Blackhall & Peterlee Practice

Updated 6 January 2017

Located on the north east coast with borders between Teesside and Durham, Blackhall and Peterlee practice is a two site practice with its main premises in Blackhall. Built around the once extensive mining industry, Blackhall'scollieryclosed in 1981 and was pulled down some years later. The Peterlee branch is located close to the main transport link of the A19. Peterlee is a new town built in the 1940s. Blackhall and Peterlee Practice is part of the Durham, Darlington, Easington and Sedgefield Clinical Commissioning Group. The total practice patient population is 9626.

The proportion of the practice population in the 65 years and over age group is higher than the England average. 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 higher than the England average. People living in more deprived areas tend to have a greater need for health services.

The Blackhall premises is a purpose built modern facility in its own grounds, with plenty of accessible parking. The Peterlee branch operates from within Peterlee Community hospital and parking dedicated for practice patients is limited. Inspectors visited both sites on the day of the inspection.

Clinical staff work across both sites and patients have the choice of which location they would like to attend for appointments. There are nine GPs in total, six are female and three are male. Five of the GPs form the partnership and four are salaried. In addition to this there are three female GP Registrars (qualified doctors training to be GPs) as Blackhall and Peterlee is a training practice . A Nurse Practitioner and four practice nurses plus healthcare assistants also form part of the clinical team, working across both sites. The practice also employs a pharmacist.

The practice is open between 8am and 8.30pm on Mondays, 8am to 6pm Tuesday to Friday, and 8am to 12pm on Saturdays. Appointments are from 8.10am to 10.45am every morning and 1.45pm to 5.30pm each afternoon, Monday to Friday. Out of hours and minor injuries facilities are close by at Peterlee Hospital when the practice is closed. At 6pm, patients can access out of hours care provided by County Durham and Darlington NHS Foundation Trust by telephoning NHS 111.

The practice has a General Medical Services contract with NHS England. They also provide some Directed Enhanced Services, for example they offer minor surgery and the childhood vaccination and immunisation scheme.

Updated 6 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Blackhall and Peterlee Practice on 9 November 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 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.
• 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.
• 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.

The areas where the provider should make improvements are:

• Ensure all staff who act as chaperones have a Disclosure and Barring service check.

• Ensure that fridge temperature recordings are correctly monitored and the results acted upon accordingly.

• Ensure all staff have an annual appraisal

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 6 January 2017

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.
• The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) was 140/80 mmHg or less was 82% which was comparable to other practices. (CCG average 77%, England average 78%)
• All these patients 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.

Updated 6 January 2017

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 percentage of females, 25-64, attending cervical screening within target period was similar to local and national averages at 77% (CCG average 77%, England average 74%)
• 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 a policy that all children aged five and under were offered a same day appointment.
• There was a designated, fully-equipped breast feeding room with baby changing facilities.

Updated 6 January 2017

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 looked after a large number of care homes and made regular face-to-face visits to these patients, ensuring continuity of care by designating a named GP.

Updated 6 January 2017

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.

Updated 6 January 2017

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

• 82% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average of 84%
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption has been recorded in the preceding 12 months is 98%, which is better than the CCG and England averages of 90%.
• 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.
• Staff had a good understanding of how to support patients with mental health needs and dementia.
• The practice provided room facilities to a Dementia Specialist Nurse to run clinics from the practice.

Updated 6 January 2017

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 other health care professionals in the case management of vulnerable patients.
• The practice worked closely with the VAWAS team (Vulnerable Adults Wraparound Team) which was set up by the federation to offer extra support to its vulnerable patients.
• 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.