Archived: Humshaugh and Wark Medical Group Also known as Wark Surgery

Updated 14 April 2016

Humshaugh and Wark Medical Group is registered with the Care Quality Commission to provide primary care services.

The practice provides services to around 3,700 patients from two locations:

• The Surgery, Humshaugh, Hexham, Northumberland, NE46 4BU.
• Wark Surgery, Wark, Hexham, Northumberland, NE46 3LS.

We visited both of these addresses as part of the inspection.

Humshaugh and Wark Medical Group is based in purpose built premises at two locations. There is level access to Wark surgery. Access to the surgery at Humshaugh is via a ramp. Some of the consulting room at Humshaugh surgery are not suitable for wheelchair users, the practice advises patients of this fact in the patient leaflet.

Parking is available adjacent to Wark Surgery and on-site parking is available at Humshaugh surgery. A disabled WC is available at each surgery.

The practice has two GP partners and one salaried GP (one male, two female). The practice employs a practice manager, data manager, nurse practitioner, two practice nurses, a medicines manager, a healthcare assistant, a secretary and a senior administrator. The practice also employs 10 staff that undertakes reception and dispensing duties as well as an apprentice administrator/receptionist, a cleaner and a delivery driver/handyman. The practice provides services based on a Personal Medical Services (PMS) contract agreement for general practice.

The practice is a dispensing practice; this service is only available to patients who live more than one mile away from a chemist. This equates to 89% of the practices’ patients.

Wark Surgery is open at the following times:

• Monday, Wednesday and Friday 8:30am to 5:30pm.
• Tuesday and Thursday 8:30am to 1pm with telephone access until 5:30pm.

Appointments are available at Wark Surgery at the following times:

• Monday, Wednesday and Friday 8:30am to 11:30am and 1pm to 5:30pm
• Tuesday and Thursday 8:30am to 11:30am.
• Extended hours appointments are available until 7:30pm each Monday evening.

The Surgery, Humshaugh is open at the following times:

• Monday to Friday 8:30am to 5:30pm with telephone access only between 1pm and 3pm on Thursday.

Appointments are available at The Surgery, Humshaugh at the following times:

• Monday, Tuesday, Wednesday and Friday 8:30am to 11:30am and 1pm to 5:30pm.
• Thursday 8:30am to 11:30am and 3pm to 5:30pm.

Extended hours appointments are available until 7:30pm each Thursday evening.

The telephones are answered by the practice from 8am until 5:30pm.

The practice is active in clinical research and patients at the practice are encouraged to participate in appropriate clinical trials.

The practice is part of NHS Northumberland clinical commission group (CCG). Information from Public Health England placed the area in which the practice is located in the eighth least deprived decile. In general, people living in more deprived areas tend to have greater need for health services. Average male life expectancy at the practice is 80 years, compared to the national average of 79 years. Average female life expectancy at the practice is 84 years, compared to the national average of 83 years.

The proportion of patients with a long-standing health condition is below average (50% compared to the national average of 54%). The proportion of patients who are in paid work or full-time employment is above average (62% compared to the national average of 60%).

The NHS 111 service and Northern Doctors Urgent Care Limited provide the service for patients requiring urgent medical care out of hours. Information about these services is available on the practice’s telephone message, website and the practice leaflet.

Updated 14 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Humshaugh and Wark Medical Group on 3 February 2016. Overall, the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Lessons were learned when incidents and near misses occurred.
• 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 were able to get an appointment with a GP when they needed one.
• Extended hours surgeries were offered up to 7:30pm one evening each week at each surgery.
• Urgent appointments were available on the day they were requested.
• 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.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw one area of outstanding practice:

• Patients could access appointments and services in a way and a time that suited them. Data from the National GP Patient Survey published in July 2015 showed that patients rated the practice highly for accessibility. For example, 100% said the last appointment they got was convenient (CCG average of 93%, national average of 92%) and 99% found it easy to get through to the surgery by phone (CCG average 77%, national average 73%).

