Archived: Barmston Medical Centre Also known as IntraHealth Limited

Updated 11 June 2015

The Barmston Medical Centre has a main surgery in Barmston and a branch surgery in Washington town centre close to the Galleries shopping centre. The practice provides services to approximately 4,800 patients from the two locations;

• Westerhope Road, Washington, Tyne and Wear,NE38 8JF
• The Galleries, Washington Centre, Washington, Tyne and Wear, NE38 7NQ

We visited both of these locations as part of the inspection of the practice. The area covered by both surgeries is predominately the postcode areas of NE37 and NE38.

Both surgeries are located in purpose built premises. The surgery at Barmston has patient facilities on the ground floor and there are disabled parking spaces in the patient car park, wheelchair and step free access. The branch surgery at the Galleries in Washington is one of four practices based in a purpose built health centre. The facility is part of the Galleries shopping complex and the reception area is shared with the local library on the first floor, there is a ramp for easy access. A lift is available to take patients to street level at the rear of the premises, there are two disabled bays shared with the other three practices.

The provider of the service is Intrahealth a corporate provider of NHS primary care services. The practice has three salaried GPs two female and one male, two nurse practitioners, two practice nurses and two healthcare assistants. There is a practice manager and seven staff who carry out reception and administration duties.

Surgery opening times at both surgeries are Monday 8am to 6.30pm, Tuesday and Wednesday 8am to 7pm. Thursday and Friday 8am to 6.30pm with extended opening at Barmston on a Saturday morning 8.30am to 12pm.

The practice is commissioned to provide services within an Alternative Provider of Medical Services Agreement (APMS) with NHS England.

The service for patients requiring urgent medical attention out of hours is through the 111 service and Primecare (Primary Care Sunderland) Sunderland.

Updated 11 June 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Barmston Medical Centre on 15 April 2015. We inspected the main surgery at Barmston and the branch surgery at The Galleries Health Centre. The practice was rated as good for all domains and population groups.

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. There were comprehensive safety systems in place.

• 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. All clinical staff had received safeguarding level three training.

• Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment. Data showed that patients rated the practice inline or just below the national averages for being caring. We saw that staff were considerate with patients, treated them with understanding and maintained confidentiality.
• Information about services and how to complain was available and easy to understand.
• Most patients we spoke with and those who completed CQC comment cards indicated they felt they could obtain appointments, including urgent appointments, when needed.
• 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 the management team. The practice proactively sought feedback from staff and patients, which they acted on.

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

The provider should:

• Provide all staff with adult safeguarding training.
• Provide effective training for staff who carry out the role of chaperone.
• Improve systems and processes for fire safety.
• Implement systems to ensure that all patients with learning difficulties are offered regular health checks.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 June 2015

There were clinical leads for the management of long term conditions which were shared between the GPs and nurse practitioners.The clinical leads covered the recall of these patients for reviews; these were carried out at least annually along with opportunistic reviews.The practice’s computerised patients records were used to flag when patients were due for review. This helped to ensure the staff with responsibility for inviting people in for review managed this effectively. For those people with the most complex needs, the practice worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 11 June 2015

The practice had systems to manage and review risks to vulnerable children and young people. They met with health visitors on a quarterly basis to discuss child safeguarding issues, immediate issues were discussed at the weekly practice meeting. Concerns were raised with the health visitor when babies and children failed to complete their vaccination programme. The practice had a dedicated GP appointed as the lead for safeguarding children.

The practice offered baby and anti-natal clinics. Nationally reported data for 2013/14 showed the practice offered child development checks at intervals that were consistent with national guidelines. They offered routine immunisations for babies and children under five, during clinic appointments.

The practice had recently participated in ‘Dr Spike’s Fun Day’, a health awareness promotion day for parents of young children which was held at the local Surestart Centre (centres which provide access to a range of early childhood services). Feedback was taken from the parents and the practice assisted in designing a leaflet for parents on services available to them from primary and secondary care.

Updated 11 June 2015

The practice had a lower than national average number of patients over the age of 65 (9%). All patients over the age of 75 had a named GP. The practice made decisions about care planning for elderly patients at their multi-disciplinary team meetings. Where appropriate the patient’s carer was included in the process. There were care plans in place for 2% of the practice population, which was the national target, with the most complex needs, which included the elderly, to help avoid unplanned admissions into hospital.

Updated 11 June 2015

The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services they offered to ensure these were accessible, flexible and offered continuity of care. Appointments were available outside normal working hours; there were surgeries running until 7pm on Tuesday and Wednesday evenings and the Barmston surgery was open on a Saturday morning. Patients we spoke with commented on the usefulness of this. There were telephone appointments available to allow patients to speak to a practice nurse or GP on the telephone. Routine appointments were bookable up to four weeks in advance. Repeat prescriptions could also be ordered via the telephone, calling into the practice on-line or by fax.

Updated 11 June 2015

The practice worked closely with mental health services. An in house counsellor attended the practice on a weekly basis. The practice liaised with MIND (a mental health charity) and primary care mental health workers. These teams provided services from both surgeries and there were also referrals onwards to services for those experiencing poor mental health.

The Barmston main surgery had a board in the waiting area dedicated to dementia and there were leaflets of advice, information regarding the screening available and how dementia can be diagnosed. The practice had a named member of staff who was a dementia champion and staff had received dementia awareness training.

Updated 11 June 2015

The practice worked with multi-disciplinary teams in the case management of vulnerable people. The practice had sign-posted vulnerable patients to various support groups and organisations. Staff we spoke with knew how to recognise signs of abuse in vulnerable adults and children. One of the nurse practitioners was the lead for vulnerable adults. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in and out of hours.

The practice’s computer system alerted GPs if a patient was also a carer. We were shown the written information available for carers to ensure they understood the various avenues of support available to them. Carers were offered the flu vaccine and screening for depression.

The practice held a register of those patients with a learning disability; however annual health checks were not up to date due to a member of staff leaving.

Vulnerable patients, for example, patients who were illiterate were coded on the practice computer system to ensure the staff could identify them and ensure their needs were met. A GP gave us an example of a patient who had become homeless who the practice had referred to social services for support.