Background to this inspection
Updated
6 November 2018
Kirkham Health Centre is in a semi-rural area of Lancashire at Moor Street, PR4 2DL and is approximately 10 miles from hospitals located in Blackpool and Preston. The practice is part of the NHS Fylde and Wyre Clinical Commissioning Group (CCG) and provides services under a General Medical Services contract with NHS England. It has 9100 patients on its register. The practice website address is www.kirkhamhealthcentre.co.uk
The surgery is provided from a large Victorian building that offers car parking facilities and disability access. The practice provides consultation and treatment rooms on the ground floor. The practice is in discussion with the CCG to move location to a newly developed health care facility. However, building work for the new health care facility has not yet commenced.
There are five GP partners, (one female and four male) and clinical support is provided by one nurse consultant, two advanced nurse practitioners and one trainee advanced nurse practitioner, three practice nurses, two healthcare assistants, one phlebotomist and a pharmacist. Five members of the nursing team and the pharmacist are non-medical prescribers of medicine. Managerial administrative support is provided by the practice manager, the assistant practice manager, two reception supervisors and a number of administrative and reception team staff.
The practice telephone lines are open Mondays to Fridays from 8am to 6.30pm. The practice provides a triage service and offers same day access to all patients requiring an appointment with either a GP or a nurse. The practice staggers appointments throughout the day from 8am until 6pm with both GPs and nurses.
Extended access is provided from 6.30pm to 9pm Monday to Friday and on Saturday and Sunday mornings from three hub locations in Freckleton, Fleetwood and Blackpool. The practice recognises these locations are not easily accessible for the local patient population.
Information published by Public Health England rates the level of deprivation within the practice population group as eight on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.
The practice has 58.3% of its population with a long-standing health condition, which is slightly lower than the CCG average of 61.1% and but higher than the England average of 53.7%. Male and female life expectancy is slightly lower at 78.7 years and 82.3 years respectively when compared with the England averages (79.2 and 83.2 years).
The practice provides family planning, surgical procedures, maternity and midwifery services, treatment of disease, disorder or injury and diagnostic and screening procedures as their regulated activities.
Updated
6 November 2018
This practice is rated as Good overall. (Previous rating December 2014 – Good)
The key questions at this inspection are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Good
Are services well-led? - Good
We carried out an announced comprehensive inspection at Kirkham Health Centre on 27 September 2018. This inspection was carried out as part of our inspection programme, and to see whether our recommendations for improvements at our December 2014 inspection had been addressed.
At this inspection we found:
- The practice was in the process of reviewing the service it provided to patients and was implementing a programme of change to improve service delivery and quality. The GP partnership had reviewed their leadership roles, allocating lead responsibilities in line with team member’s strengths and preferences. The new registered manager with the support of the new practice manager were leading these improvements.
- An overarching business plan was in place which provided an overview of the areas the practice wanted to develop, recognising areas requiring improvement and the challenges in achieving their plan.
- The practice had established systems to manage safety incidents. When incidents did happen, the practice learned from them and improved their processes.
- An overarching health and safety risk assessment was being development and the action plan in response to the fire risk assessment was being implemented.
- The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence based guidelines.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found the appointment system easy to use and reported that they could access care when they needed it.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
- The areas we identified at our previous inspection for further development had been addressed. These included improving the storage of medicines, undertaking infection control audits, undertaking a fire risk assessment, updating the practice business continuity plan and ensuring building maintenance certificates were available.
We saw one area of outstanding practice:
- The GP lead for safeguarding, together with a dedicated administrative team were committed to providing a comprehensive proactive system of monitoring and support for victims and potential victim of abuse. Systems in place included daily monitoring of data to identify patient trends, close coordinated working with health and social care professionals and collaboration with the clinical commissioning group (CCG) to develop up to date policies and guidance to share with GP practices within the CCG. Practice meetings were used for staff training and this included quizzes. Staff awareness of a range of safeguarding issues and the systems in place to monitor those at risk meant the practice responded quickly to provide appropriate and coordinated support to patients and their families.
The areas where the provider should make improvements are:
- Implement the actions identified in the fire risk assessment including designating fire marshals and complete an overarching health and safety risk assessment.
- Take action to ensure written protocols for the management of communications coming into the practice are implemented and GP audit of the process is undertaken.
- Actions completed on receipt of patient safety alerts should be logged in order to provide a clear audit trail of what has been done.
- Take action to improve the number of patients registered as carers.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice
Please refer to the detailed report and the evidence tables for further information.