Heswall and Pensby Group Practice

Updated 22 March 2016

Heswall and Pensby Group Practice are registered with the Care Quality Commission to provide primary care services. The practice provides GP services for approximately 12640 patients living in Wirral. The practice is situated in a purpose built medical centre. The practice has four male and four female GPs, a practice management team, practice nurses, administration and reception staff. It is a teaching practice and occasionally has medical students working at the practice. Heswall and Pensby Group Practice holds a General Medical Services (GMS) contract with NHS England and are part of the NHS Wirral CCG.

The hours of practice are:

Monday 8am – 6pm

Tuesday 7.20am – 6pm

Wednesday 7.20am – 6pm

Thursday 8am – 6pm

Friday 7.20am – 5pm

(normal core hours for GMS contract are 8am – 6.30pm)

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 an affluent area. The practice population is made up of a mostly working age and elderly population with 42% of the population aged over 65 years old. Fifty six percent of the patient population has a long standing health condition and there is a lower than national average number of unemployed patients (2.4%).

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

Updated 22 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Heswall and Pensby Group Practice on 23 February 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, recording and learning from significant events and untoward incidents.
• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.

• The practice used proactive methods to improve patient outcomes, working with other local providers to share best practice. For example audits were carried out based on significant event analysis in order to change practice and improve patient care.

• Patients were treated with care, compassion, dignity and respect and they were involved in their care and decisions about their treatment. They were given time at appointments and full explanations of their treatment were given. They valued their practice and felt confident with the skills and abilities of staff.

• We observed a strong patient-centred culture from dedicated staff.

• The practice proactively sought feedback from staff and patients, which it acted on. For example recruiting a further practice nurse in order to extend access to appointments with nurses.
• Information about services and how to complain was available and easy to understand.
• Patients were able to access convenient appointments with routine and urgent appointments available the same day.
• The practice had good, modern facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management.
• 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 22 March 2016

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

The practice maintained and monitored registers of patients with long term conditions for example cardiovascular disease, diabetes, chronic obstructive pulmonary disease and heart failure. These registers enabled the practice to monitor and review patients with long term conditions effectively.

• GPs, supported by practice nurses, had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. The practice reported they had a low number of unplanned admissions to hospital compared with other practices in the CCG.

• Comprehensive reviews for all patients with long term conditions were offered with a team of trained nurses.

• Performance indicators for management of diabetes were around or above national average.

• Longer appointments and home visits were available when needed. Saturday influenza clinics were held.

• All patients had a named GP and a structured annual review to check that their health and medicines needs were being met. Systems in place ensured patient recalls were highlighted.

• The GPs and nurses worked with relevant health and care professionals to deliver a multidisciplinary package of care.

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

Updated 22 March 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 vulnerable, for example, children and young people who had a high number of A&E attendances and those who did not attend for appointments.

• Immunisation rates were high for all standard childhood immunisations with immunisations uptake for all children aged five and under around 95%.

• 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 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 at national average at 82%.

• Appointments were available outside of school hours.

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

Updated 22 March 2016

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

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 admissions, dementia, nursing and residential care home support and end of life care.

• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. The practice nurse also carried out routine visits to elderly patients for chronic disease monitoring including anticoagulation.

• Proactive nursing and care home visits were undertaken with doctors providing guidance, care and support to not only the patients but to the staff at the home and patient’s families.

Updated 22 March 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 the practice offered early morning and evening appointments face to face or via the telephone.

• 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 for example well person checks for those aged 40 to 75 years old.

Updated 22 March 2016

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

• The practice carried out advance care planning for patients with dementia and 80% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months (slightly lower than the national average).

• 89% of people experiencing poor mental health (slightly above national average of 88%) had a comprehensive documented care plan in place.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• It had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health. Systems were also in place to recall patients with dementia and poor mental health when they did not attend for appointments.

• Staff had a good understanding of how to support people with mental health needs and dementia.

• Patients with poor mental health were given extended appointments.

Updated 22 March 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 those with a learning disability and with alcohol or substance misuse.

• It offered longer appointments for people with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• It was able to inform vulnerable patients about how to access various support groups and worked with voluntary organisations.

• Staff were familiar with patients from this group and knew and understood family dynamics.

• 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.