Biddlestone Health Group

Updated 14 May 2015

The practice is located close to Chillingham Road in Heaton, Newcastle upon Tyne. The practice serves those living in Heaton and the surrounding areas, from Longbenton in the North to Walker in the South. The practice provides services from the following address and this is where we carried out the inspection:

Biddlestone Road, Newcastle Upon Tyne, Tyne And Wear, NE6 5SL.

The practice provides its services to patients at ground and first floor levels, and some offices for staff are on the first floor. Patients who access services on the first floor are escorted to and from the treatment and consulting rooms by a member of staff. The practice offers on-site parking including disabled parking, accessible WC’s and step-free access. The practice provides services to around 9,500 patients of all ages based on a General Medical Services (GMS) contract agreement for general practice.

The practice has five GP partners and one salaried GP. The practice is a training practice, with one attached GP Registrar (a fully qualified doctor, allocated to the practice as part of their three year specialist training) and one F2 foundation doctor (a fully qualified doctor allocated to the practice as part of a two-year, general postgraduate medical training programme). There are also three practice nurses, one healthcare assistant, a practice manager and a team of eight administrative support staff.

The CQC intelligent monitoring system placed the area in which the practice was located in the fourth less 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 the practice had a larger percentage of patients between the ages of 20 and 34 years old than the England averages; both for male and female patients.

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

Updated 14 May 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Biddlestone Health Group on 12 February 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. It was also good for providing services for the following population groups: Older people; People with long-term conditions; Families, children and young people; Working age people (including those recently retired and students); People whose circumstances may make them vulnerable; People experiencing poor mental health (including people with dementia).

Our key findings across all the areas we inspected were as follows:

• 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.
• Risks to patients were assessed and well managed.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Information about services and how to complain was available and easy to understand.
• There was a clear leadership structure and staff felt supported by management. The practice pro-actively sought feedback from staff and patients, which it acted upon.
• The practice had an active patient participation group (PPG), which included representation from a wide range of backgrounds. The practice worked in partnership with the group to improve services for their patients.

However there were areas of practice where the provider needs to make improvements.

The provider should

• Endeavour to increase both the recording and learning from significant events. The number of recorded significant events was less than expected for the practice size, with three recorded since April 2014. We found they were correctly actioned and investigated, but concentrated exclusively on negative events rather than also celebrating good practice and recording compliments.
• Ensure that any complaints received are responded to in line with practice’s policy. The practice’s complaints policy stated ‘We shall acknowledge your complaint within 2 working days’; however the records we looked at showed this had not always happened.
• Ensure that all clinical audits measure whether agreed standards have been achieved or make recommendations and take action where standards are not being met. There was evidence of audits having been undertaken which was relevant to individual clinical practice by some clinicians, however the majority of evidence presented was a review (i.e. the first part of an audit), and there was limited evidence of completed audit cycles.
• Continue to review access for patients who require urgent appointments. Nationally reported data and feedback we received from patients themselves suggested they found it difficult at times to get an appointment with a GP when they felt their need was urgent.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 14 May 2015

The practice is rated as good for the care of people with long-term conditions. GPs and 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. Patients at high risk of hospital admission had a named GP and structured reviews 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 care professionals to deliver a multidisciplinary package of care. The practice had recall arrangements in place to ensure patients with long term conditions were reviewed on a regular basis. They used the Quality and Outcomes Framework (QOF) as one method of monitoring their effectiveness and had achieved 99.3% of the points available. This was higher than the local and national averages.

Updated 14 May 2015

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 in line with local averages for all standard childhood immunisations. For example, Hib/Men C Booster vaccination rates for five year old children were 90.1% compared to 93.9% across the CCG; and MMR Dose 2 vaccination rates for five year old children were 94.5% compared to 92.7% across the CCG. Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives and health visitors. Cervical screening rates for women aged 25-64 were well above the national average at 91.4%, compared to 81.9% nationally. The practice manager said they sent a second invite letter out to their eligible patients if they didn’t respond to the first letter sent out to them by the NHS Cervical Screening Programme. They felt this may contribute to their higher than average performance.

Updated 14 May 2015

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. For example, all patients over the age of 75 had a named GP and patients at high risk of hospital admission had a named GP and a care plan. The practice was responsive to the needs of older people, including offering home visits and rapid access appointments for those with enhanced needs. The practice maintained a palliative care register.

Updated 14 May 2015

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 which reflects the needs for this age group. GP appointments could be booked in advance online.

The practice offered extended opening hours. Appointments were available until 8.00pm on Monday evenings and patients could choose to see a GP or practice nurse. This made it easier for people of working age to get access to the service.

Updated 14 May 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). They regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. They carried out advance care planning for patients with dementia. They had participated in a number of recent initiatives around dementia. As a result, they had increased their register for patients diagnosed with dementia from 58 to 72 since October 2014.

The practice had sign-posted patients experiencing poor mental health to various support groups and organisations. Information and leaflets about services were made available to patients within the practice.

Updated 14 May 2015

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. They had carried out annual health checks for people with a learning disability. The practice offered longer appointments for people with a learning disability, if required.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. They had told 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.

Patients with no fixed abode were welcomed into the practice and could register with them the same as any other patient.