Allport Medical Centre - H Walton

Updated 26 August 2016

Allport Medical Centre - H Walton is registered with the Care Quality Commission to provide primary care services. The practice provides GP services for approximately 4,400 patients living in Wirral and is situated in a purpose built medical centre. The practice has two female GPs, one male GP, an advanced nurse practitioner, healthcare assistant, administration and reception staff and a practice management team. It is a training practice and occasionally has GP trainees working at the practice. Allport Medical Centre - H Walton holds a General Medical Services (GMS) contract with NHS England.

The practice is open Monday – Thursday 8.15am – 7pm, Friday 8.15am – 6.30pm.

Appointments for GPs start at 9am and nurses at 8.30am, with the last appointments at 6.50pm excluding Friday (6.20pm).

Patients can book appointments in person, via the telephone or online. The practice provides telephone consultations, pre-bookable consultations, urgent consultations and home visits. The practice treats patients of all ages and provides a range of primary medical services.

The practice is part of Wirral Clinical Commissioning Group (CCG) and is situated in a more affluent area of the Wirral. The practice population is made up of around national average population groups with 42% of the population under 18 years old and 32% of the population aged over 65 years old. Fifty six percent of the patient population has a long standing health condition and there is lower than the national and CCG average number of unemployed patients. Life expectancy for both males and females is higher than the CCG and national average.

The practice does not provide out of hours services. When the surgery is closed patients are directed to the Wirral GP out of hour’s service (via NHS 111). Information regarding out of hours services was displayed on the website and in the practice information leaflet.

Updated 26 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Allport Medical Centre - H Walton on 19 July 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. Safety alerts were received and acted upon.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Staff had been trained to deal with medical emergencies and emergency medicines and equipment were available.
• Infection control procedures were in place.
• 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 available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they could make appointments easily and urgent appointments were available the same day for all children and those patients who needed them.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear approach to working with others to improve care outcomes with a clear strategy and objectives including engaging with other key partners in providing health services.
• There was a clear leadership structure and staff were well supported by management. The practice proactively sought feedback from staff and patients, which it acted on with evident improvements for patients and staff.

• There was a high level of staff satisfaction with staff having worked there for long periods of time and low staff turnover rates. Staff were supervised, felt involved and worked as a team. Staff were proud of the practice and enjoyed working there.

• The provider was aware of and complied with the requirements of the duty of candour.

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

• Review the system for documenting and sharing the assessments of the safety of temperature sensitive medicines in fridges.

• Review the system in place to log and account for prescription pads.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 26 August 2016

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

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

• Performance indicators for patients with long term conditions were around or above the CCG and National average. For example:

  The percentage of patients on the diabetes register, in whom the last blood pressure reading (measured in the last 12 months) was 140/80mmHg or less was 81%. The CCG average was 80% and the national average was 78%.

  The percentage of patients with asthma, on the register, who have had an asthma review in the preceeding12 months that includes an assessment of asthma control using the three RCP questions was 78% (compared to the CCG average of 74% and national average of 75%).

• Longer appointments and home visits were available when needed for patients with long term conditions and multiple conditions.

• All these patients had 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.

• Medical records for vulnerable patients with long term conditions were highlighted so that all staff knew their needs and arranged appointments and care accordingly.

Updated 26 August 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 good for all standard childhood immunisations with immunisations uptake for all children aged five and under around 98%.

• 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.

• Unwell children were always offered same day/urgent appointments.

• The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding five years was around the national average at 81%. (CCG average – 81%, national average – 82%).

• Appointments were available outside of school hours.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 26 August 2016

The practice is rated as good for the care of older people.

The practice had an elderly population around the national and local clinical commissioning group (CCG) average number of elderly patients with 32% over the age of 65. 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 avoiding unplanned hospital admissions, dementia, and end of life care.

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

• Nationally reported data showed that outcomes for patients for conditions commonly found in older people were good. For example the percentage of patients with hypertension in whom the last blood pressure reading was 150/90mmHg or less was 89% and higher than the CCG and national average. Whilst the percentage of patients with atrial fibrillation treated with anticoagulation or anti platelet therapy was 95% and around the CCG and national average.

• All the older patients had a named GP who coordinated their care and contacted patients over 75 following discharge from an unplanned hospital admission.

The practice had a GP lead for elderly care who liaised with the local elderly care network in caring for patients.

Updated 26 August 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.

• For example, it offered online bookings of appointments and prescription requests and offered evening appointments and telephone consultations. Appointments could be pre booked or booked on the day and emergency appointments were also available daily for those in need and all children.

• The practice offered a full range of health promotion and screening that reflected the needs for this age group for example NHS health checks for those aged 40 to 75 years old.

Updated 26 August 2016

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

• 96% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the preceding 12 months which was above the national average of 88% and CCG average of 91%.

• 88% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months which is above the national average of 84%.

• 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 and could signpost to relevant specialist services.

• 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 and for those who did not attend appointments.

• Staff had a good understanding of how to support patients with mental health needs and dementia. Longer appointments were offered to those patients with poor mental health.

Updated 26 August 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, those with substance or alcohol misuse and those with a learning disability.

• The practice promoted “No Barriers” to accessing GP services and people were able to register without fear of stigma or prejudice.

• 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.