Archived: Colliery Medical Group

Updated 28 February 2017

Colliery Medical Group is registered with the Care Quality Commission (CQC) to provide primary medical services.The practice is located in the Silksworth area of Sunderland.

The practice provides services to around 5,200 patients from one location: Silksworth Health Centre, Silksworth, Sunderland, Tyne and Wear, SR3 2AN. We visited this address as part of the inspection.

The practice has two GP partners, one male and one female, both work full time, the whole time equivalent (WTE) of GPs is two. There are two practice nurses who are part-time (nursing WTE 1.62). There is a practice manager and and eight staff who carry out reception and administrative duties. One of the GPs, who is also a partner had not yet submitted a CQC application to join the partnership. The practice manager said they were aware of this and it was going to be addressed as asoon as possible.

The practice is part of Sunderland clinical commissioning group (CCG). Information taken from Public Health England placed the area in which the practice was located in the fifth more deprived decile. In general, people living in more deprived areas tend to have greater need for health services.

The practice is located in a purpose built two storey building. All patient facilities are on the ground floor. There is on-site parking, disabled parking, a disabled WC, wheelchair and step-free access. Opening hours are between 8am and 6pm Monday to Thursday and between 8.15am and 6pm on Fridays. Patients can book appointments in person, on-line or by telephone. Appointments were available between 8.30am to 11.30am; then from 3pm to 5.30pm. The practice holds an open surgery every Monday morning.

Patients are also able to access services at a local health centre between 6pm and 8pm on weekdays.

The practice provides services to patients of all ages based on a Personal Medical Services (PMS) contract agreement for general practice.

The service for patients requiring urgent medical attention out-of-hours is provided by the NHS 111 service and Vocare (known locally as Northern Doctors Urgent Care).    

Updated 28 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Colliery Medical Group on 5 January 2016, which resulted in the practice being rated as good overall but as requiring improvement for providing effective services and for the population group of people experiencing poor mental health (including people with dementia). The full comprehensive report can be found by selecting the ‘all reports’ link for Colliery Medical Group on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 19 January 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulation that we identified in our previous inspection in January 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

The practice is rated as good overall; including for providing effective services and for the population group of people experiencing poor mental health (including people with dementia).

Our key findings were as follows:

• Staff had received appropriate training.
• The practice had taken steps to to develop a programme of clinical audit.
• Action had been taken to improve the monitoring of the delivery of recommended care and treatment for patients experiencing poor mental health.
• The practice had improved on their Quality and Outcomes Framework (QOF) score compared to the previous year.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 February 2017

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

Longer appointments and home visits were available when needed. The practice’s electronic system was used to flag when patients were due for review. This helped to ensure the staff with responsibility for inviting people in for review managed this effectively. For those people with the most complex needs, GPs

worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Nationally reported QOF data (2015/16) showed the practice had achieved good outcomes in relation to some of the conditions commonly associated with this population group. For example, the practice had obtained 100% of the points available to them for providing recommended care and treatment for patients with asthma. This was above the local CCG average of 96.1% and the England average of 97.4%. However, performance in relation to diabetes was below average; the practice achieved 82.4% of the points available compared to 92.8% locally and 89.8% nationally, this had improved from 79.1% at our previous inspection in January 2016.

Updated 28 February 2017

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. 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 multidisciplinary 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. Arrangements had been made for new babies to receive the immunisations they needed. Vaccination rates for 12 month and 24 month old babies and five year old children were in line with the national averages. For example, childhood immunisation rates for the vaccinations given to under two year olds ranged from 96.3% to 100% and five year olds from 93.5% to 97.8%. The practice’s uptake for the cervical screening programme was 80.3%, which was slightly below the CCG average of 81.4% and the national average of 81.4%.

Pregnant women were able to access an antenatal clinic provided by healthcare staff attached to the practice.

Updated 28 February 2017

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 above the local clinical commissioning group (CCG) average of 99.4% and the England average of 98.1%.

The practice offered proactive, personalised care to meet the needs of the older people in its population. For example, all patients over the age of 75 had a named GP and patients at high risk of hospital

admission and those in vulnerable circumstances had care plans.

The practice maintained a palliative care register and offered immunisations for pneumonia and shingles to older people.

Updated 28 February 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 met. The practice was open between 8am and 6pm Monday to Thursday and between 8.15am and 6pm on Fridays.

Appointments were available between 8.30am to 11.30am; then from 3pm to 5.30pm. The practice held an open surgery every Monday morning.

The practice had previously offered extended hours surgeries; this had been temporarily suspended until a third doctor was recruited. However, patients were still able to access GP services at a local health centre between 6pm and 8pm each weekday.

The practice offered a full range of health promotion and screening which reflected the needs for this age group. Patients could order repeat prescriptions and book appointments on-line.

Updated 28 February 2017

At our previous inspection in January 2016, we rated the practice as requires improvement for the population group, people experiencing poor mental health (including people with dementia) as improvements needed to be made to the monitoring of this group of aptients.

These arrangements had improved when we undertook this follow up inspection in January 2017. The practice is now rated as good for the population group, 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. Care plans were in place for patients with dementia. Patients experiencing poor mental health were sign posted to various support groups and third sector organisations.The practice kept a register of patients with mental health needs which was used to ensure they received relevant checks and tests.

Nationally reported QOF data (2015/16) showed the practice had achieved 75.5% of the QOF points available to them for providing recommended care and treatment for patients with poor mental health, compared to 92.9% nationally, this had improved from 50% in the 2014/15 year. For example, the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses, who had a comprehensive, agreed care plan documented in their record, was 79.3%, compared to the national average of 88.8%. This had improved from 46.7% in the preceeding year. The practice had achieved maximum points (100%) for the clinical domain indicator group of dementia which had improved from 88% in the preceeeding year.

Updated 28 February 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 those with a learning disability. Patients with learning disabilities were invited to attend the practice for annual health checks. Longer appointments for people with a learning disability were available, if required.

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.

Good arrangements were in place to support patients who were carers. The practice had systems in place for identifying carers and ensuring that they were offered a health check and referred for a carer’s assessment. The practice had recently signed up to a local ‘Safe Place’ scheme, which gave vulnerable people a short term ‘safe place’ to go if they were feeling threatened when out and about in the local community.