Liversedge Medical Centre Also known as Valley Road Surgery

Updated 27 July 2016

Liversedge Medical Centre provides primary care services to 3379 patients under a Personal Medical Services (PMS) contract with NHS England.

• The practice is located in Liversedge Health Centre, Valley Road, Liversedge, West Yorkshire, WF15 6DF which was renovated in 2013. The premises are accessible to wheelchair users and all services are at ground floor level. There is parking available for staff and patients.

• The area is on the fifth decile of the scale of deprivation. Nine per cent of patients are from Black Minority and Ethnic (BME) populations. Six per cent of patients claim Disability Living Allowance.

• The practice works closely with two other local GP practices, Healds Road Surgery and Albion Street Surgery to improve services for patients, share learning and provide staff cover as necessary.

• The practice hosts an audiology clinic, health trainers and a paediatric nurse clinic which are operated by a local community provider.

• There are four GPs, two male and two female; two advanced nurse practitioners, one male and one female; two female practice nurses and two female health care assistants. In addition there is a team of administrative staff and an office manager. The practice manager is shared with Healds Road Surgery.

• The practice provided training and mentoring of nurses and advanced nurse practitioners. A student nurse was on placement at the time of our inspection.

• The practice is open between 8am and 6.30pm Monday to Friday. Appointments are from 8.30am to 6pm daily. Extended hours surgeries are offered until 7pm on Mondays and Tuesdays.

• When the practice is closed out of hours services are provided by Local Care Direct and NHS 111.

Updated 27 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Liversedge 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. There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.

• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, the practice took a whole team approach to improving outcomes for patients.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff who all had clear responsibilities in relation to the vision.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• 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 was available and easy to understand.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

Data showed that the practice had significantly improved patient outcomes. For example, in the preceding 12 months the practice improved their patient uptake of annual dementia reviews by 20%. An advanced nurse practitioner carried out annual reviews, including a review of their medication in patients’ own homes. Data for 2014/15 showed that 75% of patients diagnosed with dementia had their care reviewed in a face-to-face review in the preceding 12 months. The practice provided data for 2015/16 that showed this had increased to 95% which was significantly higher than local and national averages.

The areas where the provider should make improvements are:

• Ensure benzylpenicillin is available for suspected cases of meningitis
• Ensure clinical waste bags are labelled in line with current legislation and guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 July 2016

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

• Staff members contacted all patients who had failed to attend for their condition review on a weekly basis to ensure they were informed of the importance of regular reviews, to encourage attendance and identify and remove barriers to them attending.
• Performance for diabetes related indicators was better than the national average. In the preceding 12 months, all patients newly diagnosed with diabetes had a record of being referred to a structured education programme within 9 months (CCG and national average 90%).
• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Administration staff had received additional training and were given lead roles to improve QOF outcomes. They worked closely with nursing staff to proactively identify and contact patients with long term conditions to ensure they knew the importance of attending review appointments.
• 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. 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. For example, the Care Co-ordinator.
• Combined clinics were held between GPs, nurses and health care assistants to ensure that patients with complex conditions could be reviewed in a single appointment where possible.
• The practice hosted a health trainer who held weekly clinics for patients with long-term conditions to help co-ordinate the care they received. The health trainers met with patients on a one to one basis in the practice or in patients’ own homes. The health trainers provide advice on maintaining a healthy lifestyle, managing stress and identify community support services.

Updated 27 July 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. For example, childhood immunisation rates for the vaccinations given to under two year olds ranged from 95% to 100% and five year olds from 96% to 100%.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.
• The practice’s uptake for the cervical screening programme was 81%, which was comparable to the CCG and national averages of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• Same day access for babies and young children was prioritised.
• We saw good examples of joint working with midwives, health visitors and school nurses.
• The practice hosted a paediatric nurse clinic

Updated 27 July 2016

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population.
• They were responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The percentage of people aged 65 or over who received a seasonal flu vaccination was 67% which was lower than the CCG and national averages of 73%.
• There was a system to issue and deliver prescriptions without patients having to visit the surgery.
• The practice had identified patients over the age of 75 who found it difficult to access the surgery or had not been diagnosed with any condition and offered a mental and physical health review.
• Patients at high risk of hospital admission who were not under the care of a community matron were referred to a CCG employed Care Co-ordinator who liased with NHS and social care services to ensure patients were supported.

Updated 27 July 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 was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.
• Late appointments were offered on Mondays and Tuesdays and the practice offered same day telephone consultations for working people and those who could not physically attend the surgery.
• Patients could attend the open access phlebotomy service every morning Monday to Friday without an appointment.

Updated 27 July 2016

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

• The practice improved their patient uptake of annual dementia reviews by 20%. An advanced nurse practitioner carried out annual reviews, including a review of their medication in patients’ own homes.
• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the preceding 12 months compared with the national average of 88%.
• The practice actively worked with multi disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• They carried out advance care planning for patients with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• They 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.The practice was a designated Dementia Friendly Practice and staff had received additional training to better understand the needs of this group.

Updated 27 July 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 homeless people, travellers and those with a learning disability.
• They offered longer appointments for people with a learning disability.
• The practice regularly worked with multi disciplinary teams in the case management of vulnerable people.
• They had identified vulnerable patients, such as those experiencing domestic abuse, and told them 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.
• The practice accommodated all call-back requests where patients were unable to afford the cost of the telephone call.