Hetton Group Practice

Updated 10 December 2015

Hetton Group Practice is a large teaching practice providing care and treatment to 11503 patients of all ages, based on a General Medical Services (GMS) contract. The practice is based in a small town in the Coalfields area of Sunderland and is part of the NHS Sunderland Clinical Commissioning Group (CCG.) The Sunderland local authority area is significantly more deprived than the average for England and it is estimated that over 13,300 children are considered to be living in poverty. Other indicators show that in Sunderland the life expectancy for men and women is nearly respectively eleven and seven years below that of the England averages. The practice had a very low proportion of patients who were from ethnic minorities.

The Hetton Group Practice is located in a purpose built health centre and provides patients with fully accessible treatment and consultation rooms. The practice shares the building with other community health based services. Staff provide a range of services and clinics including, for example, services for patients with asthma, diabetes and coronary heart disease. It consists of eight GP partners (five male and three female), a practice manager, an office manager, two practice nurses, a triage nurse, two healthcare assistants, a pharmacy assistant and a team of administrative and reception staff. The practice also employed a female salaried GP and a GP registrar was on placement at the time of our visit.

The practice, which we visited as part of our inspection, is based at: Francis Way, Hetton-le-Hole, Houghton-le-Spring, Tyne and Wear. DH5 9EZ. The practice was open Monday to Friday between 8am and 6pm, and offered GP and nurse appointments from 8:30am until 5:40pm.

When the practice is closed patients can access out-of-hours care via the Northern Doctors Urgent Care service, and the NHS 111 service.

Updated 10 December 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Hetton Group Practice on 22 September 2015. 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;
• Risks to patients and staff were assessed and well managed;
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and responsibilities;
• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand;
• Patients said they were treated with compassion, dignity and respect and were involved in decisions about their care and treatment;
• The majority of patients who provided us with feedback did not raise any concerns over access to appointments. Results from the National GP Patient Survey of the practice showed that patient satisfaction with access to appointments, practice opening hours and appointment waiting times, was broadly in line with local Clinical Commissioning Group (CCG) and national averages. Staff continuously monitored the practice's appointment system to provide better responsiveness for their patients;
• There was a clear leadership structure and staff felt well-supported by the management team. Good governance arrangements were in place;
• Staff had a clear vision for the development of the practice and were committed to providing their patients with good quality care. This was demonstrated by the steps staff were taking to develop additional services to meet the needs of their patients.

However, there was an area of practice where the provider needs to make improvements. Importantly the provider should:

• The practice needs to assess and consider what emergency medications are appropriate for doctors to carry with them when carrying out routine home visits for use in acute situations.

We identified outstanding areas of practice:

• Staff had supported a local organisation (Sunderland People First) to carry out a check of how well their practice met the health needs of patients with learning disabilities. The practice had prepared an action plan to help address those areas where it had been identified that staff could make improvements. Staff had already taken action to implement their action plan and this had led to improvements in the services provided to patients with learning disabilities;

•  The practice offered a full range of immunisations for children who attended their child health and immunisation clinics. On the basis of the nationally reported data available to the Care Quality Commission (CQC), we saw that, where comparisons allowed, the delivery of the majority of childhood immunisations was mostly higher, when compared to the overall percentages for children receiving the same immunisations within the local CCG area.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 10 December 2015

The practice is rated as good for the care of people with long-term conditions. Effective systems were in place which ensured that patients with long-term conditions received an appropriate service which met their needs. Nationally reported data showed the practice had performed well, and obtained the maximum number of points, for providing recommended care and treatment for most of the clinical conditions commonly associated with this population group. Performance was above the local CCG and England averages in all areas. For example, the data showed the practice had achieved 100% of the total points available to them, for providing the recommended care and treatment to patients with rheumatoid arthritis. (This was 8.2% above the local CCG average and 7% above the England average.)

Updated 10 December 2015

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 who were at risk. For example, the practice maintained a register of vulnerable children and contacted families where a child had failed to attend a planned appointment. Where comparative data was available to us, this showed immunisation rates were relatively high for all standard childhood immunisations. Appointments were available outside of school hours and the practice premises were suitable for children and babies. There was a weekly midwife clinic, and a recall system in place to ensure that new mothers attended for postnatal and six-weekly checks. The practice offered contraceptive and sexual health advice, and staff were taking steps to provide an out-of-hours sexual health clinic for younger patients. The practice had completed a best practice self-review tool (You’re Welcome) to assess how accessible their services were to younger patients, and were waiting for an accreditation visit.

Updated 10 December 2015

The practice is rated as good for the care of older people. Staff offered proactive, personalised care which met the needs of these patients. The practice offered home visits and longer appointment times where this was needed by their older patients. Nationally reported data showed the practice had performed well in providing recommended care and treatment for most of the clinical conditions commonly associated with this population group. For example, the data showed the practice had achieved 100% of the total points available to them for providing the recommended care and treatment to patients with heart failure. (This was 1% above the local Clinical Commissioning Group (CCG) average and 2.9% above the England average.)

Updated 10 December 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). Staff were proactive in offering online services, as well as a full range of health promotion and screening that reflected the needs of this age group. Early and late appointments were offered, to make it easier for families and working-age patients to obtain convenient appointments. Nationally reported data showed staff were good at identifying patients who were at risk of developing long-term health conditions, such as coronary heart disease and hypertension.

Updated 10 December 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Nationally reported data showed the practice had achieved 100% of the total points available to them for providing recommended care and treatment to patients with mental health needs. (This achievement was 9.7% above the local CCG average and 9.6% above the England average.) Patients experiencing poor mental health were provided with advice about how to access various support groups and voluntary organisations, and were able to access in-house psychotherapy, as well as sessions run by MIND and Turning Point (organisations which provide help to patients experiencing mental health difficulties). Nationally reported data also showed the practice had achieved 100% of the total points available to them for providing recommended care and treatment to patients with dementia. (This achievement was 5% above the local CCG average and 6.6% above the England average.) Screening and assessment was offered to patients at risk of dementia.

Updated 10 December 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. Staff maintained a register of patients with learning disabilities and offered annual reviews to help them stay healthy. Staff had also supported a local organisation (Sunderland People First) to carry out a check of how well the practice met the health needs of patients with learning disabilities. The practice had prepared an action plan to help address those areas where it had been identified staff could make improvements. Staff had already taken action to implement their action plan and this had resulted in improvements to the services patients with learning disabilities received. Nationally reported data showed the practice had obtained 100% of the points available to them for providing recommended care and treatment to patients with learning disabilities. (This achievement was 19.4% above the local CCG average and 15.9% above the England average.) Systems were in place to protect vulnerable children. For example, staff ‘flagged’ the records of at-risk children, to identify when the practice had been contacted about these patients. Staff knew how to recognise signs of abuse in vulnerable adults and children. They understood their responsibilities regarding information sharing and the documentation of safeguarding concerns.