Bishopgate Medical Centre

Updated 11 May 2016

Bishopgate Medical Centre is situated in the centre of Bishop Auckland and provides services under a General Medical Services contract with NHS England, to the practice population of 13,792, covering patients of all ages.

The practice has four GP partners and six salaried GP’S, five male and five female GPs. There are two advanced nurse practitioners and seven practice nurses, three health care assistants and a phlebotomist. There is a practice manager, an assistant practice manager, a finance manager and a team of secretarial, administration and reception staff.

The practice is open between 8.00am to 6.00pm Monday to Friday. The practice is also open on Saturday morning between 8.00am to 12 noon (this is not every Saturday; dates are available on the practices’ website). The practice has opted out of providing out of hours services (OOHs) for their patients. When the practice is closed patients use the 111 service to contact the OOHs provider. Information for patients requiring urgent medical attention out of hours is available in the waiting area, in the practice information leaflet and on the practice website.

The practice scored two 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 lower than the England average. People living in more deprived areas tend to have greater need for health services.

Updated 11 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bishopgate Practice on 30 November 2015. 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 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.

We saw some areas of outstanding practice:

There is a strong visible, person-centred culture. Relationships between people who use the service, those close to them and staff are strong, caring and supportive.

The practice employed their own mental health care worker who triaged all mental health referral. They also had access to three in-house counsellors.

The practice had been accredited with the Young Carers Charter. The practice had signed up to a list of pledges, developed a dedicated policy to help young carers and their families.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 May 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. There were two chronic long term condition (LTC) nurses, both of whom could initiate insulin therapy.

• Nationally reported data for 2014/2015 showed that outcomes for patients with long term conditions were good. For example, performance for patient with hypertension was 100%; this was 0.8% above the local CCG Average and 2.2% above the national average.

• Longer appointments and home visits were available when needed.

• All patients with a LTC 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.

• People with long term conditions were monitored and discussed at multi-disciplinary clinical meetings so the practice was able to respond to their changing needs. Outcomes were monitored through clinical audits. Nurses and GPs worked collaboratively.

• There was a weekly onsite anti coagulation clinic which was run by the neighbouring pharmacy. The clinic provided a service to help patients manage their warfarin without having to attend hospital.

Updated 11 May 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.

• Nationally reported data for 2014/2015 showed the percentage of patients with asthma who had had an asthma review in the preceding 12 months that included an assessment of asthma control was 83.5%.This was 6.6% below the local CCG average and 2.6% below the national average.

• Children’s asthma management plan and personal action plans had been introduced.

• 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.

• National reported data from 2014/2015 showed the practices’ update for cervical screening was 100%.This was 0.5% above the local CCG average and 2.4% above the national average.

• 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.

• The practice had been accredited with the Young Carers Charter. The practice had signed up to a list of pledges, developed a dedicated policy to help young carers and their families. They made good information readily available throughout the surgery, recognising the need to maintain privacy and confidentiality.

Updated 11 May 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 offered a ‘one stop shop’ approach to appointments and clinics, which reduced the need for older patients from having to make repeated journeys to the practice.

• Home visits were conducted earlier in the day by a duty doctor, rather than the patient having to wait until later in the afternoon for their visit.

• The practice was part of the Vulnerable Adults Wrap Around Service. This was a service provided to vulnerable patients living in residential units, the housebound or those at high risk of admission. They were cared for by a GP in conjunction with Advanced Nurse Practitioners and district nurses. This was a Federation initiative through the CCG to ensure the needs assessment of vulnerable patients remained up to date.

Updated 11 May 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 reflected the needs for this age group.

Updated 11 May 2016

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

• Nationally reported data for 2014/2015 showed 93.2 of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months. This was 10.2% above the local CCG average and 9.2% above the national average

• 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 advanced care planning for patients with dementia.

• The practice had been actively involved in supporting the local community to become a dementia friendly town.

• 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.

• The practice employed their own mental health worker who worked two days per week and had access to three counsellors.

Updated 11 May 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 homeless people, travellers and 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.