Archived: Earsdon Park Medical Practice

Updated 11 June 2015

The practice is based within the Shiremoor Health Centre and also has a branch surgery at The Oxford Centre in Longbenton. The practice serves those living in Shiremoor, Longbenton and the surrounding areas. The practice provides services from the following addresses and these are where we carried out the inspection:

• Main surgery - Shiremoor Resource Centre, Earsdon Road, Shiremoor, Newcastle Upon Tyne, Tyne and Wear NE27 0HJ.
• Branch surgery - First Floor, Oxford Centre, West Farm Avenue, Longbenton, Newcastle upon Tyne, Tyne and Wear NE12 8LT.

The main surgery in Shiremoor provides all of its services to patients at ground floor level. Services at the branch surgery in Longbenton are provided from the first floor. The practice offers on-site parking at both sites including disabled parking bays, accessible WC’s and step-free access. Two passenger lifts are available for patients to use at the Longbenton branch to access the first floor. The practice provides services to around 4,350 patients of all ages based on an Alternative Provider Medical Services (APMS) contract agreement for general practice. This is a locally negotiated contract open to both NHS practices and voluntary sector or private providers. The registered provider is Freeman Clinics Limited.

The practice has six GPs in total; two salaried GPs and four regular locum GPs. There is also one regular locum nurse practitioner, two practice nurses, one healthcare assistant, a practice manager and a team of administrative support staff. At the time of the inspection there was no registered manager in post, however the provider was aware of and taking steps to address this.

The CQC intelligent monitoring system placed the area in which the practice was located in the fifth more deprived decile. In general, people living in more deprived areas tend to have greater need for health services. The practice’s age distribution profile showed slightly higher percentages of children aged 0-4 years and female patients aged 30-39 years than the national averages.

The service for patients requiring urgent medical attention out-of-hours is provided by the 111 service and Northern Doctors Urgent Care Limited.

Updated 11 June 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Earsdon Park Medical Practice on 10 March 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. It was also good for providing services for the following population groups: Older people; People with long-term conditions; Families, children and young people; Working age people (including those recently retired and students); People whose circumstances may make them vulnerable; People experiencing poor mental health (including people with dementia).

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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 were able to get an appointment with a GP when they needed one, 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 they acted on.

We saw one area of outstanding practice:

• Patients with learning disabilities were routinely offered appointments at times where they would not expect to have to wait long to be seen. For example first thing in the morning or at the start of a planned surgery session. This was in an attempt to meet these patient’s specific needs and to reduce any reservations they may have had about attending the practice.

However there were areas of practice where the provider needs to make improvements.

The provider should:

• Improve the systems used to record training completed by staff. The practice was aware of the need to do this. We saw an action plan was already in place to support the collation of copies of training certificates from staff and dates of training completed. The action plan should be followed through to completion.
• Endeavour to improve the quality of minutes produced from meetings held internally, in particular records of multidisciplinary meetings held.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 11 June 2015

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. Longer appointments and home visits were available when needed. Patients at high risk of hospital admission had structured reviews to check that their health and medication needs were being met. For those people with the most complex needs, the GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Appointments, including daily telephone appointments, were available with the on call GP each day to allow time for contact with other services to support patients who were vulnerable, had poor mental health or long term conditions should they need a more multidisciplinary team approach to their on-going care.

The practice maintained a list of patients who had a new or on-going cancer diagnosis. A traffic light system was used to highlight those patients that required more intense input from the clinical team. The list was reviewed on a monthly basis and discussed at clinical meetings with the support of the Community Macmillan Nurse. Diabetic clinics were run once a month, alongside a dedicated diabetic dietician.

Updated 11 June 2015

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. Childhood immunisation rates were in line with or slightly above averages for the local Clinical Commissioning Group (CCG). For example, Infant Men C vaccination rates for two year old children were 97.0% compared to 97.5% across the CCG; and for five year old children were 96.6% compared to 92.9% across the CCG. Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives and health visitors. Cervical screening rates for women aged 25-64 were in line with the national average at 81%.

The practice routinely wrote to patients on turning 16 years old to advise them about services such as family planning and smoking cessation. Routine contraceptive and emergency sexual health care was provided. The practice were closely supported by the one-to-one centre in Shiremoor for a more extensive range of services, such as coil and implant fitting and more detailed sexual health checks.

Updated 11 June 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. They offered proactive, personalised care to meet the needs of the older people in its population. For example, all patients over the age of 75 had a named GP and patients at high risk of hospital admission had care plans. The practice was responsive to the needs of older people, including offering home visits and rapid access appointments for those with enhanced needs.

The practice maintained a palliative care register and offered immunisations for pneumonia and shingles to older people.

Updated 11 June 2015

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 and flexible. The practice offered some online services as well as a full range of health promotion and screening which reflects the needs for this age group. GP appointments could be requested but not booked in advance online.

The practice offered extended opening hours on a Saturday morning between 8.00am and 10.30am. Patients could pre-book appointments to see a GP at these times. This made it easier for people of working age to get access to the service. They were hoping to be able to extend this provision further with early morning or weekday evening appointments in the future.

Updated 11 June 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. They carried out advance care planning for patients with dementia.

Patients with mental health diagnoses were offered opportunistic reviews at any point of contact. The practice had close links with the Community Mental Health Team (CMHT) in supporting changes to medicines prescribed and on-going reviews of care plans. Appointments, including daily telephone appointments, were available with the on call GP each day to allow time for contact with other services to support patients who were vulnerable, had poor mental health or long term conditions should they need a more multidisciplinary team approach to their on-going care.

The practice had sign-posted patients experiencing poor mental health to various support groups and organisations. Information and leaflets about services were made available to patients within the practice.

Updated 11 June 2015

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 those with a learning disability. They had carried out annual health checks for people with a learning disability. The practice offered longer appointments for people with a learning disability, if required. Patients with learning disabilities were offered appointments at times where they would not expect to have to wait long to be seen. For example first thing in the morning or at the start of a planned surgery session. This was in an attempt to meet these patient’s specific needs and to reduce any reservations they may have had about attending the practice.

Appointments, including daily telephone appointments, were available with the on call GP each day to allow time for contact with other services to support patients who were vulnerable, had poor mental health or long term conditions should they need a more multidisciplinary team approach to their on-going care.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. They made vulnerable patients aware of 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.