Archived: Railway Medical Group

Updated 20 May 2016

Waterloo Medical Group provides care and treatment to 14,004 patients of all ages, based on a Personal Medical Services (PMS) contract. The practice is part of the NHS Northumberland clinical commissioning group (CCG) and provides care and treatment to patients living in Blyth, Seaton Sluice and Newsham. We visited the following locations as part of the inspection:

Waterloo Medical Group, Blyth Health Centre, Thoroton Street, Blyth, Northumberland, NE24 1DX.

Newsham Surgery, 57 Newcastle Road, Blyth, Northumberland, NE24 4AW.

Blyth Acute Service, Blyth Community Hospital, Thoroton Street, Blyth, Northumberland, NE24 1DX.

The practice serves an area where deprivation is higher than the England average. The practice population includes more patients who are under 18 years of age, and over 65 years of age, than the England averages. The practice had a higher deprivation score, and a higher number of patients with a long-standing health condition, than the England averages. A low proportion of patients were from ethnic minority backgrounds.

The main practice is located in a purpose built health centre at the Community Hospital in Blyth and provides patients with fully accessible treatment and consultation rooms. The Blyth Acute Service is also located within the Blyth Community Hospital. The Newsham surgery is located in an adapted building. All three sites provide disabled access. The practice has four GP partners (one male and three women), two salaried GPs (female), three nurses (female), two healthcare assistants, a practice manager, a physiotherapist, a medicines manager and a small team of administrative and reception staff. The practice is a teaching practice and provides placements to 3rd year medical students. When the practice is closed patients can access out-of-hours care via the Northern Doctors Urgent Care Limited On-Call service, and the NHS 111 service.

GP opening hours and appointment times are as follows:

Waterloo Medical Group (Blyth Health Centre): Monday to Friday: 8am to 6:30pm. Saturday: pre-booked appointments only: 8am to 2:30pm.

(Weekdays: the first appointment is at 8:10am and the last one is at 5:30pm. Saturday: the first appointment is at 8:10am and the last one is at 2:20pm.)

Newsham branch surgery: Monday to Friday: 8am to 5:30pm.

(Monday to Friday: the first appointment is at 8:30am and the last one is at 5:20pm.)

Blyth Acute Service: Monday to Friday: 8am to 6:30pm.

(Monday to Friday: the first appointment is at 8:30/8:40am and the last one is at 6:20pm.)

Updated 20 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Waterloo Medical Group on 9 February 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 a highly effective system for reporting and recording significant events. The staff team took the opportunity to learn from all internal and external incidents.

• Risks to patients and staff were assessed and well managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. They had the skills, knowledge and experience to deliver effective care and treatment.

• Outcomes for patients were consistently good. The Quality and Outcomes Framework (QOF) data, for 2014/15, showed the practice had performed very well in obtaining 99.9% of the total points available to them for providing recommended care and treatment.

• The practice worked closely with other organisations when planning how services were provided, to ensure patients’ needs were met.

• Patients said they were treated with compassion, dignity and respect and that they were involved in decisions about their treatment.

• The main practice and its branches had good facilities and they were well equipped to treat patients and meet their needs.

• Services were tailored to meet the needs of individual patients and were delivered in a way that ensured flexibility, choice and continuity of care. All staff were actively engaged in monitoring and improving quality and patient outcomes.

• The leadership, governance and management of the practice assured the delivery of high-quality person-centred care, supported learning, and promoted an open and fair culture.

  We also saw areas of outstanding practice:

• The practice has demonstrated leadership within the region through their proactive and lead role in developing the Blyth Acute Service (BAS) which provides patients with urgent same-day care. The service commenced in February 2015, and at the time of the inspection, 10,347 patients had used the service at least once. (This also includes patients from the adjacent practice.) A high proportion of these patients have used the service numerous times. Healthwatch Northumberland recently carried out a service of patients about the BAS. Most patients who responded were very positive about the service, and they said they received a better quality of care and treatment than they did before. This is outstanding because staff have worked hard to develop a new way of delivering urgent, same-day care which has improved patient access and outcomes.

However, there were also areas where the provider needs to make improvements. The provider should:

• Continue to review and improve telephone access to the practice and their appointment system.

• Ensure they have documentary or electronic evidence which confirms that NHS Property Services have completed the health and safety checks they are contracted to carry out.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 May 2016

The practice is rated as good for the care of people with long-term conditions.

