Archived: Freshfields Practice

Updated 22 October 2015

Freshfield Practice is located in the Formby area of Merseyside. It is responsible for providing primary care services to approximately 3032 patients. The practice is based in a less deprived area when compared to other practices nationally. Unemployment levels amongst the patient population are relatively low. The practice population are of mixed gender and ages.

The staff team includes one regular GP who is not directly employed by SSP Health Ltd with additional GP services provided by locum and self-employed GPs. There is a practice manager, reception and administration staff. The practice is open 8am to 6.30pm Monday to Friday. Patients requiring a GP outside of normal working hours are advised to contact the GP out of hours service provided by Go to Doc.

The practice has an Alternative Provider Medical Services (APMS) contract. The practice offers a range of enhanced services including minor surgery, flu and shingles vaccinations and learning disability health checks.

Updated 22 October 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Freshfield Practice on 29 July 2015.

Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Staff were aware of procedures for reporting significant events and safeguarding patients from risk of abuse. Significant events had been appropriately managed.
• There were appropriate systems in place to reduce risks to patient safety, for example, infection control procedures.
• Staff records for self- employed GPs and locum GPs needed improvement. For example records detailing health checks carried out and the recording of the date of the most recent Disclosure and Barring Service (DBS) check.   
• Access to the service was monitored to ensure it met the needs of patients. Patients reported satisfaction with the ease of making appointments, although they were less satisfied with opening times.
• A number of locum GPs and self-employed GPs were supporting the practice which did not promote continuity of care for patients. Patient experiences of seeing or speaking to a preferred GP were less than local and national averages (National Patient Survey July 2015). The lead GP was self -employed and had worked at the practice on a permanent basis for approximately two years.
• The practice sought patient views about improvements that could be made to the service and acted on patient feedback. Information about how to complain was available.
• Patients were overall positive about the care they received from the practice. They commented that they were treated with respect and dignity and that staff were caring, supportive and helpful.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles.
• Services were planned and delivered to take into account the needs of different patient groups.
• There were systems in place to monitor and improve quality and identify risk.

There were areas where the provider must make improvements:

• The system in place to monitor and record the use of prescription pads needs to be reviewed to ensure accurate records are maintained and are auditable.
• Recruitment records for those staff not directly employed by SSP Health Ltd must contain information that demonstrates that they have the necessary skills, competencies and are of good character to provide safe services to patients.

There were areas where the provider should make improvements.

Importantly the provider should:

• Make improvements to the continuity of GPs employed at the practice to promote effective communication between clinical staff and continuity of care for patients.
• Recruitment records needed improvement with regard to the carrying out of health checks on prospective employees and or locum staff.
• Ensure that the practice website contains sufficient health promotion information for patients.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 22 October 2015

The practice is rated as good for the care of people with long-term conditions. Longer appointments and home visits were available when needed. All these patients had a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the lead GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 22 October 2015

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 high for all standard childhood immunisations. Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 22 October 2015

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 contacted patients with dementia prior to an appointment to support them to attend the appointment.

Updated 22 October 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). The needs of this group had been identified and the practice had adjusted the services it offered to ensure these were accessible and flexible. For example, the Practice offered online prescription ordering and the ability to cancel appointments by text. The practice offered a range of health promotion and screening that reflects the needs for this age group.

Updated 22 October 2015

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

comprehensive and agreed care plan documented in their records, in the preceding 12 months. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health and carried out advanced 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

Updated 22 October 2015

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 those with a learning disability. It had carried out annual health checks for people 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.