Background to this inspection
Updated
11 February 2016
Newington Health Centre is situated in the west of Hull City and provides services under an Alternative Provider Medical Services (APMS) contract with NHS England, Hull Area Team to the practice population of 7,939, covering patients of all ages.
The practice has three GP locums, two male and one female. There is one nurse practitioner and one health care assistant. There is a practice manager, a reception manager and a team of secretarial, administration and reception staff.
The practice is open between 8am to 6.30pm Monday to Friday. Appointments are from 8am to 6.30pm daily. The practice, along with all other practices in the Hull CCG area have a contractual agreement for NHS 111 service to provide Out of Hours (OOHs) services from 6.30pm. This has been agreed with the NHS England area team.
The proportion of the practice population in the 65 years and over age group is lower than the England average. The practice population in the under 18 age group is higher than the England average. The practice scored one on the deprivation measurement scale, which is the first lowest deprived. People living in more deprived areas tend to have greater need for health services. The overall practice deprivation score is higher than the England average, the practice is 55.7 and the England average is 26.6.
The practice has opted out of providing out of hours services (OOHs) for their patients. When the practice is closed patients use the 111 service to contact the OOHs provider. Information for patients requiring urgent medical attention out of hours is available in the waiting area, in the practice information leaflet and on the practice website.
The practice has a branch surgery at Calvert Lane Hull. However, we did not inspect this service as part of our visit.
Updated
11 February 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Newington Health Centre on 24 November 2015. Overall the practice is rated as good.
This practice initially registered with the Care Quality Commission (CQC) in June 2015 and as a result of this did not take part in the national GP patient survey. Some data included in the report is based on the findings of the practice following monitoring of patient experiences and may not include comparisons with local and national data.
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 well managed.
- Staff assessed patients’ needs and delivered care in line with current evidence based guidance. 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.
- Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
- The practice had good facilities and was well equipped to treat patients and meet their needs.
- There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
In addition the provider should:
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Review the systems in place to ensure the confidentiality of patient information in the waiting area.
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Patient suggestions and comments should be monitored on a regular basis.
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Ensure policies are readily available at all times to staff that need them.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
11 February 2016
The practice is rated as good for the care of people with long-term conditions (LTCs).
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Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
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Nationally reported data for 2014/2015 showed that outcomes for patients with long term conditions were generally good. However, performance for diabetes related indicators was 40.7%, this was below the local CCG and national average.
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Longer appointments and home visits were available when needed.
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All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.
Families, children and young people
Updated
11 February 2016
The practice is rated as good for the care of families, children and young people.
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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.
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Immunisation rates were relatively high for all standard childhood immunisations.
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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.
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Nationally reported data from 2014/2015 showed the practice’s uptake for the cervical screening programme was 95.0%, which was 3.6% below the local CCG average and 2.6% below the national average.
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Appointments were available outside of school hours and the premises were suitable for children and babies.
Updated
11 February 2016
The practice is rated as good for the care of older people.
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The practice offered proactive, personalised care to meet the needs of the older people in its population.
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It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
Working age people (including those recently retired and students)
Updated
11 February 2016
The practice is rated as good for the care of working-age people (including those recently retired and students).
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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.
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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.
People experiencing poor mental health (including people with dementia)
Updated
11 February 2016
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
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Nationally reported data from 2014/2015 showed 32.0% of people diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months. This was significantly lower than other practices.
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Nationally reported data from 2014/2015 showed the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive care plan documented in their record, in the preceding 12 months was 37.1%. This was significantly lower than other practices.
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The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
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The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
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It had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
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Staff had a good understanding of how to support people with mental health needs and dementia.
People whose circumstances may make them vulnerable
Updated
11 February 2016
The practice is rated as good for the care of people whose circumstances may make them vulnerable.
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The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability.
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It offered longer appointments for people with a learning disability.
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The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
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It had told vulnerable patients about how to access various support groups and voluntary organisations.
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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.