Nationally reported QOF data, for 2014/15, showed the practice had performed well, in relation to providing care and treatment for the clinical conditions commonly associated with this population group. For example, the practice had obtained 100% of the total points available to them, for providing care and treatment to patients who had diabetes. This was 5% above the local CCG average and 10.8% above the England average. Nursing staff held lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Patients with long-term conditions were offered a structured annual review, to check their health needs were being met and that they were receiving the right medication. A good call and recall system was in place, which helped ensure that all patients requiring an annual review received one. Clinical staff were very good at working with other professionals, to deliver a multi-disciplinary package of care to patients with complex needs.

Updated 20 May 2016

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

There were systems to identify and monitor children who were at risk. Alerts had been added to the records of at-risk children, or those subject to child protection procedures, to help ensure staff were aware of who they were, so this could be taken into account during any consultations. Regular ‘Supporting Families’ meetings took place, to help ensure information about vulnerable children and families was shared with the relevant health and social professionals, and to identify and manage potential risks. Appointments were available outside of school hours and the main practice and branch surgery premises were suitable for children and babies. The practice offered a range of contraceptive services as well as sexual health advice.  Staff had targeted younger patients through a poster campaign, and a member of staff acted as the Young Person’s Champion, to help raise their profile within the practice. The practice had performed well in delivering childhood immunisations. Publicly available information showed that all of their immunisation rates were above 90%. Nationally reported data showed the practice’s performance in relation to the delivery of their cervical screening programme was comparable with other practices.

Updated 20 May 2016

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

Nationally reported Quality and Outcomes Framework (QOF) data, for 2014/15, showed the practice had performed well, in relation to providing care and treatment for the clinical conditions commonly associated with this population group. For example, the practice had obtained 100% of the total points available to them, for providing care and treatment to patients who had heart failure. This was 1.1% above the local clinical commissioning group (CCG) average and 2.1% above the England average. The practice offered proactive, personalised care which met the needs of their older patients. All patients over 75 years of age had a named GP who was responsible for their care. Staff were participating in a local care homes project to look at better ways of supporting the high-risk patients who lived in them. Staff worked closely with other healthcare professionals to meet the needs of patients requiring palliative and end of life care, and to help prevent acute unplanned admissions into hospital.

Updated 20 May 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

Nationally reported data showed the practice had performed well in providing recommended care and treatment for this group of patients. For example, the QOF data, for 2014/15, showed the practice had obtained 100% of the overall points available to them for providing care and treatment to patients who had hypertension. This was 0.3% above the local CCG average and 2.2% above the England average. Staff had assessed the needs of this group of patients and developed their services, to help ensure they received a service which was accessible, flexible and provided 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 of this group of patients.

Updated 20 May 2016

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

There were good arrangements for meeting the needs of patients with specific mental health needs, including depression. Nationally reported QOF data, for 2014/15, showed the practice had performed well in obtaining 100% of the total points available to them, for providing recommended care and treatment to this group of patients. The data showed that 77.4% of these patients had a documented care plan, which had been agreed with their carers during the preceding 12 months. This was 3.1% above the local CCG average and 0.2% above the England average. Patients experiencing poor mental health were provided with advice about how to access various support groups and voluntary organisations. Staff kept a register of patients who had mental health needs, to make sure they received the support they required. The practice’s clinical IT system clearly identified these patients to ensure staff were aware of their specific needs.

The arrangements for meeting the needs of patients who had dementia were also good. Nationally reported QOF data, for 2014/15, showed the practice had performed well in obtaining 100% of the total points available to them, for providing recommended care and treatment to this group of patients. This was 0.9% above the local CCG average and 5.5% above the England average. Staff kept a register of patients who had dementia, and the practice’s clinical IT system clearly identified them, to help make sure clinical staff were aware of their specific needs. Clinical staff, including the practice’s healthcare assistant, actively carried out opportunistic dementia screening, to help ensure their patients were receiving the care and support they needed to stay healthy and safe. All staff had become Dementia Friends to help raise the profile of dementia patients registered at the practice.

Updated 20 May 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

There were good arrangements for meeting the needs of vulnerable patients, including those who had learning disabilities. The QOF data, for 2014/15, showed the practice had obtained 100% of the points available to them, for providing recommended care and treatment to patients who had learning disabilities. This was in line with the local CCG average and 0.2% above the England average. Staff maintained a register of patients with learning disabilities, which they used to ensure they received an annual healthcare review, provided by a dedicated clinician. Staff offered extended appointments for these reviews and they could take place at the patient’s home if needed. Systems were in place to protect vulnerable children from harm. Staff understood their responsibilities regarding information sharing and the documentation of safeguarding concerns. A chaperone service was available to help safeguard patients. The practice kept a register of patients who were also carers and was using this to help provide them with appropriate services.