Queen Elizabeth Hospital Extended Access

Updated 10 June 2022

Newcastle & Gateshead Clinical Commissioning Group (CCG) has commissioned the provider (Community Based Care Health Federation Limited) to provide additional capacity appointments with GPs either outside of normal GP practice hours or as in-hours ‘overspill’. This is available at two extended access facilities - Extra Care Blaydon and Extra Care Queen Elizabeth Hospital, located within the outpatient’s department. We visited Extra Care Queen Elizabeth Hospital as part of this inspection.

At this location, patients can access 15-minute pre-bookable, routine primary care appointments with a GP, providing they are already registered with a GP practice in the Gateshead area (total patient population of around 222,000).

There are certain exclusion criteria, where appointments cannot be offered:

• Routine reviews for patients with long term issues or chronic diseases.
• Patients with complex alcohol, substance or mental health issues, where the reason for

the appointment is directly related to their condition.

• Patients who require a fit note.
• Medication reviews or repeat medication requests.
• Patients who are housebound if the problem is unable to be dealt with remotely.
• Patients who have not agreed to ‘data sharing’, which would mean the service could not access their records.
• Patients on maggot therapy (a type of wound management treatment).

To book an appointment the patient must first contact their own GP practice, or 111 at the weekend. Staff will assess whether an appointment at an extra care facility is appropriate based on guidance and criteria issued by the provider. Patients are first given a nominal (am, pm or evening) time for an extra care clinician to call them, and then further booked in for a face to face appointment if required. Walk in appointments are not available and patients cannot book directly with the extra care services.

When patients attend the extra care facilities for an appointment, they are asked for consent to access their patient record.

Clinical services are provided by one clinical lead GP and three salaried GPs, and a further pool of almost 30 sessional GPs. This includes male and female GP’s. The service is located within two clinical rooms adjoined to the outpatients department of the Queen Elizabeth Gateshead hospital. This is temporary accommodation for the provider as a result of changes to resource allocation through the Covid-19 pandemic. Patients book in through the Urgent Treatment Centre reception in hours and the out of hours reception at other times. Patients are directed accordingly during their triage calls.

Administration, management and support functions are delivered by staff employed by the provider, and outside of normal working hours a further pool of sessional administrative staff. The provider also runs the local out of hours service, ‘GATDOC’, provides medicines optimisation services to some GP practices within the Gateshead area under the brand ‘Pharmicus’, and is part of the integrated urgent primary care service for the area.

Updated 10 June 2022

This service is rated as Good overall.

This was the service’s first inspection.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Extra Care Queen Elizabeth Hospital on 5 May 2022, as part of our inspection programme.

At this inspection we found:

• The service had systems to manage risk so that safety incidents were less likely to happen, however there were some gaps in the oversight of risks pertaining to the use of the hospital building.
• The service learned from incidents and used these to improve their processes.
• There were systems in place to safeguard children and vulnerable adults from abuse and staff we spoke with knew how to identify and report safeguarding concerns.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• There was a programme of quality improvement, including clinical audit.
• Staff involved and treated people with compassion, kindness, dignity and respect.
• Patients were able to access care and treatment from the service in an appropriate method within an appropriate timescale for their needs.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• Staff had the skills, knowledge and experience to deliver effective care.
• Leaders demonstrated they had the capacity and skills to deliver high-quality, sustainable care.
• Patient feedback about the service had been positive.

The areas where the provider should make improvements are:

• Continue to develop governance and oversight arrangements so that the provider can assure themselves fully that procedures and policies put in place by the hospital, in effect, the landlord, work properly.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care