West Rainton Surgery

Updated 7 January 2016

West Rainton surgery is a purpose built GP premises in West Rainton, a village in County Durham. They have a General Medical Services (GMS) contract and also offer enhanced services for example; extended hours. The practice is a dispensing practice. The practice covers the villages of West and East Rainton, Houghton-le-Spring, Hetton-le-Hole, Easington Lane, Belmont, Carrville and several small villages to the south east of Durham. There are 5670 patients on the practice list and the majority of patients are of White British background. There is a council run Traveller’s site in the village and a small number of the practice population are from the Travelling Community.

The practice is a partnership with three partners. There is one salaried GP and the practice are trying to recruit another GP following the emigration of another partner in January. There is one Nurse Practitioner, one chronic disease management Nurse, one treatment room Nurse, and two Health Care assistants. There is a Practice Manager, a Finance Manager and reception, dispensing and administration staff. The practice also employ two cleaners and a handyman/delivery driver. There is a Pharmacist attached to the practice who is employed as part of the ‘Quality Improvement Scheme’ in conjunction with the CCG.

The practice is open between 8am and 6pm Mondays to Fridays and has extended hours from 6pm to 8pm on Tuesdays.

Patients requiring a GP outside of normal working hours are advised to contact the GP out of hour’s service provided by North Durham CCG.  

Updated 7 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at West Rainton Surgery on 17 November 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 to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients 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 any further training needs had been identified and planned.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients said they found it easy to make an appointment although not always with their choice of GP. There were urgent and appointments available the same day for GPs and Nurses, and in 2 days for routine appointments with GPs.
• 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.
• Information about services and how to complain was available and easy to understand.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met people’s needs.

We saw some areas of outstanding practice;

• The practice offered dermatology treatment from one of GPs who had completed further training. On audit this had reduced referrals to secondary care in the last year by 26%.

• The practice offered a free medicine delivery service for frail, elderly and isolated patients and employed someone to do this.

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. Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All of these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and social care professionals to deliver a multidisciplinary package of care. Patients were seen in multidisciplinary clinics with a podiatrist, nurse and dietician. Diabetic patients could be seen in the practice instead of in secondary care if they needed insulin initiation due to extra training staff had undertaken.

Updated 7 January 2016

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. We saw good examples of joint working with midwives, health visitors and school nurses. Appointments for children were always available as needed.

Updated 7 January 2016

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. They were responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. Pro-active home visits were made to frail elderly patients by the Practice Nurse as part of the ‘Improving Outcomes’ scheme in conjunction with the CCG. The practice offered dermatology treatment as one of the GPs had completed extra training in this area; this meant that patients could be treated closer to home.

The practice offered a free medicine delivery service for frail, elderly and isolated patients and employed someone to do this.

Updated 7 January 2016

The practice is rated as good for the care of working-age people (including those recently retired and students). The needs of this group had been identified and the practice had adjusted the services they 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 7 January 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). 92.5% of people with dementia had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It 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. They had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

Updated 7 January 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable. They had carried out annual health checks for people with a learning disability.

The practice held a register of patients living in vulnerable circumstances including patients who were from the travelling community. We were told that this group of patients were always seen if they attended the practice.

The practice regularly worked 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 normal working hours and out of hours.