Archived: Marybone Health Centre

Updated 8 October 2015

Marybone Health Centre is located in Liverpool City Centre. The practice serves approximately 5,400 patients who live in and around the city centre. The practice population whilst varied, includes a significant number of patients between the age of 20-29 years of age, a large proportion of which are students. The practice register has grown year on year, and is expected to rise further when two new, purpose built student accommodation blocks open, housing approximately 1300 students.

The practice operates from a purpose built facility. This provides four consulting rooms, one treatment room, a patient reception and seating area with access to patient toilets that are suitable for use by people with impaired mobility. The office manager is located in a workspace at the back of the reception area. The practice also has a meeting room, administrative offices and staff restroom and utility area.

The practice clinical team is made up of three GP’s, one male and two female. These are supported by a practice nurse and healthcare assistant. The locum GPs have been at Marybone Health Centre for a considerable period and have offered continuity of care for patients registered with the practice. The services are delivered under an Alternative Primary Medical Services (APMS) contract.

The practice is open from 8.00am to 6.30pm, Monday to Friday. An extended hours surgery is provided on Tuesday of each week, when the practice is open until 8.30pm. Out of hours services are provided by Urgent Care 24 (UC24).

From data we reviewed we could see that the provider had performed in line with expectations in key areas that are measured by the Quality Outcomes Framework (QOF). (QOF is a voluntary incentive scheme which financially rewards practices for managing some of the most common long-term conditions and for the implementation of preventative measures).

All regulated activities are delivered from the address given for the practice in this report. There are no branch surgeries linked to this practice.

Updated 8 October 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Marybone Health Centre on 11 August 2015. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Some equipment at the practice was not in use, for example spirometry equipment and a defibrillator. Staff could not say when they would be available for use. There was no risk assessment in place to support any decision by the practice not to have a defibrillator available for use.
• 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 commented that 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 available and easy to understand.
• Patients commented that they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management.

However there were areas of practice where the provider needs to make improvements. Importantly the provider must:

• ensure spirometry equipment used by nurses who review patients with COPD is serviced, available and ready for use.

There were areas of practice where the provider should make improvements. The provider should:

• conduct a risk assessment on the need for a defibrillator at the practice.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 8 October 2015

The practice is rated as good for the care of people with long-term conditions. The practice nurse helped manage those patients with chronic disease and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All patients had 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.

Updated 8 October 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. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with health visitors and school nurses.

Updated 8 October 2015

The practice is rated as good for the care of older people. The practice offered personalised care that met the needs of the older people in its population. We found the service offered flexibility in terms of accommodating home visits, when these were required. It was responsive to the needs of older people, and offered appointments ‘on the day’ for those patients who were identified as having complex needs that required more support. The practice provided opportunistic dementia screening, and used risk stratification tools to identify those older patients most at risk of unplanned hospital admission. These patients had care plans in place designed to support them and their carers, and giving key named contacts, for example their named GP or community nurses.

Updated 8 October 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 recognised that students formed a large part of their patient register, being located in the city centre and accessible to students at universities in the city. The practice staff worked hard to ensure that new patients who were students found it easy to register with the practice, and were able to access services quickly. GPs encouraged all students to attend for MMR vaccination and Meningococcal C vaccination.

Updated 8 October 2015

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 people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia.

Updated 8 October 2015

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. This enabled staff to encourage these patients to attend health care appointments, and ensure out of hours services were aware of who these patients were. It had carried out annual health checks for people with a learning disability and these patients had access to a named GP. The practice offered longer appointments for patients identified as needing more time with a nurse or GP, including those patients with a learning disability.