Archived: Thornton Practice

Updated 19 February 2015

Thornton Practice serves approximately 2,500 patients and falls within the Sefton area of Liverpool. The service is delivered by a large provider, SSP Health Ltd, who manage several other practices in the area. Locum GPs deliver clinics throughout the week, with the number of sessions equating to just over one full time GP. The GP team is made up of three long term locums, two female and one male. Two nurses work at the practice to deliver a range of services including regular disease management clinics and delivery of all childhood vaccinations and immunisations.

The practice delivers services under an alternative primary medical services contract (APMS).

The practice operates from a purpose built facility which is shared with the community health team. The building and facilities are step free and accessible for wheelchair users.

The practice does not provide out of hours services. Patients are referred to another provider, Urgent Care 24 (UC24).

The practice falls within the fourth most deprived decile of the deprivation measurement scale used by NHS England. Life expectancy of males in the area is approximately 77 years of age and for females, life expectancy is 82.3 years of age.

We reviewed data from a number of sources before our inspection. The CQC intelligent monitoring placed the practice in band six. The intelligent monitoring tool draws on existing national data sources and includes indicators covering a range of GP practice activity and patient experience including the Quality Outcomes Framework (QOF) and the National Patient Survey. Based on the indicators, each GP practice has been categorised into one of six priority bands, with band six representing the best performance band. This banding is not a judgement on the quality of care being given by the GP practice; this only comes after a CQC inspection has taken place.

Updated 19 February 2015

Letter from the Chief Inspector of General Practice

This is the report of findings from our inspection of Thornton Family Health Clinic. Our inspection was a planned comprehensive inspection, which took place on 12 November 2014. The surgery is run by a large provider called SSP Health Ltd.

Our overall rating of the service is that it provided effective, responsive care that was rated as good. The practice is also rated as good for being well-led.

Our key findings were as follows:

• The locum GPs had been working at the practice for some time and had built constructive working relationships with members of the community nursing teams and with the patients they provided cared for.
• The locum GPs were familiar with governance processes. Patients commented that they valued seeing the same GP on a regular basis.
• Regular practice meetings took place which the locum GPs attended or led on. These enhanced communication to the practice team of areas for improvement at practice.
• Good working relationships were in place between the practice and community nursing and care teams which promoted patient welfare.
• Care plans were in place for those patients deemed to be at risk of unplanned admissions to hospital. Patients we spoke with were able to confirm their involvement in drawing up these care plans.
• Staff were well led by the practice manager and locum GPs. Staff were committed to providing patients with a caring service.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Review complaints about patient care and treatment using serious event analysis and investigation systems to promote learning and improve the quality of services.

In addition the provider should:

• Improve steps to gain patient feedback, such as forming a Patient Participation Group (PPG) for the practice.
• Ensure adequate risk assessments are in place which detail the reasoning for having or not having DBS checks completed on staff who are used to chaperone patients.
• Provide practice level peer review and clinical supervision of GPs work.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 February 2015

The practice nurses ran effective disease management clinics. All newly registered patients completed a health questionnaire, which asked patients to highlight any long term health conditions they had. Staff used this information to update disease registers and ensure patients had access to nurse or GP appointments so their condition could be assessed. We saw that patients had regular reviews of their medication to ensure it continued to meet their needs.

Updated 19 February 2015

Patients in this population group were well served by the practice. The percentage of patients registered with the practice, between the ages of 0 -19 years old was in line with the England average. The practice nurse delivered childhood vaccinations and immunisations, along with other adult immunisations. Appointments were sufficiently well managed to allow for emergency cases, for example any child that needed to be seen by a GP on that day. The practice had systems in place to capture and follow up on patients who had not attended appointments. This supported safeguarding systems in place for any child or young person that was subject to a safeguarding plan.

Updated 19 February 2015

The needs of older patients were met. All patients over the age of 75 years had a named GP. Data available to us before our inspection showed that the practice had performed well in the referral of patients who had showed symptoms of dementia. The rate of patients diagnosed was significantly higher than the England average. This meant those patients who received a diagnosis could be properly treated and supported. The practice worked well with community clinicians to deliver planned care for older patients.

Updated 19 February 2015

The practice provided services which met the needs of this population group. Extended hours surgeries were available on one morning and one evening in the week. Staff worked hard to ensure that these appointments were used by patients who’s working or educational commitments meant they could not attend the practice in normal working hours. A range of health screening initiatives and clinics were available to patients from this group, including well man and well woman appointments with the nurse if requested.

Updated 19 February 2015

GPs used a recognised tool to screen patients who presented with symptoms that may indicate signs of dementia. This had led to timely referrals to the memory clinic where more detailed assessment of the patient could be conducted. GPs told us they were well supported by the community mental health teams, which were based nearby.

Updated 19 February 2015

Staff maintained registers of those patients with learning disabilities. Systems were in place to ensure that these patients received regular health checks. Any patients who failed to attend planned appointments were contacted to organise a further appointment. The practice had worked to ensure continuity of care for these patients.