There are three areas where the provider should make improvements:

The provider should:

• Review the records and storage of blank prescriptions to ensure that these are stored in line with national guidance and kept securely at all times.
• Monitor the new process of signing repeat prescriptions before they are issued to patients. This is in order to demonstrate these improvements become embedded into practise in the long term.
• Review the management of complaints at the practice; verbal complaints should be recorded in line with their agreed complaints policy.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 14 April 2016

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

• Patients at risk of hospital admission were identified as a priority for care and support by the practice, comprehensive care plans were in place and regularly reviewed.
• The clinical staff and the medicines manager  provided medicine reviews for patients.
• Nationally reported data showed the practice had achieved good outcomes in relation to most of the conditions commonly associated with this population group. For example, the practice had achieved 95% of the QOF points available for providing the recommended care and treatment for patients with diabetes. This was 0.3% above the local CCG average and 6.1% above the national average.
• A diabetic clinic was held each week; supported by a podiatrist. Once a month a dietician also attended to support this clinic.
• Longer appointments and home visits were available when needed.
• All patients with a long-term condition had a named GP and were offered 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.
• The medicines manager provided support for patients who started using a ‘dosette box’ to manage their medications.

Updated 14 April 2016

The practice is rated as good for the care of families, children and young people.

• There were processes in place for the regular assessment of children’s development. This included the early identification of problems and the timely follow up of these. Systems were in place for identifying and following-up children who were considered to be at-risk of harm or neglect. For example, the needs of all at-risk children were regularly reviewed at practice multidisciplinary meetings involving child care professionals such as health visitors.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• There were arrangements for new babies to receive the immunisations they needed. Childhood immunisation rates for the vaccinations given to under two year olds were 100% (CCG average 96% to 99%) and for five year olds ranged from 93% to 96% (CCG average 95% to 99%).
• Urgent appointments for children were available on the same day.
• 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.
• Pregnant women were able to access an antenatal clinic provided by healthcare staff attached to the practice.
• Nationally reported data showed that outcomes for patients with asthma were good. The practice had achieved 100% of the QOF points available for providing the recommended care and treatment for patients with asthma. This was 0.7% above the local CCG average and 2.6% above the national average.
• The practice’s uptake for cervical screening was 95%, which was 11.5% above the local CCG average and 13.2% above and national average.

Updated 14 April 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 their population.
• All patients over the age of 75 had a named GP.
• Patients over the age of 75 with a chronic disease were offered an annual health check.
• The practice was responsive to the needs of older people; they offered home visits and urgent appointments for those with enhanced needs.
• Nationally reported data showed that outcomes for patients with conditions commonly found in older people were good. For example, the practice had achieved 100% of the Quality and Outcomes Framework (QOF) points available for providing the recommended care and treatment for patients with heart failure. This was 1.1% above the local clinical commissioning group (CCG) average and 2.1% above the national average.
• The practice maintained a palliative care register and offered immunisations for pneumonia and shingles to older people.

Updated 14 April 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.
• Extended hours appointments were available one evening each week at each surgery.
• Patients could order repeat prescriptions and book appointments on-line.
• Telephone appointments were available; the patient could request a named doctor. Patients told us that they appreciated this service.
• The practice offered a full range of health promotion and screening which reflected the needs for this age group.
• Additional services such as health checks for over 40’s, travel vaccinations and minor surgery were provided.
• The practice website provided a wide range of health promotion advice and information.

Updated 14 April 2016

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

• The practice held a register for patients experiencing poor mental health and had identified 1% of their patient population as requiring inclusion.
• Nationally reported data showed that outcomes for patients with mental health conditions were above average. The practice had achieved 100% of the QOF points available for providing the recommended care and treatment for patients with mental health conditions. This was 3.6% above the local CCG average and 7.2% above the national average.
• Nationally reported data showed that outcomes for patients with dementia were good. The practice had achieved 100% of the QOF points available for providing the recommended care and treatment for patients with dementia. This was 0.9% above the local CCG average and 5.5% above the national average. Over 95% of patients diagnosed with dementia had their care reviewed in a face-to-face meeting in the last 12 months, which is above the national average of 84%.
• The practice regularly worked with multi-disciplinary teams in the case management of people 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.
• Staff had a good understanding of how to support patients with mental health needs and dementia.
• Several staff had undertaken dementia friends training which provided additional understanding of the issues faced by patients with dementia and their carers.

Updated 14 April 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 those with a learning disability.
• The practice offered longer appointments for patients with a learning disability if required.
• The practice regularly worked with multi-disciplinary teams (MDT) in the case management of vulnerable people.
• 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.
• Good arrangements were in place to support patients who were carers. The practice had a carers’ champion who supported carers and acted as a key contact for carer information at the practice.