Dr Abbas Awad, Dr Bose Mohan, Dr Fazal Omer Also known as West View Millennium Surgery

Updated 7 July 2017

The West View Millennium Surgery, West View Road Hartlepool Cleveland, TS24 9LJ is situated to the north of Hartlepool town in an area of high deprivation. The practice provides services under a Personal Medical Services (PMS) contract with NHS England, North East Area Team. The practice list size of 6557 is predominantly white British background with a small number of patients from ethnic minorities.

The practice has three male GP partners and one salaried GP female. There are three practice nurses and one nurse practitioner. There is a practice manager and a team of secretarial, administration and reception staff.

The practice is open between 8.30am to 6pm Monday to Friday with the exception of Thursday when the practice opens between 8.30 and 5.30. The practice closes for lunch each day between 12- 1.30pm. There is a GP available to deal with any emergencies. Following patient feedback the practice will start to provide appointments from 8am on a Thursday from June 2017.

The practice score one on the deprivation measurement scale, which is the most deprived, the deprivation scale goes from one to ten, with one being the most deprived. People living in more deprived areas tend to have greater need for health services. The overall practice deprivation score is worse than the England average.

The practice, along with all other practices in the Hartlepool and Stockton CCG area have a contractual agreement for NHS 111 service to provide Out of Hours (OOHs) services from 6:30pm to 8am. The following organisations collectively provide urgent care services in the area North Tees and Hartlepool Foundation Trust, North East Ambulance Service and Hartlepool and Stockton Health (Federation) agreed with the NHS England area team. When the practice is closed, patients use the NHS 111 service to contact the OOHs provider. Information for patients requiring urgent medical attention out of hours is available in the waiting area, in the practice information leaflet and on the practice website and telephone answering machine.

Updated 7 July 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at West View Millennium Surgery on 24 May 2017. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events. All opportunities for learning from internal and external incidents were maximised.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said they found it easy to make an appointment with a named GP and there was continuity of care, 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 it acted on.

The provider was aware of the requirements of the duty of candour. The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment). Examples we reviewed showed the practice complied with these requirements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 July 2017

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

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.

• Nationally reported data for 2015/2016 showed that outcomes for patients with long term conditions were similar to the local CCG and national average. For example, the percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) was 5mmol/l or less was 82% compared to the national average of 80% and the CCG average of 83%.

• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.

• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.

All these patients had a named GP and there was a system to recall patients for 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

Updated 7 July 2017

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

• From the sample of documented examples we reviewed we found there were systems 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 accident and emergency (A&E) attendances.

• Immunisation rates were relatively low for all standard childhood immunisations. The practice is in a high deprivation area, they introduced a number of initiatives to improve uptake. The practice has a designated member of the administration team who leads on the call and recall of children who were due childhood immunisation. All children who are overdue immunisation have an alert posted on the front page of their medical records to alert staff if they contact or attend the practice.

• Patients told us, on the day of inspection, 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.

• The practice worked with midwives, health visitors and school nurses to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics and safeguarding meetings.

• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

Updated 7 July 2017

The practice is rated as good for the care of older people.

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs. The practice kept a register of house bound patients who were regularly reviewed and visited.

• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.

• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs. The practice have established a register of patients identified as at risk of admission. Following discharge from hospital, the practice reviews the patients’ needs and links with multidisciplinary teams, ensuring appropriate care planning and community services are in place to prevent further hospital admissions

• Where older patients had complex needs, the practice shared summary care records with local care services.Examples of these were working with other members of the primary healthcare team, including monthly meetings to discuss case management, including district nurses, Macmillan nurses and community matrons.

• All patients have a named GP, enabling the practice to focus on giving elderly people the care they need and prevent unnecessary admissions to hospital.All patients who are identified as being frail have a code in their medical records which prompts the clinicians during review. A register of these patients is kept including the severity of frailty.

• All clinicians have done an e-learning programme on Dementia and every patient over 75 years at review has an enquiry regarding memory and if concerns are identified referred for memory assessment.

The practice have identified and recorded carers details, ensuring they have consent where required to share information with the patient’s carer.

Updated 7 July 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 7 July 2017

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

• The practice carried out advance care planning for patients living with dementia.

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  The practice specifically considered the physical health needs of patients with poor mental health and dementia. People with a diagnosis of Dementia are invited for an annual review and signposted to appropriate services in the community and local support groups.

• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.

• Nationally reported data from 2015/2016 showed the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive care plan documented in their record, in the preceding 12 months was 96%. This was comparable to the local CCG average of 93% and above the national average of 89%.

• Children with Attention deficit hyperactivity disorder (ADHD) receiving medicines were offered 6 monthly reviews.

• Patients with drug and alcohol abuse problems were offered health assessments and referral for support if required to help with reducing their reliance on drugs and alcohol, the practice uses the Alcohol Use Disorders Identification Test (AUDIT) tool to help identify people at risk.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.

• Patients at risk of dementia were identified and offered an assessment.

• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 7 July 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 homeless people, and those with a learning disability.

• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.

• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.