Prospect Medical Group

Updated 7 January 2016

Prospect Medical Practice is a large teaching practice providing care and treatment to patients of all ages, based on a General Medical Services (GMS) contract. The practice is situated close to the centre of Newcastle-upon-Tyne and is directly opposite the Newcastle General Hospital. The practice is part of the NHS Newcastle and Gateshead Clinical Commissioning Group (CCG). The practice provides services to approximately 15210 patients. They are based at 501 Westgate Road, Newcastle-upon-Tyne, NE4 8AY. We visited this location as part of the inspection.

The health of people who live in Newcastle is variable when compared to the England average. Deprivation is higher than average with about 13200 (29%) of children living in poverty. Life expectancy for both men and women is lower than the England average. Life expectancy is 11.9 years lower for men and 9.1 years lower for women in the most deprived areas of Newcastle. A significant proportion of the practice’s patients are from the Black Minority Ethnic (BME) population.

Prospect Medical Practice is located in a purpose built health centre and provides patients with fully accessible treatment and consultation rooms. All consultation and examination rooms are on the ground floor. There is a lift to the first floor should patients need to access this area for treatment. There is on-site parking, including disabled parking, a disabled WC, and wheelchair access. The practice provides a range of services and clinics including, for example, services for patients with asthma and heart disease. There are nine GP partners (three male and six female), a practice manager and assistant practice manager, a nurse manager, two practice nurses, two healthcare assistants, and a team of administrative and reception staff. A GP registrar was on placement at the practice at the time of our visit.

The practice was open on Monday and Wednesday between 8:30am and 8pm, and on a Tuesday, Thursday and Friday between 8:30am and 6pm. Appointment times were: Monday and Wednesday between 8:30am and 7:30pm; Tuesday, Thursday and Friday between 8:30am and 5:50pm. 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 7 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Prospect Medical Practice on 13 October 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. Results from the national GP Patient Survey showed patients were satisfied with the quality of the care and treatment they received from their GPs and nurses;
• Most patients expressed no concerns about access to appointments. Whilst the practice performed well in most areas covered by the survey, their performance fell considerably below that of the local Clinical Commissioning Group (CCG) and national averages in relation to telephone access to the practice, access to appointments, and appointment waiting times. We found the practice was aware of this and were constantly adjusting the resources they had available to them to make their telephone and appointment system more responsive;
• There was a clear leadership structure and staff felt 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.

We saw several areas of outstanding practice including:

• The practice had also collaborated with a local advocacy service, and representatives of local black and ethnic minority communities, to produce a leaflet to help patients understand how to use the services provided by the practice;
• Over 50% of patients registered with the practice were people whose first language was not English. We saw the practice had taken steps to make their service accessible to this group of patients. For example, 1387 interpreter sessions had been arranged during the previous six months. Reception staff also had access to prompt sheets in some languages, to help them assist patients to explain their reasons for attending the practice. Work was underway to extend the range of languages covered by the prompt sheets. Staff were in the process of setting up a system to translate standard practice letters into a range of other languages to help promote better patient communication. A facility on the practice’s website enabled patients to obtain translations of each web page in a language of their choice. The practice had recruited two GPs who spoke some of the Indian Sub-Continent languages. The arrivals screen provided patients with information in a range of languages. The practice did not have a hearing loop system, but steps were being taken to have one installed. Information on the practice website informed patients that they could book an interpreter by contacting reception staff. Reception staff were clear about the arrangements for accessing interpreters and we saw this happen during the observation we carried out in the reception area.

The areas where the provider should make improvements are:

• Complete fire drills at the frequency outlined in the practice’s fire risk assessment;
• All staff who undertake chaperone duties should receive appropriate training;
• Develop a more proactive and structured approach to identifying topics for clinical audit;
• Continue to monitor and review the effectiveness of the practice’s appointment system to ensure it remains responsive to patients’ needs.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 7 January 2016

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 in providing recommended care and treatment for the clinical conditions commonly associated with this population group.

Updated 7 January 2016

The practice is rated as good for the care of families, children and young people. For example, patients were able to access weekly ‘drop-in’ sessions with a health visitor as well as a baby clinic advice service. The practice routinely met over 90% of their immunisation targets. Younger patients were able to access contraceptive and sexual health services, and appointments were available outside of school hours. Monthly child protection meetings took place between the practice’s safeguarding lead and attached health visitors and midwives. There were systems in place to identify and follow up children who were at risk.

Updated 7 January 2016

The practice is rated as good for the care of older people. Staff provided proactive, personalised care which met the needs of older patients. Patients aged 75 and over had been allocated a named GP to help ensure their needs were met. Arrangements had been made to meet the needs of ‘end of life’ patients. For example, staff held monthly palliative care meetings with other healthcare professionals to review and ensure these patients’ needs were met. The practice participated in the local Clinical Commissioning Group’s (CCG) Care Homes Project and acted as the link practice for two care homes. Weekly visits were undertaken to these homes and residents registered with the practice had individual care plans. The practice offered home visits and longer appointment times where these were needed by older patients. Nationally reported data showed the practice had performed well in providing recommended care and treatment for the clinical conditions commonly associated with this population group.

Updated 7 January 2016

The practice is rated as good for the care of working-age people (including those recently retired and students). The practice was proactive in offering online services, as well as a full range of health promotion screening that reflected the needs of this age group. Late appointments, until 8pm, were offered twice weekly, to make it easier for families and working-age patients to obtain convenient appointments. Nationally reported data showed staff were good at providing patients with the recommended care and treatment for all but one of the clinical conditions covered by the QOF such as coronary heart disease and hypertension.

Updated 7 January 2016

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 performed well in providing recommended care and treatment to patients with mental health needs. 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 counselling. The practice had an identified lead GP for mental health and dementia. Patients were provided with an annual healthcare review and the opportunity to participate in the preparation of a personal care plan. Staff were actively screening patients at potential risk of dementia. The GPs had monthly meetings with a consultant psychiatrist to discuss patients with mental health needs who were receiving care and treatment.

Updated 7 January 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable. For example, the practice maintained a register of patients with learning disabilities and offered annual reviews to help them stay healthy. Nationally reported data showed the practice had performed well in providing recommended care and treatment to patients with learning disabilities. 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 also understood their responsibilities regarding information sharing and the documentation of safeguarding concerns. Patients requiring palliative care (and those nearing the end of their lives) were given the mobile and home telephone numbers of their GP, for use in an emergency. These patients had also been sent a letter informing them that if they contacted the practice between 10am and 1pm, they would be guaranteed a telephone call from one of the GPs.