Archived: Collingwood Medical Group

Updated 6 April 2017

Collingwood Medical Group is registered with the Care Quality Commission to provide primary medical services. The practice provides services to around 4,700 patients from one location, we visited this address as part of the inspection:

• Collingwood Medical Group, Blyth Health Centre, Thoroton Street, Blyth, Northumberland, NE24 1DX.

As part of this inspection, we also visited Northumbria House, Cobalt Business Park, 7-8 Silverfox Way, North Shields, Tyne and Wear, NE27 0QJ, where the provider bases their central appointment system staff.

The provider of the service is Northumberland Primary Care Limited, a corporate provider of NHS primary care services that is in partnership with Northumbria Healthcare NHS Foundation Trust. It provides care and treatment to patients living in Blyth and the surrounding areas.

Collingwood Medical Group is situated in purpose-built premises, which also accommodates another GP practice and external services. The areas that patients need to access are all on the ground floor. All reception and consultation rooms are fully accessible for patients with mobility issues. An onsite car park is available which includes dedicated disabled parking bays.

The practice has an executive lead GP and four salaried GPs (two male, three female). One of the GPs is in the process of returning from maternity leave. The practice also employs: a specialist women’s health practitioner (female) who works one day a week; a clinical pharmacist; a nurse practitioner, a nurse and a medicines manager. They also employ a practice team lead, an administration lead, a reception team lead and three receptionists. A deputy group manager provides support for all of the practices in the group; they were based at the practice at the time of the inspection. A matron also provides support for all practices in the group. The practice provides services based on a General Medical Services (GMS) contract agreement for general practice.

Collingwood Medical Group is open at the following times:

• Monday to Friday 8am to 6:30pm.

The telephones are answered by the practice between 8am and 6pm. When the practice is closed patients are directed to the NHS 111 service. This information is also available on the practice’s website. The service for patients requiring urgent medical care out of hours is provided by the NHS 111 service and Vocare, which is locally known as Northern Doctors Urgent Care Limited.

Appointments are available at Collingwood Medical Group at the following times:

• Monday 8.20am to 11:40am then 1pm to 5.30pm.
• Tuesday 8.20am to 11:40am then 1pm to 5.30pm.
• Wednesday 8.20am to 12pm then 1pm to 5.30pm.
• Thursday 8.20am to 11:40am then 1pm to 5.30pm.
• Friday 8.30am to 11am then 3pm to 5.20pm.

Extended hours appointments are not currently available.

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 second most deprived decile. In general, people living in more deprived areas tend to have greater need for health services.

The proportion of patients with a long-standing health condition is above the national average (77% compared to the national average of 54%). The proportion of patients who are in paid work or full-time employment, or education, is below with the national average (47.3% compared to the national average of 62.5%). The proportion of patients who are unemployed is above the national average (8.3% compared to the national average of 4.4%).

Updated 6 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Collingwood Medical Group on 24 January 2017 and 4 February 2017. 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.
• 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.
• Some patients said they found it difficult to make a routine appointment with a GP. Urgent appointments were available on 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 at the practice. Staff told us that the last year had been stressful due to the large number of staff changes but that the deputy group managers supporting the practice had been very supportive.
• The practice had comprehensive policies and procedures governing their activities and there were good systems in place to monitor and improve quality.
• The practice proactively sought feedback from staff and patients, which it acted on.
• Information about services and how to complain was available on the practice website and easy to understand.
• The provider was aware of and complied with the requirements of the duty of candour regulation.

We saw one area of outstanding practice:

• The practice had introduced a weekly ward round at a local care home for patients with advanced dementia over three years ago. A lead GP visited the care home each Thursday morning. As part of these visits, care plans were reviewed and family members were able to speak to the GP if they wished too. The aim was to improve the care of patients who lived in care home and ensure continuity of care. The same GP visited these care homes each week and a buddy system was used to ensure continuity of care. Other practices in the group had adopted this approach. Feedback from the care home was very positive and they told us that families appreciated how easy it was to speak to a GP regularly.

