 October 2016. This report covers our findings in relation to those requirements and improvements made since our last inspection.

.

Overall the practice is now rated as Good

Our key findings were as follows:

• The practice had taken immediate steps to update their registration with the Care Quality Commission, to include the delivery of family planning services by the practice.

At our previous inspection on 15 October 2015, we found the practice had taken steps ensure that all patient data was transferred to a new practice computer system, but this was taking time. Until all records were correctly collated, this placed an extra work burden on GPs which could have impacted on patient safety. When we checked on the progress of this, we saw that the practice had received on-going support from the Clinical Commissioning Group IT team to ensure that patient records had been correctly transferred, meaning all information required by GPs for each consultation could be accessed.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 10 December 2015

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

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

• Practice leaders had identified areas for improvement in diabetes care and management and had given the nursing team ownership of this area of care. We saw that all patients with higher blood readings of Hba1c (a type of haemoglobin used to measure the plasma glucose concentration over long periods) had been recalled as a priority.

• 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 medicines 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.

Updated 10 December 2015

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.

• 2014-15 QOF achievement for cervical screening was 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.

• GPs at the practice had combined the post natal check for mothers with the six week new baby check. This provided a longer appointment time to ensure the health needs of both patients are met and that new mothers are adapting well to motherhood.

Updated 10 December 2015

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.

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

• The practice had worked with community stakeholders to offer older patients greater access to local services, for example, by inviting a fitness service (Active Lifestyles) into the practice when running flu immunisation clinics. This followed on from success in the previous year when Healthwatch representatives had attended the annual flu immunisation clinics in 2014.

• Clinical audit was used to drive improvement. We saw that dementia diagnosis rates had increased from 34% in 2014 to 48% by March of 2015.

• The practice delivered a service for the frail elderly population as part of a Local Quality Contract.

Updated 10 December 2015

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.

• One of the GP partners had jointly led work on a pilot to use technology to transmit ECG tests by phone to give far quicker analysis and interpretation of results for patients.

• Opening hours were designed to meet the needs of patients with working, studying and caring responsibilities.

• Practice leaders considered other services that could be offered to patients within this group, for example, offering the HPV vaccine to school age females who may not have been offered this at private schools.

Updated 10 December 2015

The practice is rated as outstanding 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 people experiencing poor mental health, including those with dementia.

• The practice GPs support a local nursing home for patients experiencing poor mental health and patients in the community on Community Treatment Orders (CTO).

• The practice GPs had set up regular meetings with the Primary Care Mental Health Liaison Practitioner to discuss the care of patients and how this could be improved. The GPs requested that the adult consultant Psychiatrist visit the practice to share good practice and review clinical treatment of some patients.

• It carried out advance care planning for patients with dementia.

• Prescribing for mental health patients followed best practice guidance and audit had been used to drive improvements in this area.

• Latest QOF figures (2014-15) showed 93% of patients experiencing poor mental health had an agreed care plan in place; 96% of patients in this group had blood pressure readings and alcohol consumption levels recorded in their medical records. All patients prescribed Lithium were regularly reviewed and showed 100% compliance with required medication levels.

• All staff had received training in suicide awareness and dementia awareness.

Updated 10 December 2015

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

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

• The practice regularly supported a group of 76 travellers in the area. This provided contact for the whole family with GPs, nurses and other healthcare professionals, such as midwives and health visitors. The practice could show long term health benefits delivered to this patient group, in the form of a rapid response to a measles outbreak, childhood immunisations, health screening, contraceptive services, chronic disease management – particularly asthma, cervical screening and breast care and well man clinics. A relationship of trust and confidence had been built, such that the practice had been able to introduce other community professionals such as the Liverpool Community Health Link Nurse for Children out of School, who visits the travellers site. Other professionals have joined this team to support these families, for example, by helping to read letters about health care appointments and explaining what will happen at any referral appointments, for example, for a mammography appointment.

• 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.

• The practice had accepted visitng patients on their list, who needed a significant amount of care and support whilst terminally ill.

• 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