Archived: Knotty Ash Medical Centre

Updated 9 June 2017

Knotty Ash Medical is registered with the Care Quality Commission to provide primary care services. It provides GP services for approximately 2,344 patients living in an area with high deprivation in Liverpool. The practice is managed by an individual GP (female) and has one salaried GP. There is currently a vacancy for a practice nurse but the practice was being assisted by the local practice nurse development team. There are administration and reception staff and a practice manager. The practice holds a General Medical Services (GMS) contract with NHS England.

The practice is open during the week; between 8am and 6.30pm. Patients can book appointments in person, online or via the telephone. 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 Liverpool Clinical Commissioning Group (CCG).

Patients accessed the Out-of-Hours GP service by calling NHS 111.

Updated 9 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Knotty Ash Medical Centre on 8 May 2017. Overall the practice is rated as good.

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

• Knotty Ash Medical is situated in converted residential buildings. There were disabled access and translation facilities.
• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Information from Care Quality Commission (CQC) comment cards reviewed indicated that patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available.
• Urgent appointments were available the same day.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Carry out a risk assessment as to how the practice would manage a medical emergency without a defibrillator.
• Have appropriate children’s oxygen masks for use in a medical emergency.
• Review significant events and incidents periodically to identify any trends.
• Have a written protocol for managing uncollected prescriptions.
• Have a Legionella risk assessment carried out by a suitably qualified assessor.
• Arrange for all staff to receive training about the Mental Capacity Act.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 June 2017

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

• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• All these patients had a named GP and there was a system to recall patients for a structured annual review to check their health and medication 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.
• The practice had plans to hold a weekly GP led chronic disease management clinic.

Updated 9 June 2017

The practice is rated as good for the care of families, children and young people.

• The practice worked with midwives and health visitors to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics and provided immunisations.
• The practice had emergency processes for acutely ill children and young people.

Updated 9 June 2017

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

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.
• The practice worked closely with district nurses and community matrons to deliver co-ordinated care.

Updated 9 June 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.
• The practice offered pre-bookable appointments four weeks in advance.

Updated 9 June 2017

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 patients experiencing poor mental health, including those living with dementia.
• The practice worked closely with the mental health services in Liverpool. The practice was able to signpost patients experiencing poor mental health to access various support groups and voluntary organisations.

Updated 9 June 2017

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 those with a learning disability.
• 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 had information available for vulnerable patients about how to access various support groups and voluntary organisations.