Weaver Vale Practice

Updated 22 September 2016

Weaver Vale Practice is based in Runcorn, Cheshire and is located within the Hallwood Health Centre, close to Halton Hospital. The practice falls within Halton Clinical Commissioning Group. The practice is run by a partnership of four GPs, who are supported by a further three salaried GPs and a locum GP as and when required. The working hours of the GPs gives the equivalent of 5.5 full time GPs. There are two full time practice nurses and a part time health care assistant that support the GPs. At the time of our inspection, one salaried GP was on a period of leave, which was covered by partners, the other salaried GPs or by appointing a locum GP to support the team.

The practice is a teaching practice, hosting trainee GPs and medical students. The patient list is made up of approximately 9,000 patients. A practice manager overseas the daily running of the practice. The practice manager is supported by a management assistant and a deputy practice manager. The practice administrative team is made up of 10 staff who perform a mixture of reception, secretarial and administrative roles. There is also an apprentice who works with this team.

The practice is in a shared facility and is jointly owned by the partners of the two practices who use the building. The building is fully accessible to all. There is a parking area outside the building with a designated disabled space. The reception space is shared, with two, clearly signed reception desks for each of the practices based in the building. Patients are then directed to separate waiting areas. The practice has eight consulting rooms, two nurses’ rooms and one treatment room which is used to perform surgical procedures. There is a room that is used by other services that visit the building, for example, the Wellbeing Officers. There is a treatment room provided for the delivery of baby vaccinations and immunisations and for phlebotomy. There are patient toilets, male and female, a disabled toilet facility, and a baby change and feeding room. The rest of the practice space is given over to administrative rooms, a meeting room and staff break and rest facilities.

The practice is open from 8.30am to 6.30pm each day, with the exception of Tuesday, when the practice is open until 8pm. Surgery times are from 9am to 11.30am each weekday morning, and from 2.30pm to 4.30pm each weekday afternoon. There is an extend hours surgery on Tuesday of each week, from 6.30pm to 8pm.  When the practice is closed, patients are directed to call the NHS 111 service. If patients are found to need a GP, NHS 111 refers on to the out of hours provider, Go to Doc.

Updated 22 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Weaver Vale Practice on 3 August 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 an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.

• The practice carried out audits of clinical work, which drove improvements in care of patients.

• Staff had the skills, knowledge and experience to deliver effective care and treatment.

• 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 and easy to understand. Improvements were made to the quality of care as a result of audits, reviews, complaints and concerns.
• Patients said they could make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• There was a clear leadership structure and staff felt supported by management.
• The practice was a training practice hosting trainee GPs and medical students. We saw that there was sufficient mentor support in place for these trainees.
• The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 September 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• QOF achievement for the treatment of patients with long term conditions such as diabetes were in line with local and national averages.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met.

• For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 22 September 2016

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 relatively high for all standard childhood immunisations, except for Meningitis C immunisations of children under 12 months of age.

• 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.

• The practice had addressed historical low rates of uptake for cytology screening, and this work was continuing.

• The practice health care assistant worked alongside health visitors at the weekly baby clinic to assist in the monitoring of infant patients. This acted as a link to families with the surgery, promoting other services to patients that were available, such as wellbeing initiatives and psychological therapies.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw other, positive examples of joint working with midwives and school nurses.

Updated 22 September 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• All patients have a named GP; for older patients this service is prioritised by all staff to promote better continuity of care.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with complex needs.

• We saw evidence of good communication and joint working with community based nurses and clinicians, who regularly attended multi-disciplinary team meetings at the practice.

Updated 22 September 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 was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

• As a result of systematic audit, the practice were trialling a new appointment model, which meant access to appointments would be improved, particularly for patients who would need to take time away from work or study.

Updated 22 September 2016

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

• 87% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is higher than the local clinical commissioning group (CCG) average of 82% and national average of 84%.

• The percentage of patients with other mental health conditions, who had a comprehensive agreed care plan documented in their record within the last 12 months was 96%, compared to the CCG average of 92% and national average of 88%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance 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.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health, and where possible we saw that it was a patient's named GP that had contact with or consulted with the patient.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 22 September 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.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed 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.

• The practice had conducted audits of the patient register to ensure that no vulnerable adult or child, had been missed as a safeguarding case, ensuring that all records of children and adults at risk were correctly updated and annotated.