Archived: 49 Marine Avenue Surgery

Updated 19 May 2016

49 Marine Avenue Surgery is registered with the Care Quality Commission to provide primary care services. The practice is located in the town of Whitley Bay in North Tyneside.

The practice provides services to around 6,100 patients from one location: 49 Marine Avenue, Whitley Bay, Tyne and Wear, NE26 1NA. We visited this address as part of the inspection. The practice has four GP partners (three female and one male), a nurse practitioner and two practice nurses (all female), a practice manager, and nine staff who carry out reception and administrative duties.

The practice is part of North Tyneside clinical commissioning group (CCG). The practice population is made up of a higher than average proportion of patients over the age 65 (26.6% compared to the national average of 18.9%). The number of patients over the age of 75 is also well above the national average (13.8% compared to 8.8% nationally). Information taken from Public Health England placed the area in which the practice is located in the ninth less deprived decile. In general, people living in more deprived areas tend to have greater need for health services. Life expectancy for both male and females is above local and national averages (female – 84 compared to the CCG average of 82, and male – 80 compared to the CCG average of 78).

The practice is located in a converted three storey building. Patient facilities are on the ground and first floors. There is no dedicated car parking at the site however; there is parking in the streets surrounding the surgery. There is a disabled WC and step-free access.

Opening hours are between 8am and 6pm Monday to Friday. The practice is trialling earlier opening hours and on some days opens at 7.30am. Patients can book appointments in person, on-line or by telephone. Appointments are available between 7.45am or 8am and 11.50am, then between 2pm and 5.25pm. A duty doctor is available each afternoon until 6.30pm.

The practice provides services to patients of all ages based on a General Medical Services (GMS) contract agreement for general practice.

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

Updated 19 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at 49 Marine Avenue Surgery on 19 April 2016. Overall the practice is rated as good.

Our key findings were as follows:

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• Feedback from patients was overwhelmingly positive and the practice achieved very high scores in the National GP Patient Survey.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• 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 proactively sought feedback from staff and patients, which they acted on.
• Staff throughout the practice worked well together as a team. Several staff commented that the practice was ‘like a family’ and they all looked after each other.
• The practice had achieved the Royal College of General Practitoners’ (RCGP) Practice Accreditation Award. This measured the quality of care provided to patients across 72 quality standards.

We saw an area of outstanding practice:

The National GP Patient Survey published in January 2016 showed the satisfaction scores on consultations with doctors and nurses were all above local and national averages. Results showed that 98% of respondents had confidence and trust in their GP, compared to 95% nationally. 95% of respondents said the last GP they saw was good at treating them with care and concern, compared to the national average of 89%. 100% of respondents said they had confidence and trust in the last nurse they saw, which was above the national average of 97%. The practice also scored well in relation to access; 99% (compared to 85% nationally and 86% locally) of respondents were able to get an appointment or speak to someone when necessary; and scored highly on the ease of getting through on the telephone to make an appointment (99% of patients said this was easy or very easy, compared to the national average of 83% and a CCG average of 81%).

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

The provider should:

• Carry out a risk assessment to determine which medicines are necessary to hold, to ensure staff can manage medical emergencies.

• Take action to ensure actual temperatures on refrigerators used to store vaccines are recorded every working day.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 19 May 2016

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

• Nursing staff had lead roles in chronic disease management and patients at risk of admission to hospital were identified as a priority.
• Longer appointments and home visits were available when needed. The practice’s electronic system was 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.
• Patients had regular reviews to check with health and medicines needs were being met.
• For those people with the most complex needs, GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 19 May 2016

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

• The practice had identified the needs of families, children and young people, and put plans in place to meet them.
• 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, and we saw evidence to confirm this.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses.
• The practice’s uptake for the cervical screening programme was 87%, which was above the clinical commissioning group (CCG) average of 83.1% and the national average of 81.8%.
• Pregnant women were able to access an antenatal clinic provided by healthcare staff attached to the practice.

Updated 19 May 2016

The practice is rated as good for the care of 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 and those in vulnerable circumstances had care plans.
• The practice was responsive to the needs of older people and offered home visits and urgent appointments for those with enhanced needs.
• Doctors carried out a weekly ward round and had regular phone contact with staff at a local nursing home.
• A palliative care register was maintained and the practice offered immunisations for pneumonia and shingles to older people.

Updated 19 May 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 and flexible. The practice was trialling earlier opening hours and on some days opened at 7.30am.

• The practice offered a full range of health promotion and screening which reflected the needs for this age group. Patients could order repeat prescriptions and book appointments on-line.

• Additional services were provided such as health checks for the over 40s and travel vaccinations.

Updated 19 May 2016

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

• The practice worked closely with multi-disciplinary teams in the case management of people experiencing poor mental health including those with dementia. Care plans were in place for patients with dementia.
• Patients experiencing poor mental health were sign posted to various support groups and third sector organisations.
• The practice kept a register of patients with mental health needs which was used to ensure they received relevant checks and tests.

Updated 19 May 2016

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.

• Patients with learning disabilities were invited to attend the practice for annual health checks. The practice offered longer appointments for people with a learning disability, if required. One of the nurses was the designated lead for patients with learning disabilities; they had developed a health assessment tool to help ensure patients’ needs were understood and met.

• The practice had effective working relationships 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 and out of hours.
• Good arrangements were in place to support patients who were carers. The practice had systems in place for identifying carers and ensuring that they were offered a health check and referred for a carer’s assessment.