Kings Lane Medical Practice - Dr D Kershaw

Updated 4 May 2016

Kings Lane Medical Practice is registered with the Care Quality Commission to provide primary care services. The practice provides GP services for approximately 4584 patients living in Wirral and is situated in a purpose built medical centre. The practice has five female GPs, three practice nurses, administration and reception staff and a practice manager. It is a teaching/training practice and occasionally has medical students and trainee GPs working at the practice. Kings Lane Medical Practice holds a General Medical Services (GMS) contract with NHS England and is part of the NHS Wirral Clinical Commissioning Group (CCG).

The practice reception is open:

Monday – Friday 8.15am - 6.30pm

Phone lines are open 8am - 6.30pm

(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 34% of the population aged over 65 years old. Fifty five percent of the patient population has a long standing health condition and there is a lower than national average number of unemployed patients.

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 4 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kings Lane Medical Practice - Dr D Kershaw on 5 April 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. Systems were in place for reporting, recording and learning from accidents, significant events and untoward incidents. Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses.
• Staff were trained in safeguarding and protection of children and vulnerable adults and understood their roles and responsibilities. Local authority guidance and protocols were accessible and staff were aware of how to raise concerns.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

• 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, amending the appointment system following surveys and patient participation group (PPG) feedback.
• Information about services and how to complain was available and easy to understand.
• Patients were able to access convenient appointments; however comments indicated there was a lack of continuity of care with GPs.
• 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.

The areas where the provider should make improvement are:

• Review the audit program to include infection control audits being undertaken regularly and where local prescribing issues are identified, that these are audited to establish adherence to the local prescribing guidance.

• Review the practice’s policies and procedures including infection control policies and procedures to make them accessible to staff and up to date with current guidance and legislation.

• Review the process for learning from significant events and complaints to include regular reviews to learn from themes and trends and to monitor completion of action plans.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 4 May 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.

• Annual reviews for all patients with long term conditions such as diabetes and asthma were offered.

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

• Longer appointments and home visits were available when needed.

• 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.

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

Updated 4 May 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 under the age of five 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 higher than the national average at 86%.

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

Updated 4 May 2016

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

The practice had a higher than national and local clinical commissioning group (CCG) average number of elderly patients with 34% over the age of 65. 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.

• Nursing and care home visits were undertaken. The practice was a member of the local elderly care network and liaised closely with community integrated care teams.

Updated 4 May 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, following patient feedback, the practice altered its appointment system and now offered telephone consultations.

• The practice offered Tele dermatology and Tele ECG. Tele medicine is the use of telecommunication and information technologies to provide clinical health care at a distance, including monitoring and assessments without the need for GP visits.

• 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 4 May 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 87% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months (higher than the national average of 84%).

• 97% of people experiencing poor mental health (higher 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.

• It had a system in place to follow up patients 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.

Updated 4 May 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 at risk of hospital admissions, those at the end of their life, those with a learning disability and children at risk.

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

• 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.