The areas where the provider should make improvements are:

• Continue to monitor and review access to appointments and the telephone system currently in operation.
• Introduce a system to monitor the general cleaning at the practice.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 6 April 2017

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

• The practice nurses had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority and supported by the practice, comprehensive care plans were in place and regularly reviewed.
• Nationally reported data showed that outcomes for patients with conditions commonly found in this population group were good. For example, the practice had achieved 100% of the QOF points available for providing the recommended care and treatment for patients with diabetes. This was 4.2% above the local CCG average and 10.1% above the national average. The practice’s clinical exception rate for diabetes was 15%, which was above the national average of 11.6%.
• 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 practice held regular clinics for long term conditions and a musculoskeletal practitioner was available for two and a half days a week.

Updated 6 April 2017

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 multi-disciplinary 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 ranged from 87.3% to 100% (CCG average 93.6% to 98.6%) and for five year olds ranged from 85.2% to 98.4% (CCG average 91.9% to 98.7%).
• Urgent appointments for children were available on the same day.
• 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 above average. The practice had achieved 100% of the QOF points available for providing the recommended care and treatment for patients with asthma. This was 1.1% above the local CCG average and 2.6% above the national average.
• The practice employed a specialist women’s health practitioner, appointments were available one day a week.

Updated 6 April 2017

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. The practice worked to reduce the unplanned hospital admissions for patients over the age of 75.
• 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 the same as the local clinical commissioning group (CCG) average and 1.9% above the national average. The practice’s clinical exception rate for heart failure was 6%, which was below the national average of 9.2%. (Exception reporting is the removal of patients from QOF calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of side effects).

Updated 6 April 2017

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.
• Patients could order repeat prescriptions, book routine healthcare appointments and access their patient records online.
• Telephone appointments were available.
• The practice had a text message reminder service for appointments.
• The practice offered a full range of health promotion and screening which reflected the needs for this age group.
• The practice’s uptake for cervical screening was 85.3%, compared to the CCG average of 83.5% and the national average of 81.8%. The practice’s clinical exception rate for cervical screening was 15.9%, which was above the national average of 9.4%.
• Additional services such as new patient health checks and health checks for over 40’s were provided.
• Patients were able to receive travel vaccinations that were available on the NHS. The practice was also a designated yellow fever vaccination centre.
• The practice website provided a good range of health promotion advice and information.

Updated 6 April 2017

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

• The practice had identified 1.5% of their population with enduring mental health conditions on a patient register to enable them to plan and deliver relevant services. Seventy patients were on this register; of these 84% had had an annual review completed, and 36% had received an influenza vaccination (2015/2016 data).
• 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 3.7% above the local CCG average and 7.2% above the national average. The practice’s clinical exception rate for mental health was 8%, which was below the national average of 11.3%.
• Nationally reported data showed that outcomes for patients with dementia were above average. 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 3.4% above the national average. The exception reporting rate was 11% which was above the CCG average of 12.7%.
• The practice had introduced a weekly ward round at a local care home for patients with advanced dementia over three years ago. A lead GP visited the care home each Thursday morning. As part of these visits, care plans were reviewed and family members were able to speak to the GP if they wished too. The aim was to improve the care of patients who lived in care home and ensure continuity of care. The same GP visited these care homes each week and a buddy system was used to ensure continuity of care. Other practices in the group had adopted this approach.
• 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.
• Staff had a good understanding of how to support patients with mental health needs and dementia. Some staff at the practice had completed dementia awareness training.

Updated 6 April 2017

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 patients with a learning disability; patients with learning disabilities had been invited to the practice for an annual health check. Fifty-five patients were on this register, 56% had had an annual review and 40% had received an influenza vaccination (2015/2016 data).
• The practice offered longer appointments for patients with a learning disability if requested. Some staff at the practice had completed learning disability awareness training.
• 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 and a carers champion had just been appointed.