Sunniside Surgery Also known as Sunniside Medical Practice

Updated 20 April 2016

Sunniside Surgery provides Primary Medical Services to the village of Sunniside and the surrounding areas. The practice provides services from one location, 8 Dewhurst Terrace, Sunniside, Newcastle upon Tyne, NE16 5LP. We visited this address as part of the inspection.

The surgery is located in two converted houses which have been adapted and made into a surgery. There is access for wheelchairs via a ramp at the rear of the practice. There is no dedicated car parking at the site however, there is parking in the streets surrounding the surgery.

The practice has three GP partners and one salaried GP. Three are female and one male. They all work part-time. The practice teaches 3rd, 4th and 5th year medical students. There are four practice nurses and a health care assistant, all work part-time. There is a practice manager, deputy practice manager. There are seven reception and administration staff.

The practice provides services to approximately 3200 patients of all ages. The practice is commissioned to provide services within a General Medical Services (GMS) contract with NHS England.

The practice is open from 8am until 6pm Monday to Friday. There are extended opening hours on alternate Tuesday and Thursday evenings from 6.30pm and 8.15pm These appointments are for those patients who find it difficult to attend the surgery during normal opening hours.

Consulting times with the GPs and nurses range from 8 or 8:30am until 11am then from 2:30pm until 5:40pm other than a Friday when the last appointment is 5:20pm. On extended opening days consulting times run from 6:30pm to 8:15pm.

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

Information taken from Public Health England placed the area in which the practice was located in the eighth least deprived decile. The average male life expectancy is 79 years and the female is 84. The male life expectancy is higher than the CCG average which is 77 years and the same as the England average. The female life expectancy is above the CCG average of 81 years and the England average of 83 year. The practice has a higher percentage of patients between the ages of 40+ and 50+ and higher numbers of children aged between five and nine years. The percentage of patients reporting with a long-standing health condition is slightly higher than the national average (practice population is 59% compared to a national average of 57%).

Updated 20 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Sunniside Practice on 10 March 2016. Overall the practice is rated as good. The practice is rated outstanding for caring services and good for providing safe, effective, responsive and well-led services.

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.

• Risks to patients were assessed and well managed.

• Outcomes for patients who use services were good.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff were consistent and proactive in supporting patients to live healthier lives through a targeted approach to health promotion. Information was provided to patients to help them understand the care and treatment available

• Patients said they were treated with compassion, dignity and respect. The proportion of patients who described their overall experience of the GP surgery as good or very good in the GP National Survey was 100%, compared to the national average of 85%. Several patients we spoke with commented on the helpfulness of the staff and caring manner of the GPs and said it was the best practice they had ever been registered at.

• The practice had a system in place for handling complaints and concerns and responded quickly to any complaints.
• The practice had good access arrangements, patients said they were able to get an appointment with a GP when they needed one, 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 in place and staff felt supported by management. The practice sought feedback from staff and patients, which they acted on.
• Staff throughout the practice worked well together as a team.

We saw four areas of outstanding practice:

• The practice had excellent results from the GP National Patient Survey in January 2016. The practice were ranked as one of the top five from this survey by a North East in a newspaper article. They did well in all categories and were ranked 34 out of 7708 practices nationally.

• The practice went the extra mile to ensure that patients received person centered care. They could give us several examples of how they had a low threshold for raising safeguarding concerns for vulnerable children and adults. They also had a strong supportive culture for their patients, for example, when patients failed to attend review appointments, the GP would sent a personal letter setting out the risks to their health and how it was inadvisable to continue in that way. These letters would often be hand delivered.

• The practice shared a frailty nurse with four other practices. The funding was made available from the CCG for this service. There was a scoring and referral system for the nurse to visit patients. This had led to improvements for patients needs for example the nurse had been instrumental in a patient being able to have a wet room installed in their home.

• The practice had a good appointment system. They believed this had led to patients rarely using the local walk in centre service. Their patients had only accounted for 0.3% of all appointments (the highest practice in the area was 25%) in the last quarter of 2015.

The areas where the provider should make improvements are:

• Record the numbers of the pre-printed prescription stock which had been distributed in the practice in accordance with national NHS Protect guidance.

• Take steps to ensure staff complete all training appropriate to their role including information governance training.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 April 2016

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

The practice had a register of patients with long term conditions which they monitored to recall patients for regular health checks. Patients with more than one condition were offered a joint appointment where possible. Where patients were working there were evening appointments available for patients for a review. When patients failed to attend review appointments, the GP would send a personal letter setting out the risks to their health and how it was inadvisable to continue in that way. These letters would often be hand delivered

Nationally reported Quality and Outcomes Framework (QOF) data (2014/15) showed the practice had achieved below average outcomes in relation to some of the conditions commonly associated with this population group. Performance for diabetes related indicators was below the national average (84.9% compared to 89.2% nationally). The practice had recently carried out work on the diabetic recall system.

Updated 20 April 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, the practice could give us several examples of safeguarding concerns raised. Child protection meetings were held every two months. Childhood immunisation rates for the vaccinations given were in line with CCG/national averages. For example, childhood immunisation rates for the vaccinations given to under two year olds ranged from 91% to 100%, compared to the CCG averages of 81% to 97% and for five year olds from 93% to 100%, compared to CCG averages of 90% to 98%.

The practice’s uptake for the cervical screening programme was 86.9%, which was above the national average of 81.8%. Appointments were available outside of school hours and the premises were suitable for children and babies.

Mother and baby clinics were offered by the health visiting team on Wednesday. With child immunisations were carried out by making an appointment with the practice nurse.

The practice offered minor surgery which included intrauterine device (IUD), contraceptive coil fitting.

Updated 20 April 2016

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

Nationally reported data showed the practice had good outcomes for conditions commonly found amongst older people. For example, the practice had obtained 100% of the points available to them for providing recommended care and treatment for patients with heart failure. This was above local clinical commissioning group (CCG) average (97.9%) and above the England average (97.9%).

The practice offered proactive, personalised care to meet the needs of the older people in its population. For example, patients at high risk of hospital admission and those in vulnerable circumstances had care plans in place.

The practice was responsive to the needs of older people, including offering home visits usually by the same GP. All patients over 75 had a named GP.

One of the GPs was the named GP for patients in the local nursing home and carried out a weekly ward round with the nurse from the home. The practice shared a frailty nurse with four other practices which meant there was more care available for the more complex elderly patients.

The practice maintained a palliative care register and end of life care plans were in place for those patients it was appropriate for. They offered immunisations for pneumonia and shingles to older people.

Updated 20 April 2016

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 had excellent patient satisfaction for access. They were proactive in offering online services which included appointment booking and ordering repeat prescriptions. There was a text messaging service as a reminder for appointments and for abnormal results. There was a full range of health promotion and screening that reflected the needs for this age group. Flexible appointments were available as well as extended opening hours.

Updated 20 April 2016

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

There were dementia care plans in place and 26 patients on the register, these patients had an annual review. Data showed 81.8% of patients identified as living with dementia had received an annual review in 2014/15 (national average 84%). The practice also worked together with their carers to assess their needs.

Performance for mental health related indicators was better than national average. For example, 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had their alcohol consumption recorded in the preceding 12 months (01/04/2014 to 31/03/2015) compared to the national average of 88.4%.

Updated 20 April 2016

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

The practice had a number of patients on their list who had been excluded from other surgeries. They held a register of patients living in vulnerable circumstances; often they contacted the patient by phone to advise that a health review was due. For one patient they knew to not withhold the number so they would answer the phone. They had several patients who were deaf and they used a sign interpreter.

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.

The practice’s computer system alerted GPs if a patient was a carer. There was a practice register of all people who were carers and were being supported, for example, by offering health checks and referral for social services support. There were 45 patients on the carer’s register which was 1.4% of the practice population. Five of the carer’s were young carers. Written information was available for carers to ensure they understood the various avenues of support available to them. This included a national carers charity.