Background to this inspection
Updated
25 February 2016
The area covered by Mayfield Medical Centre is predominantly Jarrow also parts of Hebburn and Boldon Colliery in South Tyneside. The practice provides services from the following address and this is where we carried out the inspection, Park Road, Jarrow, Tyne and Wear, NE32 5SE.
The surgery is purpose built and has been extended. The facilities are on the ground floor with disabled access and a car park.
The practice has two GPs partners, three salaried GPs and GP registrars (a fully qualified doctor allocated to the practice as part of a three-year, general postgraduate medical training programme), two of the GPs are female and three male. The practice is a training practice. There are two nurse practitioners and three practice nurses and two health care assistants. There is a business manager, operations manager and an office manager. There are 13 administrative staff which include secretaries, receptionists and administration clerks.
The practice provides services to approximately 9,100 patients of all ages. The practice is commissioned to provide services within a General Medical Services (GMS) agreement with NHS England.
The practice is open Monday to Friday 8:30am to 6:00pm and until 7:30pm on Thursdays. Patients are able to book appointments either on the telephone, at the front desk or using the on-line system.
The service for patients requiring urgent medical attention out of hours is provided by the NHS 111 service and Northern Doctors Urgent Care Limited.
Updated
25 February 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection of this practice on 30 June 2015. A breach of legal requirements was found. After the comprehensive inspection the practice wrote to us to say what they would do to meet the following legal requirements set out in the Health and Social Care Act (HSCA) 2008:
We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Mayfield Medical Centre on our website at www.cqc.org.uk.
Our key findings were as follows:
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The practice had addressed the issues identified during the previous inspection.
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Staff had received the appropriate training required for their role. There was a training matrix in place to monitor when refresher training was due.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
13 August 2015
The practice is rated as good for the care of patients with long-term conditions.
The practice had planned for, and made arrangements to deliver, care and treatment to meet the needs of patients with long-term conditions. Patients with long-term conditions such as hypertension and diabetes, structured annual review to check that their health and medication needs were being met, or more often where this was judged necessary by the GPs.
Longer appointments and home visits were available when needed. Recall appointments were aligned to the patients birthday month and a holistic review of the patient’s long-term conditions would be carried out in one appointment where possible by the practice nurse. This group of patients were offered immunisations for pneumonia.
Families, children and young people
Updated
13 August 2015
The practice is rated as good for the care of families, children and young people.
The practice had identified the needs of families, children and young people, and put plans in place to meet them. The practice had a dedicated GP and a practice nurse appointed as the lead for safeguarding vulnerable children. There was a safeguarding children policy. There were regular multidisciplinary team meetings involving child care professionals such as health visitors. This covered safeguarding and families who required support.
Appointments were available outside of school hours and the premises were suitable for children and babies. Arrangements had been made for new babies to receive the immunisations they needed. Some of the data for the last year’s performance for immunisations was slightly below the averages for the clinical commissioning Group (CCG) for children aged under 12 months and 24 months. However, at the age of five the percentages of children receiving vaccines was in line with the CCG averages. Pregnant women were able to access an antenatal clinic provided by healthcare staff attached to the practice.
Updated
13 August 2015
The practice is rated as good for the care of older people.
Nationally reported data showed the practice had good outcomes for conditions commonly found amongst older people. For example, the practice had obtained 100% of the points available to them for providing recommended care and treatment for patients with heart failure. This was 2 percentage points above the local Clinical Commissioning Group (CCG) average and 2.9 points above the England average.
The practice offered personalised care to meet the needs of the older people in its population. The practice had written to patients over the age of 75 years to inform them who their named GP was. The practice maintained a palliative care register and offered immunisations for pneumonia and shingles to older people. High risk groups of elderly patients, such as those receiving palliative and residential care had care plans in place. One of the GPs had responsibility for visiting a local nursing home every two weeks. They would contact the care home in advance of their visit to prepare to visit the patients who needed to be visited or reviewed. There was a dedicated repeat prescription telephone line for house bound patients.
Working age people (including those recently retired and students)
Updated
13 August 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. There was a same day telephone access to a clinician service and if an appointment was necessary it could be arranged at a suitable time for the patient. The practice operated a text reminder service for patients who had registered their mobile phones with the practice. There were extended opening hours until 7:30pm on Thursday which was useful for patients with work commitments.
The practice offered repeat prescriptions on line. They offered a full range of health promotion and screening which reflected the needs for this age group for example smoking cessation clinics.
People experiencing poor mental health (including people with dementia)
Updated
13 August 2015
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
The practice worked closely with multi-disciplinary teams in the case management of people experiencing poor mental health including those with dementia. All patients aged over 75 had been notified of their named GP. 83.3% of patients experiencing dementia had received annual reviews, the England average is 77.9%. There was a template for the GPs to complete if patients were identified as being at risk of dementia. The patients would have bloods screened and attend a 20 minute appointment for an assessment.
Both of the GP partners had diplomas in mental health conditions. Annual review appointments were offered for this group of patients with a GP of their choice. There was access to a GP for patients experiencing poor mental health on the day regardless of urgency. The practice had developed its own template in order to carry out comprehensive reviews.
Nationally reported QOF data (2013/14) showed the practice had achieved good outcomes in relation to patients experiencing poor mental health. For example, the practice had obtained 98.4% of the points available to them for providing recommended care and treatment for patients with poor mental health. This was 8.6 percentage points above the local CCG average and 8 points above the England average.
People whose circumstances may make them vulnerable
Updated
13 August 2015
The practice is rated as good for the care of people whose circumstances may make them vulnerable.
The practice had effective working relationships with multi-disciplinary teams in the case management of vulnerable people. 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 and out of hours.
The practice carried out annual health reviews of patents with learning disabilities, there was a spread sheet used as the recall system for this. Patients could access drug and alcohol support services via the practice and an in-house drug and alcohol counsellor attended the practice weekly. Vulnerable patients had the ability to pre book or book appointments on the day without having a triage appointment.
The practice’s computer system alerted GPs if a patient was also a carer. There was support available for carers from the local carer’s support group. Carer’s were given the dedicated telephone line number to use for repeat prescriptions.