Archived: Dr Chi Kee Liu

Updated 16 December 2016

Dr Chi Kee Liu is situated in Somersham, Huntingdon. The practice provides services for 2,285 patients. It holds a General Medical Services contract with Cambridgeshire and Peterborough CCG.

According to information taken from Public Health England, the patient population has a higher than average number of patients aged 40 – 85+ years. The practice has a lower than average number of patients aged 0 – 39 years compared to the practice average across England. The practice is in an area with a low level of deprivation.

The practice team consists of a male GP partner, a male salaried GP, a practice manager, and two female practice nurses. The team also includes dispensary, secretarial and reception staff.

The practice is open from Monday to Friday. It offers GP and nurse appointments from 8.30am to 1pm and 2pm to 6pm on Mondays, Tuesdays, Thursdays and Fridays. It offers GP and nurse appointments between 8.30am and 1pm on Wednesdays. The practice offers an extended hours clinic between 6.30pm and 8pm on Mondays.

The practice has branch surgeries in the neighbouring villages of Earith and Bluntisham. GP appointments are available in Bluntisham on Tuesdays and Fridays between 9.15am and 10.45am, and patients can see a nurse between 9.15am and 12pm on Thursdays. GP appointments are available in Earith on Tuesdays and Fridays between 11.30am and 12.30pm, and patients can see a nurse between 11.30 and 12.30 on Wednesdays.

Updated 16 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced follow up inspection at Dr Chi Kee Liu on 27 October 2016. Overall the practice is rated as good.

We had identified a number of shortfalls at our previous inspection in February 2016 and issued four requirement notices as a result. During this inspection, we found that the practice had taken sufficient action to address the breaches in regulations.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Systems had been implemented to ensure that information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed. The practice had completed further risk assessments to protect patients and staff.
• 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 appraisals had been undertaken or scheduled since the previous inspection.
• Feedback from patients about their care was generally positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Data from the National GP Patient Survey published in July 2016 showed that patients rated the practice higher than others for all areas of care. For example, 99% of patients said that they had confidence and trust in the last GP they saw or spoke to in comparison to the local and national average of 95%.
• Information about services and how to complain was available and easy to understand. Improvements had been made to the complaints process to enable the practice to manage and act on patient feedback.
• Patients said they found it easy to make an appointment with a GP and that there was continuity of care. Urgent appointments were available on the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice proactively sought feedback from patients and staff. A virtual patient group had been developed to encourage further feedback from patients.
• The provider was aware of and complied with the requirements of the duty of candour.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 December 2016

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

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• The practice used the information collected for the Quality and Outcomes Framework (QOF) to monitor outcomes for patients (QOF is a system intended to improve the quality of general practice and reward good practice). Data from 2015/2016 showed that performance for diabetes related indicators was 85%, which was below the local average of 91% and national average of 90%. Exception reporting rates were significantly below local and national averages for all diabetes related indicators (exception reporting is the removal of patients from QOF calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of side effects).
• A community diabetic specialist nurse held regular clinics at the practice.

• Longer appointments and home visits were available when needed.
• Patients with complex needs had a named GP and a structured annual review to check their health and medicines needs were being met. There was a robust recall system in place to ensure that patients were invited and attended annual reviews.
• 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.

Updated 16 December 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 high for all standard childhood immunisations.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.
• The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding five years was 87%, which was above the local average of 84% and the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice offered a full range of contraception services and chlamydia screening.
• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 16 December 2016

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

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. All home visits were triaged by a clinician to prioritise visits and ensure appropriate and timely intervention.
• The practice contacted all patients after their discharge from hospital to address any concerns and assess if the patient needed GP involvement at that time.
• Both GPs and practice nurses visited local care homes. Feedback from local nursing and residential care homes was consistently positive about the quality fo care received from staff.
• Nationally reported data showed that outcomes for patients for conditions commonly found in older people, including rheumatoid arthritis and heart failure, were above local and national averages.

Updated 16 December 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 where possible.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.
• Extended hours appointments were available at the main site between 6.30pm and 8pm on Mondays.
• Practice staff carried out NHS health checks for patients between the ages of 40 and 74 years. The practice was able to refer patients to a health trainer to encourage lifestyle changes.
• The practice offered many NHS services in house, reducing the need for outpatient referral and therefore improving patient convenience.

Updated 16 December 2016

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

• 100% of patients diagnosed with dementia had received a face to face care review in the last 12 months, which was above the local average of 87% and the national average of 86%.
• 72% of patients experiencing poor mental health had a comprehensive care plan in place, which was below the local average of 90% and the national average of 89%.
• 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.
• 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.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 16 December 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 travellers and 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, and held regular multidisciplinary team meetings.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
• The practice was engaged with the local carers support group, which provided guidance, support and respite for carers. Written information was available to direct carers to the various avenues of support available to them.
• 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.