Queens Park Medical Centre

Updated 25 February 2016

Queens Park Surgery is near the centre of Stockton and has a mixed client group. There are 19,666 patients on the practice list. There are a higher proportion of patients over the age of 65 on the patient list compared to the practice average across England.

There are 12 GP partners’, six (female), and six (male). Seven practice nurses and seven health care assistants (all female), two of the nurses are nurse prescribers all are female. There is a practice manager who is supported by reception, medicines management, secretarial and other administration staff.

The practice is training and a teaching practice (Teaching practices take medical students and training practices have GP trainees and F2 doctors).There was one GP registrar at the time of the inspection, however there are normally two at any one time.

The practice is open from 8.30am to 6pm, Monday to Friday. The practice does not provide extended hours. We saw that appointments can be booked by walking into the practice, by the telephone and on line. The practice did not use a telephone triage system. However telephone slots where patients requested a call back from the GP or nurse were booked at the end of each surgery. Patients requiring a GP outside of normal working hours are advised to contact the GP out of hour’s service provided by Northern doctors via the NHS 111 service. The practice has a General Medical Service (GMS) contract. The practice is close to the town centre and there is parking available at the practice and nearby. There are good transport links near and access to public transport.

Updated 25 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Queens Park Surgery on 16 December 2015. Overall the practice is rated as good. Specifically, we found the practice to be outstanding for providing caring services. We found the practice to be good for offering safe, effective, and responsive and well led services.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that 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 and complied with the requirements of the Duty of Candour. This means providers must be open and transparent with service users about their care and treatment, including when it goes wrong.

We saw several areas of outstanding practice including:

• The practice offered a clinic for complex leg ulcers which was delivered by nurses who had undertaken further training to deliver this service. The practice had also adapted a treatment room to meet the needs of this patient group. The scheme was started in the practice for a range of reasons. There was a lack of a local accessible service in the community and patients were required to travel to the local acute hospital. The service provided care closer to home and meant patients had a reduced traveling time. In a six month period the average number of patients using the service was 174.

• The GP partners held a personal patient list, which meant the GPs always saw their own patients. The exception would be such things as when a GP was on annual leave. When the GP was not available another GP provided buddy cover. These meant patients were seen by their named GPs or the buddy even when requesting an emergency appointment. In addition there were direct phone lines which were always manned by the receptionists attached to the particular GP. This enabled good relationships to be built between the patient, the GP and the receptionists. The staff were also able to build up a good knowledge of their patients and their families. The system meant patients although part of large practice were familiar with their named clinicians. The practice had a reduced rate of patients using Accident and Emergency or requiring home visits. Patients were positive about this system and were complementary about the named receptionist.

• The practice gathered feedback from all staff on a monthly basis which they used to improve services in the practice. The staff feedback forms were attached to the staffs pay slip. The staff completed the forms and returned them to the manager. The feedback has led to minor improvements such as extra toasters for the staff to the appointment of additional staff and providing support services for staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 February 2016

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

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

• The proportion of patients on the diabetes register with a record of foot examinations in the preceding 12 months was 92% which is above the national average of 88%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and 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.

• The practice provided a dressing clinic for patients with advanced leg ulcers which meant care was provided close to home. This service was funded by the practice to meet the needs of their patients.

• Patients were given hand held care plans agreed between nurse and patient.

Updated 25 February 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. Immunisation rates were relatively high for all standard childhood immunisations.

• 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.

• The proportion of women aged 24 -64 who had been cervical screening performed was 80.9% which was comparable with the national average of 81%.

• 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 25 February 2016

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

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

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. The practice provided input into local care homes regularly working at a weekend to visit homes.

• Every patient over 75 had a named GP.

• Patients who were carers were identified and added to the carers’ register. Information about support groups and useful contact details was provided. The practice offered longer appointments for older people and those with long term conditions.

Updated 25 February 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 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. The practice offered text reminders for appointments.

Updated 25 February 2016

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

• 88% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is above the national average of 84%.

• The proportion of patients with mental illness and other psychoses who had had a comprehensive agreed care plan documentsin the last 12 months was 98% compared with the national average of 86%.

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

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

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. The practice provided services in the practice such as cognitive behaviour therapy and counsellors.

• 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 25 February 2016

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.

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

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• 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.