Helsby Street Medical Centre Also known as The Partners of Helsby Street Medical Centre

Updated 3 June 2016

Helsby Street Medical Centre is located at 2 Helsby Street, Warrington, Cheshire WA1 3AW. The practice was providing a service to approximately 8,300 patients at the time of our inspection. The practice is situated in an area with average levels of deprivation when compared to other practices nationally. The percentage of patients with a long standing health condition is lower than the local and national average.

The practice is run by four GP partners (two male and two female). There are two practice nurses, one health care assistant, a practice manager and a team of reception/administration staff. The practice is open from 8am to 6.30pm Mondays and Fridays, 7.30am to 6.30pm Wednesdays and Thursdays and 7.30am to 8pm on Tuesdays. The practice had signed up to providing longer surgery hours as part of the Government agenda to encourage greater patient access to GP services. As a result patients could access a GP at a Health and Wellbeing Centre in the centre of Warrington from 6.30pm until 8pm Monday to Friday and between 8am to 8pm Saturdays and Sundays. This was by pre-booked appointment. Outside of practice hours patients can access the Bridgewater Trust for primary medical services. The practice is a training practice for trainee GPs and it also hosts medical students.

The practice has a General Medical Services (GMS) contract. The practice provides a range of enhanced services, for example: extended hours, childhood vaccination and immunisation schemes, checks for patients who have a learning disability and avoiding unplanned hospital admissions.

Updated 3 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Helsby Street Medical Centre on 4 May 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. Significant events had been investigated and action had been taken as a result of the learning from events.
• Systems were in place to deal with medical emergencies and all staff were trained in basic life support.
• There were systems in place to reduce risks to patient safety. For example, infection control practices were good and there were regular checks on the environment and on equipment used.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Feedback from patients about the care and treatment they received from clinicians was very positive.
• Data showed that outcomes for patients at this practice were similar to outcomes for patients locally and nationally.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Staff felt well supported in their roles and were kept up to date with appropriate training.
• Patients said they were treated with dignity and respect and they were involved in decisions about their care and treatment.
• The appointments system was flexible to accommodate peoples’ needs. Overall patients told us they could get an appointment when they needed one. However, a small number of patients said they had difficulty in getting through to the practice by telephone and in getting an appointment.
• The practice had good facilities, including disabled access. It was well equipped to treat patients and meet their needs.
• Information about services and how to complain was available. Complaints had been investigated and responded to in a timely manner.
• The practice had a clear vision to provide a safe and high quality service.
• There was a clear leadership and staffing structure and staff understood their roles and responsibilities.
• The practice provided a range of enhanced services to meet the needs of the local population.
• The practice sought patient views about improvements that could be made to the service. This included the practice having and consulting with a patient participation group (PPG).

The areas where the provider should make improvement are:

• Review and make improvements to the telephone access and appointment request system.

• Review and update the information provided to patients about how they can make a complaint about the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 June 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. This included conditions such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. The information was used to target service provision, for example to ensure patients who required immunisations received these.

• Regular, structured health reviews were carried out for patients with long term conditions. Patients with several long term conditions were offered a single, longer appointment to avoid multiple visits to the surgery. Home visits were also provided for patients who required these.

• Data from 2014 to 2015 showed that the practice was performing in comparison with other practices locally and nationally for the care and treatment of people with chronic health conditions such as diabetes. For example, the percentage of patients with diabetes, on the register, who had had an influenza immunisation was 96% compared to a national average of 94%.

• The practice provided an enhanced service to prevent high risk patients from unplanned hospital admissions. This included these patients having care plans, a review of their medicines, a named GP and access to an alternative phone number for easier access to the practice.

• Regular clinical meetings were held to review the clinical care and treatment provided and ensure this was in line with best practice guidance.

Updated 3 June 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 those who were at risk, for example, children and young people who had a high number of A&E attendances. A GP was the designated lead for child protection.

• Staff we spoke with had appropriate knowledge about child protection and they had ready access to safeguarding policies and procedures.

• Child surveillance clinics were provided for 6-8 week olds and immunisation rates were comparable to the national average for all standard childhood immunisations. The practice monitored non-attendance of babies and children at vaccination clinics and reported any concerns appropriately.

• Family planning services were provided. The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding five years was 83% which was comparable to the national average of 81%.

• Babies and young children were offered an appointment as priority and appointments were available outside of school hours.

• The premises were suitable for children and babies and baby changing facilities were available.

Updated 3 June 2016

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

• The practice offered proactive, personalised care and treatment to meet the needs of the older people in its population. The practice kept up to date registers of patients with a range of health conditions (including conditions common in older people) and used this information to plan reviews of health care and to offer services such as vaccinations for flu. The practice provided a range of enhanced services, for example, the provision of a named GP for patients over the age of 75 and the screening of patients for dementia.

• Nationally reported data showed that outcomes for patients for conditions commonly found in older people were similar to or better than local and national averages.

• GPs carried out regular visits to local care homes to assess and review patients’ needs and to prevent unplanned hospital admissions. Home visits and urgent appointments were provided for patients with enhanced needs.

• The practice used the ‘Gold Standard Framework’ (this is a systematic evidence based approach to improving the support and palliative care of patients nearing the end of their life) to ensure patients received appropriate care.

• The practice had hosted two events for patients over the age of 75. These included guest speakers and provided patients with advice on medicines, accident prevention and health promotion.

Updated 3 June 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 provided extended hours with early morning appointments available three days per week and late appointments avialable one evening per week.

• The practice was also part of a cluster of practices whose patients could access appointments at a local Health and Wellbeing Centre up until 8pm in the evenings Monday to Friday, and from 8am to 8pm Saturdays and Sundays, through a pre-booked appointment system.

• Telephone consultations were available and these were advantageous for people in this group as they did not always have to attend the practice in person.

• The practice provided a full range of health promotion and screening that reflected the needs of this age group.

• The practice was proactive in offering online services including the booking of appointments and request for repeat prescriptions. Electronic prescribing was also provided.

Updated 3 June 2016

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

• Data about how people with mental health needs were supported showed that outcomes for patients using this practice were similar to patients locally and nationally. For example, data showed that 90% of patients with schizophrenia, bipolar affective disorder and other psychoses had had a comprehensive, agreed care plan documented in the preceding 12 months. This compared to a national average of 88%.

• The practice provided an enhanced service to proactively offer assessment to patients at risk of dementia and to improve the quality and effectiveness of care provided to patients with dementia.

• The practice worked with other health and social care professionals in the case management of people experiencing poor mental health, including those with dementia.

• A system was in place to follow up patients who had attended accident and emergency and this included where people had been experiencing poor mental health.

• Processes were in place to prompt patients for medicines reviews at intervals suitable to the medication they took.

• Patients experiencing poor mental health were informed about how to access various support groups and voluntary organisations.

Updated 3 June 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 in order to provide the services patients required. For example, a register of people who had a learning disability was maintained to ensure patients were provided with an annual health check and to ensure longer appointments were provided for patients who required these.

• The practice had a GP lead for people with a learning disability and for people with drug and alcohol misuse issues.

• The practice worked with other health and social care professionals in the case management of vulnerable people. A social care practitioner attended the practice weekly to support patients with health and social care or support needs. The practice also hosted a drug and alcohol misuse clinic once per week. The GPs also provided primary care to patients living at a local womens’ refuge.

• There was an adult safeguarding lead. Staff knew how to recognise signs of abuse in vulnerable adults. 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.

• The practice was accessible to people who required disabled access and facilities and services such as a translation service were available.

• Information and advice was available about how patients could access a range of support groups and voluntary organisations.