Houghton Medical Group

Updated 25 February 2016

The practice is located in the Houghton–le-Spring area of Tyne and Wear to the South of the River Wear. The practice provides care and treatment to 7,808 patients from Houghton-le Spring, Fencehouse, Chilton Moor and the surrounding areas. It is part of the NHS Sunderland Clinical Commissioning Group (CCG) and operates on a General Medical Services (GMS) contract.

The practice provides services from the following address, which we visited during this inspection:

Houghton Medical Group, Houghton Health Centre, Church Street, Houghton-le-Spring, Tyne and Wear, DH4 4DN

The practice is located in a modern purpose built two storey building which was erected in 1977. The premises are shared with another GP practice, a chiropodist, a dentist, district nurses and social workers. All reception and consultation rooms are on the ground floor and fully accessible for patients with mobility issues. On-site parking is available, which includes dedicated disabled parking bays.

The practice opening and appointment time are as follows:

Monday 7.30am to 6pm – appointments with a GP available from 7.30am to 5.10pm and with a nurse from 7.30am to 5.45pm

Tuesday 7.30am to 6pm – appointments with a GP available from 7.30am to 5.10pm and with a nurse from 8.30am to 5.45pm

Wednesday 7.30am to 6pm – appointments with a GP available from 7.30am to 5.10pm and with a nurse from 7.30am to 5.15pm

Thursday 8.30am to 6pm – appointments with a GP available from 8.30am to 4.50pm and with a nurse from 8.30am to 5pm

Friday 8am to 6pm – appointments with a GP available from 8.30am to 5.10pm and with a nurse from 8am to 5pm

The service for patients requiring urgent medical attention out-of-hours is provided by the NHS 111 service and Northern Doctors Urgent Care Limited (NDUC).

Houghton Medical Group offers a range of services and clinic appointments including chronic disease management clinics, antenatal clinics, new patient health checks, childhood immunisations, cervical screening, travel advice, contraception and minor surgery. The practice consists of:

• Six GP partners (five female and one male)
• Two practice nurses (both female)h
• A practice manager and assistant practice manager
• Ten administrative/reception staff

The area in which the practice is located is in the fourth (out of ten) most deprived decile. In general people living in more deprived areas tend to have greater need for health services.

The practice’s age distribution profile showed slightly more patients than the national average in the 65-84 year age group. All other age groups were comparable to the national average. Average life expectancy for the male practice population was 77 (national average 79) and for the female population 80 (national average 83).

Updated 25 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Houghton Medical Group on 5 January 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 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.
• The practice had recently reviewed and changed their appointment system and were monitoring its effectiveness. Urgent appointments were 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.

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 patients with long-term conditions.

Longer appointments and home visits were available when needed. The practice’s electronic system was used to flag when patients were due for review. This helped to ensure the staff with responsibility for inviting people in for review managed this effectively. For those people with the most complex needs, GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Practice nurses were supported in undertaking additional training to help them understand and care for patients with certain long term conditions, such as diabetes.

Nationally reported Quality and Outcomes Framework (QOF) data (2014/15) showed the practice had achieved good outcomes in relation to some of the conditions commonly associated with this population group. For example, the practice had obtained 100% of the points available to them for providing recommended care and treatment for patients with asthma compared with the local CCG average of 97.1% and national average of 97.4%.

The practice offered smoking cessation and weight management advice and support.

Updated 25 February 2016

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

The practice had identified the needs of families, children and young people, and put plans in place to meet them. There were processes in place for the regular assessment of children’s development. This included the early identification of problems and the timely follow up of these. Systems were in place for identifying and following-up children who were considered to be at-risk of harm or neglect. For example, the needs of all at-risk children were regularly reviewed at practice multidisciplinary meetings involving child care professionals such as health visitors.

Appointments were available outside of school hours and the premises were suitable for children and babies. Arrangements had been made for new babies to receive the immunisations they needed. Vaccination rates for 12 month and 24 month old babies and five year old children were in line with or above the national averages. For example, childhood immunisation rates for the vaccinations given to two year olds ranged from 95.1% to 100% (compared with the CCG range of 96.6% to 100%). For five year olds this ranged from 95.3% to 100% (compared to CCG range of 31.6% to 98.9%).

The practice’s uptake for the cervical screening programme was 79.4%, which was higher than the clinical commissioning group (CCG) average of 77.2% and national average of 74.3%.

Pregnant women were able to access an antenatal clinic provided by healthcare staff attached to the practice.

The practice had obtained the ‘You’re Welcome’ accreditation to ensure their services were accessible to children and young people and met their needs. There was a separate youth section on the practice website containing relevant health information. The practice was also participating in locality projects around childhood obesity and teenage sexual health.

The practice was proactive in ensuring that medication reviews were carried out regularly in respect of any child under the age of 16 to ensure they were taking the correct dose of medicine regularly.

Updated 25 February 2016

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

Nationally reported data showed the practice had good outcomes for conditions commonly found amongst older people. For example, the practice had obtained 100% of the points available to them for providing recommended care and treatment for patients with heart failure. This was above the local clinical commissioning group (CCG) average of 98.7% and the England average of 97.9%.

The practice offered proactive, personalised care to meet the needs of the older people in its population. For example, all patients over the age of 75 had a named GP and patients at high risk of hospital admission and those in vulnerable circumstances had comprehensive care plans.

The practice maintained a palliative care register and held open days to administer flu vaccinations.

The practice held multi-disciplinary unique care meetings to discuss vulnerable patients and those with complex long term conditions with a view to avoiding admission to hospital.

The practice was also participating in a local care homes integrated teams project to improve services and support available for older people.

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 met. The practice was open from 7.30am to 6pm on a Monday, Tuesday and Wednesday (GP appointments available from 7.30am to 5.10pm), from 8.30am to 6pm on a Thursday (GP appointments available from 8.30am to 4.50pm) and from 8am to 6pm on a Friday (GP appointments from 8am to 5.10pm). Early morning nurse appointments were also available on Mondays and Wednesdays.

The practice was proactive in offering online services as well as a full range of health promotion and screening which reflected the needs for this age group. The practice also a text message appointment reminder service and travel vaccinations.

Updated 25 February 2016

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

At 89.7% the percentage of patients diagnosed with dementia whose care had been reviewed in a face to face meeting in the last 12 months was higher than the national average of 84%.

The practice worked closely with multi-disciplinary teams in the case management of people experiencing poor mental health including those with dementia. Care plans were in place for patients with dementia. Patients experiencing poor mental health were sign posted to various support groups and third sector organisations. The practice kept a register of patients with mental health needs which was used to ensure they received relevant checks and tests.

All practice staff were trained as dementia friends. The practice regularly referred patients with mental health issues to wellbeing services who were able to support patients to achieve and maintain a sense of health, wellbeing and happiness. A mental health well-being guide was available on the practice website.

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. Patients with learning disabilities were invited to attend the practice for annual health checks. Longer appointments for people with a learning disability were routinely available.

The practice had effective working relationships with multi-disciplinary teams in the case management of vulnerable people. 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 and out of hours.

Good arrangements were in place to support patients who were carers. The practice had systems in place for identifying carers and ensuring that they were offered a health check and referred for a carer’s assessment.

The practice worked with the Sunderland People First initiative to improve access to services for patients with a learning disability. The practice had also signed up to a local ‘Safe Place’ scheme, which gave vulnerable people a short term ‘safe place’ to go if they were feeling threatened when out and about in the local community.