Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Mather Avenue Surgery on 19 May 2016. Overall the practice is rated as good.

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

• The practice was in the middle of a refurbishment programme. Some rooms had recently been refurbished but some patient facilities, including disabled facilities, were yet to be completed.

• There were systems in place to mitigate safety risks including analysing significant events and safeguarding.

• Patients’ needs were assessed and care was planned and delivered in line with current legislation.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice had a mixture of appointments available including an open access service every morning, telephone consultations and pre-bookable appointments.
• Information about services and how to complain was available. The practice sought patient views about improvements that could be made to the service; including carrying out regular surveys and having a patient participation group (PPG) and acted, where possible, on feedback.

• The practice team had a good skill mix with GPs having a range of clinical expertise. The practice encouraged career progression. Staff worked well together as a team and all felt supported to carry out their roles. The nurse clinician took a lead role for revalidation of nurses for Liverpool and had been nominated for the Nursing Times Lead Nurse award.

• Some staff took an active role in various projects to improve lifestyle and health outcomes for the Liverpool population. For example, co-ordinating care between primary and secondary services for children suffering asthma.

There were outstanding elements of practice:

• All urgent dermatology referrals under the two week rule received a second opinion from another GP to reduce any unnecessary referrals.

• The practice had a diverse system for appointments including an open access system every morning and patients were offered a GP of their choice. The practice recognised that it was impractical to expect very young children to wait and had a designated time slot every morning for them to attend. All GPs, including the trainee GP, met after the open access clinic to discuss house visits to ensure continuity of care and any clinical queries. In the afternoon there was an on call GP who dealt with all urgent cases.

• The practice dedicated one session a week for one of the GP partners to work on quality improvement. Quality improvements included, communications with patients, staffing, premises, medicines management and computing skills.

However, there were areas where the provider should make improvements.

The provider should:

• Revise their complaints protocol to include the correct details of who patients should contact if they are not satisfied with the outcome of any investigation by the practice for a complaint.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke with four people who used the service. People told us they had been able to make decisions about their care and treatment and they told us they had been treated with dignity and respect. Their comments included:

"I haven't got a problem with the practice."

"The only thing I would say is that it is sometimes hard to get an appointment."

We found that patients care and treatment was assessed, planned and delivered in order to meet the individual patient's needs. Care and treatment plans were fully documented and reviewed via a computerised records system. We also saw evidence that staff were inducted, trained and supervised appropriately.

We found the provider had effective systems in place for monitoring the quality of services. Regular audits were undertaken, there was an effective complaints process and regular patient satisfaction surveys were undertaken. A patient participation group functioned within the practice which gave patients the opportunity to give their views and offer feedback regarding the service.