Northgate Medical Centre

Updated 3 March 2016

Northgate Medical Centre is responsible for providing primary care services to approximately 6636 patients. The practice is based in an area with average levels of economic deprivation when compared to other practices nationally. The number of patients with a long standing health condition, health related problems in daily life and with caring responsibilities is about average when compared to other practices nationally. The practice had a high proportion of patients between the ages of 20-29.

The staff team includes four partner GPs, a nurse practitioner, two practice nurses, a health care assistant, practice manager, administration manager, office/reception manager, medicines manager and ten administration and reception staff. The practice is a training practice and at the time of our visit had two GP registrars working for them as part of their training and development in general practice.

The practice is open 08:00 to 18.30 Monday to Friday. An extended hour’s service for routine appointments and an out of hour’s service are commissioned by West Cheshire CCG and provided by Cheshire and Wirral Partnership NHS Foundation Trust. The practice shares a building with other GP practices and a number of community services such as community nursing, podiatry and sexual health services.

The practice has a General Medical Service (GMS) contract. The practice offers a range of enhanced services including spirometry, near patient testing, flu and shingles vaccinations and learning disability health checks.

Updated 3 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Northgate Medical Centre on 7th January 2016.

Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Staff were aware of procedures for safeguarding patients from the risk of abuse.
• There were systems in place to reduce risks to patient safety, for example, infection control procedures and the management of staffing levels. However, improvements were needed to the record keeping relating to significant events and staff recruitment.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.

• Staff told us they had received training appropriate to their roles. Records of all staff training needed to be improved to assist in monitoring and planning for the training needs of staff.

• Patients were very positive about the care they received from the practice. They commented that they were treated with respect and dignity and that staff were caring, supportive and helpful.

• Services were planned and delivered to take into account the needs of different patient groups.

• Access to the service was monitored to ensure it met the needs of patients. Patients reported satisfaction with opening hours and said they were able to get an appointment when one was needed.

• Information about how to complain was available. There was a system in place to manage complaints.

• There were systems in place to monitor and improve quality and identify risk.

The areas where the provider should make improvements are:

• Maintain a log of significant events to assist in identifying patterns and trends. Document reviews of significant events to demonstrate that actions identified have been implemented.

• Establish a system to ensure complete documentation is held on staff recruitment files.

• Review the system of identifying staff training needed and undertaken to assist in monitoring and planning for the training needs of staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 March 2016

The practice is rated as good for the care of people with long-term conditions. The practice held information about the prevalence of specific long term conditions within its patient population such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. This information was reflected in the services provided, for example, reviews of conditions and treatment, screening programmes and vaccination programmes. The practice had a system in place to make sure no patient missed their regular reviews for long term conditions. GPs and practice nurses were responsible for different long term conditions and kept up to date in their specialist areas. The practice had multi-disciplinary meetings to discuss the needs of palliative care patients and patients with complex needs. The practice worked with other agencies and health providers to provide support and access specialist help when needed.

Updated 3 March 2016

The practice is rated as good for the care of families, children and young people. Child health surveillance and immunisation clinics were provided. The staff we spoke with had appropriate knowledge about child protection and they had access to policies and procedures for safeguarding children. The safeguarding lead GP liaised with and met regularly with the health visiting service to discuss any concerns about children and their families and how they could be best supported. Family planning and sexual health services were provided.

Updated 3 March 2016

The practice is rated as good for the care of older people. The practice was knowledgeable about the number and health needs of older patients using the service. They kept up to date registers of patients’ health conditions and used this information to plan reviews of health care and to offer services such as vaccinations for flu and shingles. The practice worked with other agencies and health providers to provide support and access specialist help when needed. The practice worked with the Clinical Commissioning Group (CCG) and local practices to enhance patient care. For example, the local practices had developed a role for and employed a nurse practitioner to work with elderly patients. The aim of this role being to take practice nursing services, such as chronic disease management out to housebound patients and to prevent hospital admissions where possible. Care plans were being developed for older people with the aim of ensuring all necessary support was provided and reducing hospital admissions. Annual health checks for patients over 75 years of age were carried out.

Updated 3 March 2016

The practice is rated as good for the care of working-age people (including those recently retired and students). The practice offered pre-bookable appointments, book on the day appointments and telephone consultations. Patients could book appointments on-line or via the telephone and repeat prescriptions could be ordered on-line which provided flexibility to working patients and those in full time education. The practice was open from 08:00 to 18:30 Monday to Friday. allowing early morning and late evening appointments to be offered to this group of patients. There was also a plan to re-introduce lunch time appointments to further improve assess. An extended hour’s service for routine appointments was commissioned by West Cheshire CCG. The practice had identified that it needed to make its services more responsive to the needs of its student patient population and had plans in place to further develop the services offered.

Updated 3 March 2016

The practice is rated good for the care of people experiencing poor mental health (including people with dementia). The practice maintained a register of patients receiving support with their mental health. Patients experiencing poor mental health were offered an annual review. Patients who did not keep appointments were followed up to ensure the practice was monitoring their health needs appropriately. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The practice carried out assessments of patients at risk of dementia to encourage early diagnosis and access to support.  The majority of staff had recently attended training in dementia to highlight the issues patients living with dementia may face. Patients were referred to services to support them with their mental health such as counselling and psychiatry services.

Updated 3 March 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable. Patients’ electronic records contained alerts for staff regarding patients requiring additional assistance. For example, if a patient had a learning disability to enable appropriate support to be provided. The practice nurses visited vulnerable housebound patients to administer flu vaccinations. There was a recall system to ensure patients with a learning disability received an annual health check. Staff we spoke with had appropriate knowledge about safeguarding vulnerable adults and they had access to the practice’s policy and procedures. All staff had received training in this and refresher training was planned for staff who were due for an update.