Grove Road Surgery

Updated 28 January 2016

Grove Road Surgery is registered with the Care Quality Commission to provide primary care services. It provides GP services for approximately 2500 patients living in Wirral. The practice is situated in a converted residential building which is currently undergoing extension and refurbishment to improve facilities and service provision. The practice has two male GP and two female GPs, a practice manager, practice nurses, administration and reception staff. Grove Road Surgery holds a Personal Medical Services (PMS) contract with NHS England.

The hours of practice are:

Monday 9.30am – 11.45am and 4pm – 6pm

Tuesday 7.30am – 11.45am and 3pm – 6pm

Wednesday 9am – 11.45am and 4pm – 7.30pm

Thursday 9am – 11.45am

Friday 9am to 11am and 4pm – 6pm

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 a moderately affluent area. The practice population is made up of a mostly working age and elderly population with 35% 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 higher than national average number of employed patients or those in full time education (62%).

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 (Wirral GP Out of Hours service) and NHS 111 for help. However information regarding out of hours services was not up to date nor was it easily accessible to patients.

Updated 28 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Grove Road Surgery on 15 December 2015. 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 and recording significant events.
• 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.
• Patients were treated with care, compassion, dignity and respect and they were involved in their care and decisions about their treatment. They were not rushed 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.
• The practice proactively sought feedback from staff and patients, which it acted on. For example installing a patient lift in the new building.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with routine and urgent appointments available the same day.
• 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.

We saw an area of outstanding practice:

• The practice staff worked well as a team delivered a high standard of care and put patients first. There was continuity in care and individuality with patients being well known to the practice. There was an exceptionally high level of patient satisfaction with the care given. Patients we spoke with, comment cards and data from patient surveys reviewed confirmed a high level of satisfaction with the care given by the practice staff. The practice was rated as the best for patient satisfaction in the North West. Staff demonstrated they were motivated and inspired to offer kind and compassionate care.

There were areas where the provider could make improvements and they should:

• Carry out water temperature checks in line with recommendations following the Legionella risk assessment.

• Update and publicise information for patients in respect of out of hour’s services and how to access them.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 January 2016

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.

• Clinical staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

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

• Longer appointments and home visits were available when needed.

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

• For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 28 January 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 with all of immunisations for five year olds uptake at 100%.

• 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.

• The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding five years was around the national average at 81%.

• Appointments were available outside of school hours and we saw good examples of joint working with midwives, health visitors and school nurses.

Updated 28 January 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 and end of life care.

• The percentage of people aged 65 or over who received a seasonal flu vaccination was higher than the national average at 76%.

• It was responsive to the needs of older people, and offered home visits (including to their patients in care homes) and urgent appointments for those with enhanced needs. The practice nurse also carried out routine visits to elderly patients for reviews and vaccinations/immunisations.

Updated 28 January 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.

Updated 28 January 2016

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

• The practice had mental health and dementia leads. They carried out advance care planning for patients with dementia and 100% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months. (This was well above the national average).

• 94% of people experiencing poor mental health (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 had told patients experiencing poor mental health 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.

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

• All patients with poor mental health were given extended appointments.

Updated 28 January 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, homeless 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 had told vulnerable patients about how to access various support groups and worked with voluntary organisations such as the Wirral Alcohol Service.

• 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.