10 March 2023
Dunstan Village Group Practice is located in Liverpool at:
The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services, family planning, treatment of disease, disorder or injury and surgical procedures.
The practice is situated within the Cheshire and Merseyside Integrated Care System (ICS) and delivers General Medical Services (GMS) to a patient population of about 7330. This is part of a contract held with NHS England.
The practice is part of Picton primary care network, a wider network of GP practices.
Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the lowest decile (one of 10). The lower the decile, the more deprived the practice population is relative to others. A lower deprivation can indicate challenges in providing health care. The supply of healthcare services tends to be lower in more deprived areas due to a number of factors but has an increased demand. The population tends to have poorer health status among individuals with a greater need for health services. For example, there may be higher levels of long-term conditions such as those affecting the cardiovascular system and respiratory system,
This practice had higher than local levels for diabetes and obesity.
According to the latest available data, the ethnic make-up of the practice area is 65.6% white, 10.7% Black, 8.5% Asian, 8.5% other and 6.7% Mixed.
The age distribution of the practice population closely mirrors the local and national averages. There are more working age patients registered at the practice compared to older and younger people.
The provider consists of a GP and clinical pharmacist partnership. The practice has one full time salaried GP, an advanced nurse practitioner and three practice nurses. The GPs are supported at the practice by a team of 7 reception and administration staff. The practice manager and assistant practice manager provide managerial oversight for the day to day running of the practice.
The practice is open between 8 am to 6:30 pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.
Extended access is provided by the practice Wednesdays and Friday 6:30 – 8pm. Saturday appointments are within the Picton Primary Care Network. Out of hours services are provided by Primary Care 24.
10 March 2023
We carried out an announced comprehensive inspection) at Dunstan Village Group Practice on 6, 8 and 9 December 2022. Overall, the practice is rated as requires improvement.
Safe - requires improvement
Effective – requires improvement
Caring - good
Responsive - good
Well-led - requires improvement
Following our previous inspection on 11, 18 and 27 May 2022, the practice was rated requires improvement overall and for key questions effective, and well-led and inadequate for providing safe services. Caring and responsive were rated as good.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for Dunstan Village Group Practice on our website at www.cqc.org.uk
Why we carried out this inspection
We carried out this inspection to follow up concerns identified from our previous inspection.
How we carried out the inspection
This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.
- Conducting staff interviews using video conferencing.
- Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
- Reviewing patient records to identify issues and clarify actions taken by the provider.
- Requesting evidence from the provider.
- A short site visit.
We based our judgement of the quality of care at this service on a combination of:
- what we found when we inspected
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations.
We found that:
- The provider had implemented recall and monitoring systems and processes in order to ensure patients were treated safely.
- Steps had been taken to ensure there were sufficient staff who were suitably qualified and trained.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- Patients could access care and treatment in a timely way.
- A new management structure and lead roles were implemented to support staff. The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
We found one breach of regulation. The provider must:
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
Whilst we found no breaches of regulations, the provider should:
- Review safeguarding flags for household members.
- Take steps to reduce the number of patient records which require summarising.
- Improve prescribing practice forgabapentin and pregabalin.
- Take action to address the actions identified from the fire and health and safety risk assessments.
- Continue to monitor and improve the uptake of cervical cancer screening.
- Take action to monitor progress against the strategy.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA
Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services