Westway Medical Centre Also known as Westway Medical Centre

Updated 23 September 2016

The partnership practice of Drs Hulme, Wray, Gough and Killough, also known as Westway Medical Centre is based in Maghull Merseyside. The practice patient list at the time of inspection was approximately 8,500 patients. The partnership is made up of four partners, two male and two female; Dr Chandra had recently left the practice and CQC will update its records to reflect this.

The practice GPs are supported by two salaried GPs, one male and one female, a female Advanced Nurse Prescriber and two practice nurses, both female. The practice manager is supported by an assistant practice manager and a senior administrator/data/IT lead. The administrative support team is made up of two secretaries, ten administrators/reception staff, and an administrative assistant. A housekeeper is also employed. The practice premises are close to a local supermarket and is served by a number of regular buses. The practice was inspected in February 2014 under the regulations applicable at that time, and was found to be meeting required standards.

The practice is located in a building owned by the partners. This is adjacent to a community health facility, which is a base for midwives, health visitors, community nurses, phlebotomy services and other health professionals. The premises are fully accessible to disabled patients and all facilities, consulting and treatment rooms are at ground floor level. There is some car parking available immediately outside the building with a number of designated disabled parking bays. There are patient toilets available which are accessible for people with limited mobility. There is also a baby change facility available.

The practice has recently taken on the patients of a neighbouring GP who had retired. Initially this increased the practice list size to 9,000 patients. As a result of problems with IT transfer, the loss of a long serving nurse who chose to retire, and the loss of a full time GP at the time of taking on these extra patients, the practice applied to NHS England to close the practice list to new patients for a period of six months. This had recently been extended to September 2016, when the practice will review the situation again. 

Updated 23 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs Hulme, Wray, Gough, and Killough, also known as Westway Medical Centre on 10 August 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 and recording significant events.

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.

• Staff had the knowledge and skills to perform their duties. All staff had access to training to support them in their role.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice encouraged all staff and patients to share ideas on how services could be improved. The patient participation group at the practice was active.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 23 September 2016

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

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

• The practice had recruited a pharmacist who conducted medicines reviews and provided advice to patients on how to take medicines correctly to maximise their effectiveness.

• QOF data showed the practice managed the treatment of patients of diabetes well. Achievement was either in line with or above that of the local Clinical Commissioning Group (CCG) average and national averages.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met.

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

Updated 23 September 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 relatively high for all standard childhood immunisations.

• 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 practice rates for cervical screening were higher that both local and national averages, at 99% of eligible women screened in the preceding five years, compared to the local average of 82% and national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

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

Updated 23 September 2016

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

• The practice offered personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• Initiatives the practice signed up to were focussed on the care required. For example older patients could be referred to a virtual ward, managed by community matrons, often avoiding hospital admission. (A virtual ward is a list of patients managed by community matrons in the community; the support from the multi-disciplinary team helps these patients to be managed at home, rather than necessitating a stay in hospital.)

• An acute visiting service was also in operation, which supported the care and management of patients in nursing homes nearby.

• Older patients were screened for risk of frailty

• A system of named GPs for each patient was in place, which we found worked well in practice, providing continuity of care.

Updated 23 September 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.

• The practice had taken part in a research project with the Royal Liverpool University Hospital, enabling patients at risk of osteoporosis to access bone density scans, which supported early diagnosis of osteoporosis.

• The practice offered online appointment booking as well as a full range of health promotion and screening that reflects the needs for this age group.

• The practice could refer patients to the community health centre at the same site for some contraceptive services that they did not offer directly.

• The practice provides extended hours surgeries one early morning each week from 7am, which alternates between a Tuesday, Wednesday and Thursday. The practice is also open on Saturday morning for pre-booked appointments.

• Midwives, district nurses and health visitors liaised with all clinicians in the shared care of patients within the community.

Updated 23 September 2016

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

• 82% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the CCG average of 82% and national average of 84%.

• Indicators from QOF showed the practice scored highly for care of patients experiencing poor mental health. For example:

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses, who had a comprehensive, agreed care plan documented in their patient record was 97%, compared to the CCG average of 88% and national average of 88%.

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses, whose alcohol consumption had been recorded in the preceding 12 months, was 97%, compared to the CCG average of 90% and national average of 90%.

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

• The practice carried out advance care planning for patients with dementia. We were told by the lead clinical partner for mental health at the practice that one area of focus this year, was on the speed and accuracy of dementia diagnosis, to ensure these patients received the care and support they needed

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• There was a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

Updated 23 September 2016

vulnerable.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients. The practice had retained the services of a former district nurse, who knew some of the patients with severe learning difficulties, well. This nurse could visit patients in their home where they felt more comfortable, to deliver health checks, collect blood samples and offer other health advice.

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

• 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.