Derby Lane Medical Centre

Updated 27 March 2017

Dr PL Gupta's Practice is registered with CQC to provide primary care services, which include access to GPs, family planning, ante and post-natal care. The practice is a long established GP practice working in the centre of Liverpool in a newly purpose built and deprived area of the city. The practice has a General Medical Services (GMS) contract with a registered list size of 3500 patients (at the time of inspection). The practice had a high proportion of patients between the ages of 25-34.

The practice has two GP partners, a salaried GP, a long term locum GP, practice nurse and health care assistant, practice and finance manager and a number of administration and reception staff. The practice is open from 8am to 6.30pm Monday to Friday. Home visits and telephone consultations were available for patients who required 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 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 27 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr PL Gupta's Practice, known locally as Derby Lane Medical Centre on 31 March 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 a system in place for reporting and recording significant events. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. However, the records made of such events required improvement.

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

• Risks to patients were assessed and well managed.

• 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.

• Feedback from patients on the day of the inspection about their care was consistently and strongly positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Feedback also indicated there were problems with accessing GP appointments but there was good open access to GP appointment each day for urgent and emergency appointments.
• Data showed that outcomes for patients at this practice were similar to outcomes for patients locally and nationally.
• Information about services and how to complain was available but required improvement to be easily understood.

• 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.
• There was a clear leadership and staff 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 areas where the provider must make improvements are:

• The provider must ensure that suitable guidance, policies and procedures are available to staff for the protection of vulnerable people.

The areas where the provider should make improvement are:

• The records made of the reporting of significant events required improvement to ensure the full detail of the event is captured and the learning has taken place.

• Infection control risk assessment should be completed on a regular basis and signed off by the registered provider.

• The provider should review the system in place for complaints to ensurea full record of the complaint is logged in line with the practice policy.

• Staff files should have records and certificates to show the full and completed training undertaken for each staff member.

• A risk assessment for the need to have oxygen on site in an emergency should be undertaken. According to current external guidance and national standards this equipment should be in place in all practices.

• All staff practice meetings should be introduced.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 26 May 2016

The practice is rated as good for the care of people with long-term conditions. Nursing staff were appropriately trained and had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. The practice provided a named GP to ensure continuity of care. They work with outside agencies to ensure patients were supported and receive a high quality of care within the community. These include district nurses, heart failure team and a neighbourhood team made up of both Health and Social care staff. Patients with long term conditions were provided with literature and disease specific information to enable self-management of conditions. For example, patients with lung disorders were given self-management plans and rescue packs of antibiotics in case of exacerbation at home. Care plans were in place for at risk patients which permits information sharing with the wider community team. Initial appointments were made with the GP followed by regular review by the nurses at the practice.

Updated 26 May 2016

The practice is rated as good for the care of families, children and young people. Weekly mother and baby clinics for baby and postnatal checks were provided. 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 good 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. For babies and young children up to the age of 5 an appointment to attend was provided at the end of the morning to avoid long waits. Appointments were also available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 26 May 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. 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 dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. The practice participated in the Avoiding Unplanned Admission enhanced service as proposed by NHS England. This involved co-ordinated working between GPs, practice nurses, district and mental health nurses and wider primary care health team as well as social services and secondary care input to focus on the needs of the vulnerable elderly patients. The practice had named GPs for all patients and also specifically for those over the age of 75 years. The practice offered a variety of health checks for older people specifically memory screening and osteoporosis risk assessments.

Updated 26 May 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 offers a telephone consultation service every day as well as pre-bookable appointments for morning and afternoon surgeries . 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. The practice also used the Electronic Prescribing System, increasing convenience for patients who might work during the day.

Updated 26 May 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia and has a mental health register of patients. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health.

Updated 26 May 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 and those with a learning disability. It offered longer appointments for people with a learning disability. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients 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.