Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Westminster Medical Centre on 15 June 2016. Overall the practice is rated as good and outstanding for providing services for the population group of vulnerable patients.

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

• The practice is situated in a purpose built health centre in a deprived area of Liverpool. The practice was clean and had good facilities including disabled access, translation services and a hearing loop.

• 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.
• Information about services and how to complain was available. The practice sought patient views about improvements that could be made to the service; including having an established patient participation group (PPG) and acted, where possible, on feedback.

• The practice had been without a practice nurse during 2014-2015 and had relied on local nursing teams. As a consequence some of the performance data for 2014-2015 we reviewed was lower than average, but a new full time nurse had joined the practice in 2015 and performance was constantly improving.

• Two members of staff had been promoted to practice manager and deputy practice manager approximately 10 weeks before our inspection. The staff had worked hard to maintain and improve the service delivered to patients and the systems in place to ensure the safety of the practice. This included revising all policies and risk assessments and actions needed as a result. Staff worked well together as a team and all felt supported to carry out their roles.

There were examples of outstanding practice being provided for more vulnerable patients:

• The practice was aware of the challenges that a very economically deprived area presented such as high levels of alcohol and drug misuse and the risk of homelessness. The practice patient information available in the waiting room areas was specifically designed to help these patients. The newly appointed practice manager and deputy had attended a community open day for homeless people and had liaised with a local organisation to provide contact cards for the homeless. The practice did register homeless patients. Food tokens were also available from the practice (24 so far had been used).

• The practice had a register of more vulnerable patients and a designated member of staff who was responsible for contacting these patients to ensure their health needs were being met and when necessary GP appointments were made.

• The practice was aware of the difficulties facing single mothers with several children to attend the practice and had carried out home visits to provide vaccinations for more vulnerable children.

• The practice nurse carried out home visits for patients with learning disabilities requiring cervical screening. Information about the procedure was available in easy read format.

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

The provider should:

• Update information for patients on how to make a complaint by including the correct contact details for NHS England.

• Complete actions identified on health and safety risk assessments where practical.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice