Archived: Sunderland GP Alliance - Barmston Medical Centre

Updated 30 November 2017

Sunderland GP Alliance is registered with the Care Quality Commission to provide primary care services. The practice provides services to around 13,500 patients from three locations and we visited these addresses as part of the inspection.

• The Galleries Health Centre, Washington, Tyne and Wear, NE38 7NQ
• Barmston Medical Centre, Westerhope Road, Washington, Tyne and Wear, NE38 8JF
• Pennywell Medical Centre, Portsmouth Road, Sunderland, Tyne and Wear, SR4 9AS

The three locations were previously separate GP practices. They were merged under one contact from 1 October 2016. The provider of the service is a limited company of local GP providers, Sunderland GP Alliance. The board of six directors is made up of four GPs, one practice manager and one nurse; they serve a four year term on the board of directors. The patients can now access care at any of the surgeries.

The Galleries Health Centre is situated in purpose-built premises in Washington; the health centre is shared with other primary medical and secondary services. All reception and consultation rooms are fully accessible for patients with mobility issues. There is car parking available in the nearby shopping centre and there are dedicated disabled parking bays on the ground floor of the building. There is a lift to access the higher floors.

Barmston Medical Centre is a purpose built premises, there are patient facilities on the ground floor and there are disabled parking spaces in the patient car park, with wheelchair and step free access.

Pennywell Medical Centre is based in purpose built premises that are shared with external community services. All reception and consultation rooms are fully accessible and on one level. There is on-site parking and disabled parking. A disabled WC is available.

The practice has two lead GPs who work 14 sessions per week between them, six salaried GPs who work 19 sessions per week between them and two long term locum GPs who work 6 sessions per week (Five GPs are female and three male). There are four advanced nurse practitioners (whole time equivalent WTE 3.41), two practice nurses (WTE 1.49), three career start practice nurses (WTE 2.6) and four healthcare assistants (WTE 3.24). Career start nurses are first level registered nurses, the career start scheme assists them in their career in practice nursing. There are full time business and practice managers. There are 15 (WTE 11.64) staff who undertake administration duties.

The three locations are open Monday to Friday 8am to 6.30pm, with The Galleries surgery open from 7am on Wednesday mornings.

GP appointments are available from 8am until 11am and 2pm until 5pm. There is an on call GP every day from 9.30am until 6.30pm.

The provider is also part of a federation of GP practices in the Sunderland area who work together to provide appointments with GPs, nurses or health care assistants outside of their normal working hours. This meant the practice were able to provide early morning, late evening, weekend and bank holiday appointments. Patients could contact the practice reception team to arrange these appointments.

The telephones are answered by the practice during their opening times. When the practice is closed patients are directed to the NHS 111 service. This information is also available on the practice website and in the practice leaflet.

The practice is part of NHS Sunderland clinical commission group (CCG). The practice provides services based on an Alternative Provider Medical Services (APMS) contract agreement for general practice.

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.

Updated 30 November 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Sunderland GP Alliance - The Galleries

17 October 2017. Overall the practice is rated as requires improvement.

• Staff understood and fulfilled their responsibilities to raise concerns, and report incidents and near misses.
• Data from the Quality and Outcomes Framework (QOF) for 2016/17 showed that patient outcomes were below average at 91.7% when compared to local and national averages.
• Staff were consistent and proactive in supporting patients to live healthier lives through a targeted approach to health promotion.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.
• The practice was aware of and complied with the requirements of the duty of candour.

The areas where the practice must make improvements are;

• Ensure care and treatment is provided in a safe way to patients (See Requirement Notice Section at the end of this report for further detail).

The areas where the provider should make improvements are:

• Continue to improve the system for management of chronic disease and medication reviews.
• Continue to improve the patient experience in relation to making appointments, in line with the practice action plan.
• Obtain records of staff immunisations, where necessary, for existing staff.
• Monitor the frequency of the cleaning of curtains in treatments rooms.
• Develop and review the carers register.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 30 November 2017

The practice is rated as requires improvement for the care of patients with long-term conditions.

There were chronic disease registers in place; however they were not up to date. With the help of the IT team at the practice they were working through the lists to ensure that all patients received a review at least once yearly in their birth month. Similarly a new system for medication reviews had been set up.

Data the practice provided us with showed the practice had low scores in diabetes (79%) and chronic obstructive pulmonary disease (COPD) 79%, these were less than the national and local averages which were; diabetes national average 91%, local average 92.8%. COPD national average 96.1%, local average 96.6%.The practice had arranged extra training for nurses in these areas to improve the care for patients with chronic conditions. However the score for hypertension was 100% and asthma was 97%.

Updated 30 November 2017

The practice is rated as requires improvement for the care of families, children and young people. This is because the practice is rated as requires improvement for providing safe, effective, caring and responsive services.

The practice had identified the needs of families, children and young people, and put plans in place to meet them. Staff had received safeguarding training and there were practice leads for safeguarding adults and children.

Appointments were available outside of school hours and the premises were suitable for children and babies. Patients were able to access out of hours appointments from the local GP federation of practices in the area with GPs, nurses or health care assistants outside of their normal working hours. This meant the practice were able to provide early morning, late evening, weekend and bank holiday appointments.

Childhood immunisation rates for the vaccinations given were in line with CCG/national averages. For example, childhood immunisation rates for the vaccinations given to five year olds were at 90%, compared to CCG averages of 92% to 100%. Pregnant women were able to access an antenatal clinic provided by healthcare staff attached to the practice. 

Updated 30 November 2017

The practice is rated as requires improvement for the care of older people. This is because the practice is rated as requires improvement for providing safe, effective, caring and responsive services.

The practice offered proactive care to meet the needs of the older people in its population. Older people had a named GP. Data from Quality and Outcomes Framework (QOF) which the practice provided us with showed they had good outcomes for conditions commonly found amongst older people. For example, the practice had obtained 98% of the points available to them for providing recommended care and treatment for patients with heart failure.

There were care plans in place for 1.7% of the practice population, including older people, via the local unplanned admissions service.

The practice maintained a palliative care register. They offered immunisations against pneumonia and shingles to older people and in their own home where necessary. Health checks were offered to all patients over the age of 75. Prescriptions could be sent to any local pharmacy electronically. 

Updated 30 November 2017

The practice is rated as requires improvement for the care of working-age people (including those recently retired and students). This is because the practice is rated as requires improvement for providing safe, effective, caring and responsive services.

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 and routine healthcare appointments online. Telephone consultations were available. 

The practice offered health promotion and screening, they had access to appropriate health assessments and checks, which included exercise and dietary advice and a smoking cessation programme. The practice’s uptake for cervical screening was 77%, which is below the national average of 81%. 

Updated 30 November 2017

The practice is rated as requires improvement for the care of people experiencing poor mental health (including people with dementia). This is because the practice is rated as requires improvement for providing safe, effective, caring and responsive services.

Data the practice provided us with showed their scores for mental health, they were low compared to national and local averages. They were mental health were 85%, depression 88% and for dementia 88%.

The practice maintained a register of patients experiencing poor mental health and dementia and recalled them for regular reviews. There were care plans in place for those with dementia and staff had received dementia awareness training. Patients were advised how to access various support groups and voluntary organisations. Where appropriate patients with complex conditions were discussed  at their MDT meetings.

Updated 30 November 2017

The practice is rated as requires improvement for the care of people whose circumstances may make them vulnerable.

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.

The practice had a learning disabilities register of 84 patients and a lead nurse in place to manage this. They had worked with outside agencies to bring the register up to date.

The practice had 121 carers registered on their system which was less than 1% of the overall practice population. Similarly, the practice were aware that they needed to do more work around the identification of carers. There was written information available for carers to help them understand the various avenues of support available to them in the practice waiting room.