Archived: Prenton Medical Centre

Updated 23 April 2015

Prenton Medical Centre is based in Prenton a suburb of Birkenhead in the Wirral area. The practice treats patients of all ages and provides a range of medical services. The staff team includes one GP partner, one salaried GP, a non-clinical partner, a practice manager, a practice nurse and three administrative and reception staff.

The practice is open Monday to Friday. From 08:30 until 10:00 walk in appointments are offered where a GP is able to see patients without an appointment. Bookable appointments are offered after 10:00. In the afternoon appointments are offered to patients from 16:00 – 18:00 Monday and Thursday and from 14:00 - 16:00 on a Tuesday and Friday. Extended hours GP appointments are available on a Thursday evening from 18:30 – 19:30. No afternoon appointments are provided on a Wednesday. Nurse consulting times are available Monday, Tuesday and Thursday from 8:30/9:00 – 13:00 and 14:00 – 17.30/18.00 and from 09:00 – 13:00 on a Friday. Patients can book appointments in person, by telephone or on-line. Telephone consultations are available and home visits are offered to patients whose condition means they cannot visit the practice. When the practice is closed patients access the GP out-of-hours provider operated by Wirral Community NHS Trust.

The practice is part of NHS Wirral Clinical Commissioning Group. It is responsible for providing primary care services to approximately 1,718 patients. The practice is situated in an area with average levels of economic deprivation when compared to other areas nationally. The majority of the practice population are between the ages of 15 – 64. Seventy percent of the practice population have a long standing health condition and 22 percent have caring responsibilities. The practice has a General Medical Services (GMS) contract.

The CQC intelligent monitoring placed the practice in band 5. The intelligent monitoring tool draws on existing national data sources and includes indicators covering a range of GP practice activity and patient experience including the Quality Outcomes Framework (QOF) and the National Patient Survey. Based on the indicators, each GP practice has been categorised into one of six priority bands, with band six representing the best performance band. This banding is not a judgement on the quality of care being given by the GP practice; this only comes after a CQC inspection has taken place.

Updated 23 April 2015

Letter from the Chief Inspector of General Practice

This is the report of findings from our inspection of Prenton Medical Centre which is registered with the Care Quality Commission to provide primary care services.

We undertook a planned, comprehensive inspection on 20 January 2015 at the practice location. We spoke with patients, staff and the practice management team.

The practice was rated overall as Good. A caring, safe, effective, responsive and well- led service was provided that met the needs of the population it served.

Our key findings were as follows:

• There were systems in place to protect patients from avoidable harm, such as from the risks associated with staff recruitment, equipment and cross infection. Improvements should be made to records of medication reviews, security of prescription pads and the management of significant events.

• Patients care needs were assessed and care and treatment was being considered in line with best practice national guidelines. Staff were proactive in promoting good health and referrals were made to other agencies to ensure patients received the treatments they needed.

• Feedback from patients showed they were happy with the care given by all staff. They felt listened to, treated with dignity and respect and had confidence in the GPs and nurse. Patients felt involved in decision making around their care and treatment.

• The practice planned its services to meet the differing needs of patients. The appointment system in place allowed good access to the service. The practice encouraged patients to give their views about the services offered and made changes as a consequence.

• There was a leadership structure in place and clear lines of accountability. The practice ensured that staff had access to learning and improvement opportunities.

There were areas of practice where the provider needs to make improvements.

The provider should:

• Improve the management of significant events by ensuring that lessons learned and actions taken are fully recorded. A review of significant events should also be carried out to demonstrate that any actions taken have been effective.
• Record serial numbers of prescription pads to minimise the risk of inappropriate use.
• Ensure that all medication reviews are fully documented in patients’ medical records.
• Revise the consent form for minor surgical procedures and guidance around seeking consent to ensure patients’ rights are fully promote

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 April 2015

The practice is rated as good for the population group of people with long term conditions. The practice held information about the prevalence of specific long term conditions within its patient population such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and asthma. This information was reflected in the services provided, for example, reviews of conditions, screening programmes and vaccination programmes. The practice had a system in place to make sure patients attended regular reviews for long term conditions. The practice had implemented the gold standards framework for end of life care. One of the GPs took the lead for this group of patients. They had a palliative care register and liaised regularly with other health care professionals to discuss the care and support needs of patients and their families.

Updated 23 April 2015

The practice is rated as good for the population group of families, children and young people. Child health surveillance and immunisation clinics were run on a weekly basis. The practice monitored any non-attendance of babies and children at vaccination clinics and worked with the health visiting service to follow up any concerns. Staff were knowledgeable about child protection and a GP took the lead for safeguarding. Staff put alerts onto the patient’s electronic record when safeguarding concerns were raised. Regular meetings were held with the health visiting service to discuss any children who were at risk of abuse and to review if all necessary GP services had been provided.

Updated 23 April 2015

The practice is rated as good for the care of older people. The practice was knowledgeable about the number and health needs of older patients using the service. They kept up to date registers of patients’ health conditions and information was held to alert staff if a patient was housebound. The practice had a record of carers and used this information to discuss any support needed and to refer carers on to other services if necessary. The practice ensured each person who was over the age of 75 had a named GP. The practice worked with other agencies and health providers to provide support and access specialist help when needed. The practice had identified all patients at risk of unplanned hospital admissions and a care plan had been developed to support them.

Updated 23 April 2015

The practice is rated as good for the population group of working-age people (including those recently retired and students). The practice was open Monday to Friday and offered a walk-in service each day where no appointment was needed. Extended hours GP appointments were available on a Thursday evening. The practice also offered bookable appointments on the day, up to two weeks in advance and telephone consultations. Appointments could be booked and repeat prescriptions ordered on line. The practice monitored patient satisfaction with access to the service through patient feedback. Patient feedback indicated patients were overall satisfied with the range of appointments available. Health checks were offered to patients over 40 years of age to promote patient well-being and prevent any health concerns.

Updated 23 April 2015

The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). GPs worked with other services to review and share care with specialist teams. The practice maintained a register of patients who experienced poor mental health. The register supported clinical staff to offer patients an annual appointment for a health check and a medication review. The practice referred patients to appropriate services such as psychiatry and counselling services. Referrals were made to Child and Adolescent Mental Health Services (CAHMS) to support younger patients. The practice had information for patients in the waiting areas to inform them of other services available. For example, for patients who may experience depression or those who would benefit from counselling services for bereavement.

Updated 23 April 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable. The practice was aware of patients in vulnerable circumstances and ensured they had appropriate access to health care to meet their needs. For example, a register was maintained of patients with a learning disability and annual health care reviews were provided to these patients. Staff were knowledgeable about interpreter services for patients where English was their second language. Patients’ electronic records contained alerts for staff regarding patients requiring additional assistance in order to ensure the length of the appointment was appropriate. Staff were knowledgeable about safeguarding vulnerable adults. They had access to the practice’s policy and procedures and had received training in this. Monthly meetings took place with the community nurse lead for safeguarding to discuss any concerns about vulnerable patients.