Archived: Freeman Clinics Limited Also known as Ponteland Road Health Centre

Updated 20 October 2017

Freeman Clinics Limited provides care and treatment to around 3,100 patients. The practice is part of NHS Newcastle Gateshead clinical commission group (CCG) and operates on an Alternative Provider Medical Services (APMS) contract agreement for general practice.

The practice provides services from the following address, which we visited during this inspection:

• 169 Ponteland Road, Cowgate, Newcastle upon Tyne, NE3 5AE.

The Freeman Clinics is a limited company, which runs three GP practices in the Newcastle and North Tyneside areas. The company also holds the contract for the walk in centre at Ponteland Road Health Centre. The majority of the work of the walk in centre is sub contracted to an NHS Trust. However, the practice provides GP clinical support to the walk in centre.

During the inspection, the local Healthwatch and clinical commissioning group were holding a consultation on the future of the practice. The consultation related to the GP practice only, and did not include the walk in service on the same site. The consultation was due to run until early October 2017.

The practice is located in a purpose-built two storey building. There is a lift, on-site parking, disabled parking, a disabled WC, wheelchair and step-free access.

The practice has two salaried GPs (one female, one male), a pharmacist, a practice nurse (female), a healthcare assistant (female), a radiography assistant, a practice manager, an assistant practice manager and 13 staff who carry out reception or administrative duties.

Freeman Clinics Limited is open at the following times:

• Monday to Sunday 8am to 8pm.

Appointments are available at Freeman Clinics Limited at the following times:

• Monday to Friday 8.10am to 7pm
• Saturday and Sunday 8.10am to 8.30am, 11.00am to 11.20am, 1.20pm to 1.40pm then 3.55pm to 4.15pm.

The telephones are answered by the practice during their opening hours. The NHS 111 service and Vocare Limited, (which is locally known as Northern Doctors Urgent Care), provide the service for patients requiring urgent medical care out of hours.

Information from Public Health England placed the area in which the practice is located in the most deprived decile. In general, people living in more deprived areas tend to have greater need for health services. Average male life expectancy at the practice is 76.7 years, compared to the national average of 79.4 years. Average female life expectancy at the practice is 80 years, compared to the national average of 83.1 years.

Updated 20 October 2017

Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection on 6 October 2015 and announced focused inspection on 2 November 2016 at Freeman Clinics Limited.

At the inspection on 6 October 2015, we rated the practice as good. However, there was a breach of legal requirements. In particular, we found that the provider had not ensured they maintained appropriate records in relation to the management of the practice and that sufficient arrangements were in place to share learning and improve safety following significant events. After the comprehensive inspection, the practice wrote to us to say what they would do to meet the above regulation.

We carried out a focused inspection on 2 November 2016 to check whether the provider had taken steps to comply with the above legal requirement. We found they had complied with legal requirements; however, there were still areas were the practice should make further improvements. We told them they should continue to review their clinical staffing levels to enable sufficient and appropriate staff to be available to support the safe running of the practice. In addition, they should review their arrangements for the monitoring of staff training.

This inspection was an announced focused inspection, carried out on 30 August 2017, to check on the progress the practice had made with the improvements to maintain safe services. Overall the practice is rated as good.

You can read the report from our last comprehensive and focused inspections by selecting the ‘all reports’ link for Freeman Clinics Limited on our website at www.cqc.org.uk.

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

• The practice had continued to improve the process for recording significant events. They now recorded full details of the significant event when staff initially reported it.
• The practice had taken steps to address the areas we told them they should improve. The practice had improved the arrangements for the monitoring of staff training.
• Although the practice still had issues with GP clinical resources, they had taken reasonable and practical steps to address this and improve continuity of care.

There were areas where the provider needs to make improvements.

The provider should:

• Continue to monitor staffing levels.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 November 2015

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

The practice had planned for, and made arrangements to deliver, care and treatment to meet the needs of patients with long-term conditions. Patients with long-term conditions such as hypertension and diabetes were offered a structured annual review to check that their health and medication needs were being met, or more often where this was judged necessary by the GPs.

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. Patients were able to book in at a time to suit them for their recall appointments, rather than have to attend clinics at set times.

Nationally reported QOF data (2013/14) showed the practice had achieved good outcomes in relation to 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 epilepsy This was 9.3 percentage points above the local CCG average and 10.6 points above the national average.

Updated 19 November 2015

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 reviewed at monthly 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 local CCG area.

Pregnant women were able to access an antenatal clinic provided by healthcare staff attached to the practice. The practice had obtained 100% of the QOF points available to them for providing recommended maternity services and carrying out specified child health surveillance interventions. Cervical screening rates (90.9%) were well above the national average (81.9%).

Updated 19 November 2015

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 1.1 points above the local Clinical Commissioning Group (CCG) average and 2.9 points above the England average.

The practice offered personalised care to meet the needs of the older people in its population. The practice had written to patients over the age of 75 years to inform them who their named GP was. The practice was responsive to the needs of older people, and offered home visits for health checks and flu vaccinations. GPs had good links to the local care home and regularly visited patients living there.

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

Updated 19 November 2015

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 and flexible. The practice offered some online services as well as 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. The practice was open everyday between 8.00am and 8.00pm. These extended hours were particularly useful to patients with work commitments.

The practice provided additional services such as NHS health checks for the over 40s and travel vaccinations.

Updated 19 November 2015

The practice is rated as good for the care of 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.

Nationally reported QOF data (2013/14) showed the practice had achieved good outcomes in relation to patients experiencing poor mental health. For example, the practice had obtained 92.5% of the points available to them for providing recommended care and treatment for patients with poor mental health. This was in line with the local CCG average and 2.1 points above the England average. The practice kept a register of patients with mental health needs which was used to ensure they received relevant checks and tests.

Updated 19 November 2015

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. The practice offered longer appointments for people with a learning disability, 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.

The practice worked closely with a local carer’s service (Newcastle Carers) and a member of staff from the practice being nominated as the ‘carers champion’ within the practice.