The Spinney Medical Centre

Updated 7 November 2016

The Spinney Medical Centre is based in Thatto Heath near St Helens. There were 7130 patients on the practice register at the time of our inspection.

The practice is a training and teaching practice managed by four GP partners (two male, two female). There are four female salaried GPs. There is a nurse prescriber, a practice nurse and a healthcare assistant. Members of clinical staff are supported by a practice manager, reception and administration staff.

The practice is open 8am to 6.30pm every weekday except Wednesdays when the practice is closed between 12pm-2pm. The practice is open on Saturday morning between 8am-11.30am for both GP and nurse appointments. Patients requiring a GP outside of normal working hours are advised to contact the GP out of hours service St Helens GP Rota.

The practice has a Personal Medical Services (PMS) contract and has enhanced services contracts which include childhood vaccinations. 

Updated 7 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Spinney Medical Centre on 23 September 2016. Overall the practice is rated as good.

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

• The practice is situated in a purpose built health centre and has a separate administration building. 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.
• The practice was aware of and had systems in place to ensure compliance with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment).
• 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 a patient participation group (PPG) and acted, where possible, on feedback.
• Staff worked well together as a team and all felt supported to carry out their roles.

The practice is rated outstanding for well led because of the strong leadership and an open and committed culture for education and development. For example:

• The practice had asked for an external risk review from their medical indemnity insurer and as a result improved their systems in place. For example, the complaints process. The complaints process was altered so that it required a second person with the same role to independently review any response to a complaint sent to a patient.

• The practice proactively worked with the patient participation group to support patients, in particular carers. There was a ‘care for carers’ policy. In collaboration with the PPG the practice facilitated educational sessions for patients and invited guest speakers. These sessions were used as an opportunity to provide patients with information on a range of general health topics. The practice won the local Healthwatch’s Patient- Friendly Practice Award in 2016.

• There was a focus on continuous learning. In 2015 the practice was designated as one of six Enhanced Training Practices across Health Education North West and coordinated all non-medical student university placements across four boroughs. Staff were encouraged in their careers. For example, the nurse had taken a prescriber’s course as a result of discussions at appraisal. The practice was aware of not only the shortage of GPs nationally, but within the local area and worked with local schools to provide career advice for students interested in medicine.

However, there were improvements that should be made.

The practice should:

• Review the equipment and processes for cleaning the premises and clinical equipment to ensure national guidance is followed.
• Analyse incidents in order to identify any trends to prevent reoccurrence.
• Include reference to emergency situations in their home visiting policy.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 November 2016

The practice is rated as good for providing services for people with long term conditions.  The practice had registers in place for several long term conditions including diabetes and asthma. Longer appointments and home visits were available when needed. All these patients had a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. 

Updated 7 November 2016

The practice is rated as good for providing services for families, children and young people. The practice regularly liaised with health visitors to review vulnerable children and new mothers. 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. 

Updated 7 November 2016

The practice is rated as good for providing services for older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and offered home visits and care home visits. The practice participated in meetings with other healthcare professionals to discuss any concerns. There was a named GP for the over 75s and all these patients received a comprehensive geriatric assessment of their needs.  

Updated 7 November 2016

The practice is as rated good for providing services for working age people. The needs of this population group had been identified and the practice had adjusted the services it offered to ensure these were accessible. There were online systems available to allow patients to make appointments. The practice was open on Saturday mornings for both GP and nurse appointments.

Updated 7 November 2016

The practice is rated as good for providing services for people experiencing poor mental health. Patients experiencing poor mental health received an invitation for an annual physical health check. Those that did not attend had alerts placed on their records so they could be reviewed opportunistically.  The practice worked with local mental health teams and staff had received dementia awareness training.

Updated 7 November 2016

The practice is rated as good for providing services for people whose circumstances 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 and longer appointments were available for people with a learning disability.