Archived: Dr EA Bainbridge's Practice

Updated 15 December 2016

Dr EA Bainbridge's Practice is responsible for providing primary care services to approximately 4266 patients. The practice has a General Medical Services (GMS) contract and offers a range of enhanced services such as flu and shingles vaccinations, unplanned admissions and timely diagnosis of dementia. The number of patients with a long standing health condition is about average when compared to other practices locally and nationally. The practice has three GP partners, one salaried GP, one locum GP, a number of trainee doctors and two practice nurses.

The practice is open from 8am to 6.30pm Monday to Friday. 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. Home visits and telephone consultations are available for patients who require them, including housebound patients and older patients. There are also arrangements to ensure patients receive urgent medical assistance out of hours when the practice is closed.

The practice is part of the Liverpool Clinical Commissioning Group and part of the West Derby neighbourhood. The area is the eight most deprived in the city. In addition it is estimated that the average household income is significantly lower than both the Liverpool and national averages. Unemployment is significantly higher than the city rate and 7% of the population are long term sick or disabled. People living in more deprived areas tend to have greater need for health services.

Updated 15 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr EA Bainbridge's Practice on 20 October 2016. Overall the practice is rated as good.

• 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.

• Systems were in place to deal with medical emergencies and all staff were trained in basic life support.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

• Feedback from patients about their care was consistently positive.

• 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 had good facilities and was well equipped to treat patients and meet their needs.

• The appointments system was flexible to accommodate the needs of patients. Urgent appointments were available the same day and routine appointments could be booked in advance.

• 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 practice had strong and visible clinical and managerial leadership and governance arrangements.

• The practice provided a range of enhanced services to meet the needs of the local population.

There were also areas of practice where the provider should make improvements. The provider should:

• Have a regular system of appraisals in order to support staff.

• Facilitate all staff meetings.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 December 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 regular checks received these. Practice nurses held dedicated lead roles for chronic disease management.  As part of this they provided regular, structured reviews of patients’ health. The practice referred patients who were over 18 and with long term health conditions to a well-being co-coordinator for support with social issues that were having a detrimental impact upon their lives. Data from 2014 to 2015 showed that the practice was performing in comparison with other practices nationally for the care and treatment of people with chronic health conditions such as diabetes. The practice held regular multi-disciplinary meetings to discuss patients with complex needs and patients receiving end of life care. Regular clinical meetings were held to review the clinical care and treatment provided and ensured this was in line with best practice guidance. Longer appointments and home visits were available for patients with long term conditions when these were required. Patients with multiple long term conditions were offered a single appointment to avoid multiple visits to the surgery.

Updated 15 December 2016

The practice is rated as good for the care of families, children and young people. Child health surveillance and immunisation clinics were provided. The practice had a reminder system for parents who did not bring children and babies for immunisation, sending these letters out in their native language whenever possible. Appointments for young children were prioritised. The practice encouraged face to face meetings with the Health Visitor to review children under 5, which included vulnerable children and those newly registered at the practice. The staff we spoke with had appropriate knowledge about child protection and how to report any concerns. The practice provided a comprehensive and confidential sexual health and contraceptive service delivering the full range of contraceptive services.

Updated 15 December 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 had a higher than average number of older people in its population. Up to date registers of patients with a range of health conditions (including conditions common in older people) were maintained and these were used to plan reviews of health care and to offer services such as vaccinations for flu. Nationally reported data showed that outcomes for patients for conditions commonly found in older people were similar to or in some cases better than local and national averages. The practice provided an enhanced service to prevent high risk patients from unplanned hospital admissions. This included these patients having a care plan detailing the care and treatment they required. GPs and practice nurses 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. Monthly multi-disciplinary meetings were held to discuss the care and treatment for patients with complex needs.

Updated 15 December 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 reflects the needs for this age group. The practice had an active website as well as noticeboards in reception advertising services to patients.

Updated 15 December 2016

The practice is rated good for the care of people experiencing poor mental health (including people with dementia). The practice maintained a register of patients receiving support with their mental health. These patients were mostly known by reception staff and we saw they would call patients to remind them an appointment had been booked for them. Patients experiencing poor mental health were offered an annual review. The practice worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The practice referred patients to appropriate services such as psychiatry and counselling services. The practice had information in the waiting areas about services available for patients with poor mental health. For example, services for patients who may experience depression.

Updated 15 December 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 worked with relevant health and social care professionals in the case management of vulnerable people. The practice referred patients to local health and social care services for support, such as drug and alcohol services. 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. Information and advice was available about how patients could access a range of support groups and voluntary organisations.