The Densham Surgery

Updated 4 October 2016

The Densham Surgery is located in Stockton-on-Tees. It is part of the NHS Hartlepool and North Tees Clinical Commissioning Group. The total practice patient population is 4234. Housed in a purpose built health centre, the practice shares space with podiatrists, screening services and three other GP practices.

The proportion of the practice population in the 65 years and over age group is above the England average. The practice scored four on the deprivation measurement scale, the deprivation scale goes from one to ten, with one being the most deprived. The overall practice deprivation score is higher than the England average. People living in more deprived areas tend to have a greater need for health services.

The staff team comprises two GP partners, both female, and a female GP registrar. There are two practice nurses. The practice is managed and supported by a practice manager, administration, secretarial and reception staff. In total there are 14 staff, in addition to the GPs.

The practice is open Monday to Friday 8.30am until 6pm (excluding bank holidays). Appointments with GPs are offered between 8.30am and 11am, then 4pm to 5.30pm. The practice offers pre-bookable appointments where these are booked up to two weeks in advance. Urgent appointments are available daily for patients that need them. The practice telephones switch to the out-of-hours provider at 6pm each evening and at weekends and bank holidays. The practice is a training practice and often has GPs in training.

The practice has a General Medical Services contract with NHS England. They also provide some Directed Enhanced Services, for example they offer minor surgery and the childhood vaccination and immunisation scheme.

Updated 4 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Densham Surgery on 17 August 2016. 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.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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.

• 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 acted upon feedback from staff and patients.
• The provider was aware of and complied with the requirements of the duty of candour.

However there were areas of practice where the provider should make improvements:

• The provider should ensure telephone accessibility is improved, enabling patients to contact the practice.

• The provider should improve accessibility to routine appointments with a GP.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 4 October 2016

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

• Performance for diabetes related indicators was similar to the national average.

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

• Longer appointments and home visits were available when needed.

Patients with a long term condition had a named GP and a structured annual review to check their health and medicine 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 4 October 2016

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

• There were systems in place 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 A&E attendances. Uptake rates were high for all standard childhood immunisations.

• The practice had a system of follow up when it had been informed that a child had not attended an appointment with an external agency or alternative care provider.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 4 October 2016

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

• The practice demographic indicates a higher than average percentage of older people within its registered list.

• The practice worked closely with the community matron to support patients at home.

• As part of the unplanned admission scheme the practice offered same day telephone appointments with a GP to patients who are elderly or vulnerable.

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

Updated 4 October 2016

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. Some appointments were available outside of routine working hours.

• 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 4 October 2016

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

• Performance for mental health related indicators was similar to the national average.

  The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive care plan documented in the record, in the preceding 12 months was 95% which was around 2% higher than the CCG average and 7% higher than the national average.

• The percentage of patients diagnosed with dementia whose care has been reviewed in a face-to-face review in the preceding 12 months was 82% which was 5% below the CCG average and 2% below the national average.

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

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

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

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

  
  

Updated 4 October 2016

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

• The practice had a good general awareness of its vulnerable patients.

• 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 informed vulnerable patients about how to access various support groups and voluntary organisations, and there were posters about this in the waiting room.

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.