Westmoreland GP Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Westmoreland GP Centre on 17 June 2016.

Overall the practice is rated as good but requires improvement for providing safe services.

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

• The practice is situated in old hospital buildings within the grounds of Aintree Hospital, Liverpool. The premises were in need of redecoration and refurbishment. The reception area was too cramped for reception staff and signage for patients to direct them to the correct consultation room was confusing. The practice did have a ramp and a wheelchair, but disabled patients would require assistance to enter the building. There were translation services and a hearing loop. We were advised that the practice were exploring options and was meeting with the hospital estates management to discuss refurbishment plans.

• The practice was very busy and provided services for 12,567 patients. Patient survey information and comments reviewed showed well below average patient satisfaction rates with regards to making appointments and being able to get through to the practice on the telephone. The practice was aware of the results and had installed extra telephone lines in March 2016 and was planning to introduce a call waiting system. The practice told us evaluation of the actions was to take place at the end of June 2016.

• The practice had recently had a new computer system installed and there were on going issues relating to data management to enable the practice to have an effective recall system in place for patients with long term conditions. Plans were in place to overhaul the recall system and appointments including employing a pharmacist to assist with medication reviews.

• There were systems in place to mitigate safety risks including analysing significant events and safeguarding. However, some risk assessments and monitoring systems to ensure the safety of staff and patients were incomplete.

• Patients’ needs were assessed and care was planned and delivered in line with current legislation.

• 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. The practice sought patient views about improvements that could be made to the service; including having a patient participation group (PPG) and acted, where possible, on feedback.
• The practice was aware of and had systems in place to ensure compliance with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment).

• Staff worked well together as a team and all felt supported to carry out their roles. The practice had various plans to help the more vulnerable patients including setting up a charitable organisation.

However, there were areas where the provider must make improvements.

The provider must:

• Ensure that the documentation for practice nursing staff to carry out vaccinations is complete.

• Monitor stock and expiry dates for emergency medications kept in GP rooms.

The provider should:

• Include the correct details in patient information literature regarding who patients can complain to as an alternative to the practice i.e. NHS England.

• Continue to liaise with the local IT support team to help with data management issues.

• Have risk assessments in place for staff who do not have recruitment checks i.e. disclosure and barring checks.

• Continue to liaise with the hospital estates management to improve the décor and improve the layout of the reception area and signage to improve patient safety, access and staff welfare. Any changes made require the input of patient and staff views and appropriate risk assessments.

• Have their own monitoring systems in place for cleaning the premises and equipment.

• Check all staff know who the lead members of staff are for infection control.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice