Background to this inspection
Updated
11 February 2016
Dr D Y Patwala & Dr N Mugerwa are registered with the Care Quality Commission to provide primary care services. The practice provides GP services for approximately 2500 patients living in Wirral. The practice is situated in a purpose built medical centre. The practice has two female GPs, a practice manager, practice nurses, administration and reception staff. Dr D Y Patwala & Dr N Mugerwa hold a General Medical Services (GMS) contract with NHS England.
The hours of practice are:
Monday – Friday 8.30am – 6.30pm with extended hours until 7.30pm on Mondays and
Wednesdays for GP and nurse appointments.
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 fairly affluent area. The practice population is made up of a mostly working age and elderly population with 30% 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 (65%).
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 Emergency Out of Hours service) via NHS 111 for help. Information regarding out of hours services was displayed on the website and in the practice.
Updated
11 February 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Church Road Medical Centre on12 January 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 and untoward incidents.
- 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 had plenty of 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.
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We observed a strong patient-centred culture from a personal and family orientated practice.
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The practice proactively sought feedback from staff and patients, which it acted on. For example extending clinical time of practice nurses and change of certain clinic days to ease parking issues.
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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.
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There was a clear leadership structure and staff felt supported by management.
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The provider was aware of and complied with the requirements of the Duty of Candour.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
11 February 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.
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Clinical staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
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Performance indicators for management of diabetes were all above national average.
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Longer appointments and home visits were available when needed. Saturday influenza clinics were held.
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All 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 were highlighted.
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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.
Families, children and young people
Updated
11 February 2016
The practice is rated as good for the care of families, children and young people.
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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.
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Immunisation rates were high for all standard childhood immunisations with all of immunisations for five year olds uptake at 100% and immunisations for 12 and 24 month olds at 100% also.
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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.
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The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding five years was slightly higher than the national average at 85%.
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Appointments were available outside of school hours and the practice worked well with midwives, health visitors and school nurses.
Updated
11 February 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.
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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.
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The percentage of people aged 65 or over who received a seasonal flu vaccination was higher than the national average at 88.5%.
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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 chronic disease monitoring including anticoagulation.
Working age people (including those recently retired and students)
Updated
11 February 2016
The practice is rated as good for the care of working-age people (including those recently retired and students).
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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 morning and extended evening appointments face to face or via the telephone.
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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.
People experiencing poor mental health (including people with dementia)
Updated
11 February 2016
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
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The practice 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 (above the national average).
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93% of people experiencing poor mental health (above national average of 88%) had a comprehensive documented care plan in place.
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The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
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The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
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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.
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Staff had a good understanding of how to support people with mental health needs and dementia.
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Patients with poor mental health were given extended appointments.
People whose circumstances may make them vulnerable
Updated
11 February 2016
The practice is rated as good for the care of people whose circumstances may make them vulnerable.
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The practice held a register of patients living in vulnerable circumstances including those with a learning disability and with alcohol or substance misuse.
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It offered longer appointments for people with a learning disability.
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The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
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It had told vulnerable patients about how to access various support groups and worked with voluntary organisations.
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Staff were familiar with patients from this group and knew and understood family dynamics.
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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.