Bankhouse Surgery

Updated 12 August 2016

Bankhouse Surgery One Life Hartlepool, Park Road, Hartlepool, Cleveland is also known as Dr Smith & Partners. The practice is situated in Hartlepool Town centre in a purpose built centre providing other health services. There is parking available near the practice. Many of the patients live within walking distance of the practice and there is good access to public transport. There is a mixed client group predominantly from the surrounding area. There are 9800 patients on the practice list. The practice scored three on the deprivation measurement scale, the deprivation scale goes from one to ten, with one being the most deprived. People living in more deprived areas tend to have a greater need for health services.

There are five GPs, two female and three male. The practice also employs a salaried GP (male). There are three practice nurses and one health care assistant (HCA) (all female). There is a practice manager and an assistant practice manager.

The practice is training and a teaching practice (Teaching practices take medical students and training practices have GP trainees and F2 doctors). The practice also provides support for GP registrars. Pharmacy and nursing students are also allocated to the practice.

The practice is open from 8am to 6pm, Monday to Friday. The practice provides some extended hours on a Saturday morning between 8am and 12pm. Appointments can be booked by walking into the practice, by the telephone and on line. Patients requiring a GP outside of normal working hours are advised to contact the GP out of hours service provided by Northern Doctors via the NHS 111 service. The practice holds a General Medical Service (GMS) contract.

Updated 12 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bankhouse surgery on 21 June 2016. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• 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 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.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns. The practice promoted a no blame culture and encouraged staff to raise concerns and possible risks.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• Feedback from patients about their care was consistently positive.
• 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.
• We saw that the practice had a dedicated member of staff who was a carer’s champion/co-ordinator who liaised between the surgery, carers and Hartlepool carers group. The member of staff had a good knowledge of the services available locally for carers and promoted awareness of carers in the practice. There was a weekly drop in to the practice from Hartlepool carers.
• The provider was aware of and complied with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with care and treatment).

The practice should:

• Ensure that the performers list assurance checks, indemnity, revalidation and safeguarding training were checked when employing locum doctors.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 August 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.

• Nationally reported data for 2014/2015 showed that outcomes for patients with long term conditions were good. For example, the percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) was 5mmol/l or less was 80%. This was 3% below the local CCG average and the same as the England average.

• 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 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. There was a daily on-call GP available to deal with urgent queries and urgent home visits.

• The practice promoted self-management for some long term conditions.

• The practice was involved in the healthy lung and healthy heart checks.

Updated 12 August 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 practice held weekly clinical forum meetings attended by the practice leads and clinicians where they reviewed child safeguarding and discussed those children who did not attend pre-booked hospital appointments, GP or immunisation appointments.

• Nationally reported data from 2014/2015 showed the practice’s uptake for the cervical screening programme was 87%. This was above the local CCG average which was 83% and the England 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 health visitors and school nurses.

Young people were able to access contraception and screening for sexually transmitted diseases (STD).

Updated 12 August 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. Patients over the age of 75 had a named GP and nurse led annual reviews. The practice offered 20 minute appointments annually.

• Regular patient summaries were supplied to the nursing homes to aid the GP visits and urgent care as part of the avoiding unplanned admissions.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice was delivering ‘The Care Home Scheme’ locally. This scheme ensured patients living in care homes had structured annual reviews. The practice was allocated two nursing homes that were visited on a weekly basis. The practice had completed Care Plans for all residential home patients which were regularly reviewed.

• The practice had identified and reviewed the care of those patients at highest risk of admission to hospital. These patients who had an unplanned admission or presented at Accident and Emergency (A&E) had their care plan reviewed and patients were contacted within three days of hospital discharge. All discharges were reviewed to identify areas for improvement.

• Patients at high risk of admission were provided with an emergency contact number for the practice to avoid a busy switchboard.

Updated 12 August 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 provided Saturday morning appointments which offered a range of services such as contraception, smears, and dressings as well as GP appointments.

Updated 12 August 2016

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

• Nationally reported data from 2014/2015 showed the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive care plan documented in their record in the preceding 12 months was 100%, which was comparable to other practices and above 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 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 had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Patients on medicines requiring regular monitoring and who shared care with mental health services were monitored regularly in the practice. Those patients with complex problems were reviewed regularly at multi-disciplinary meetings held in the practice.

Updated 12 August 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 and provided a supportive and non-judgemental approach. Examples of these patient groups were drug and alcohol and learning disability were there were same day appointments available for those in crisis.

• The practice offered longer appointments for patients with a learning disability. Annual reviews for this group were monitored by the practice. The practice had  appointed two named GPs to lead in this area.

The practice regularly worked with other health care professionals in the case management of vulnerable patients. 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.