Background to this inspection
Updated
12 November 2015
Dr ME Scott and Partners is based in the west end of Newcastle Upon Tyne. The area covered by the practice is Newburn, Throckley, Walbottle, North Walbottle, West Denton, Chapel House, Chapel Park, Lemington and Stella Riverside. The practice provides services from one location, Newburn Surgery, 4 Newburn Road, Newburn Newcastle Upon Tyne, NE15 8LX.
Newburn Surgery operates from a converted house in Newburn which has been extended to provide extra consulting rooms. Patient facilities are on the ground and first floors. There is step free access at the front of the building and a disabled toilet on the ground floor. There is no dedicated parking for patients; the surgery is on a main road. Car parking can be found in the streets close to the surgery.
The practice has four GP partners and one salaried GP, three female and two male. The practice is a training practice and teaches 3rd, 4th and 5th year medical students and also foundation year doctors. At the time of our inspection there were two foundation year doctors working at the practice.
There is a nurse prescriber, a practice nurse and two health care assistants. There is a practice manager, deputy practice manager, seven reception and administrative staff and one domestic member of staff.
The practice provides services to approximately 5,400 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 between 8.30am and 6pm Monday to Friday. There are extended opening hours on 6:30pm and 7pm on Monday evenings and the surgery opens every fourth Saturday between 9am and 11am.
Consulting times are Monday to Friday 8.50am to 11.50am, 3.10pm to 5.40pm every afternoon other than a Wednesday when they are between 3pm and 5pm. Consulting times on a Monday evening are 6.30pm to 6.50pm.
The service for patients requiring urgent medical attention out of hours is through the NHS 111 service and Northern Doctors Urgent Care Limited.
Updated
12 November 2015
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Dr M E Scott & Partners on 6 October 2015. Overall the practice is rated as good.
Our key findings across all the areas we inspected were as follows:
- Risks to patients were assessed and well managed.
- Significant events were recorded, investigated and learned from. However, staff awareness of significant events was limited.
- Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles.
- 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 was in the process of securing more suitable premises for the surgery to operate from. The practice management team had done as much as they could to modify the premises to suit patients’ 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 an area of outstanding practice:
- The practice had been involved in local CCG projects to improve the care of those patients with long term conditions. This included a chronic obstructive pulmonary disease (COPD) project which ensured the identification and management of patients with this condition. There was also a social prescribing project, Ways to Wellness, which provides support to patients with certain long-term health conditions. A Link Worker works with each person referred, on a one-to-one basis, in the areas where they most need support.
The areas where the provider should make improvements are:
- Consider training staff on the significant event process.
- Set up a system to ensure the relevant staff have seen and read patient safety alerts.
- Carry out disclosure and barring checks (DBS) for staff who carry out the role of chaperone.
- Set up a system to record clinical audit and ensure the audits have clear standards and evidence of audit cycle.
- Consider replacement of carpets within treatment rooms adjacent to consulting rooms with easy clean flooring.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
12 November 2015
The practice is rated as outstanding for the care of people with long-term conditions.
The practice had been involved in local clinical commissioning group (CCG) projects to improve the care of those patients with long term conditions. These included;
- A chronic obstructive pulmonary disease (COPD) project which ensured the identification and management of patients with this condition.
- A social prescribing project, Ways to Wellness, which provides support to patients with certain long-term health conditions who are referred by their GP in the local area. A Link Worker works with each person referred, on a one-to-one basis, in the areas where they most need support.
The practice were also involved in the diabetes year of care project in providing personalised results to patients to provide shared goals and action plans for patients.
Nationally reported data showed that outcomes for patients with long term conditions were good for example, performance for asthma related indicators was above the national average (100% compared to 97.2% nationally). Current QOF results for 2013/14 were 99.6% of the total number of points available.
There practice had a register for patients with long term conditions; this was not only for conditions defined by QOF but for other conditions for example gout. There were allocated clinical lead roles in chronic disease management. Patients were provided an annual review in their birthday month check that their health and medication needs were being met.
The practice offered flu vaccines to all patients with long term conditions. There were flexible appointments including telephone appointments and home visits where necessary.
The practice had recently enabled on line access to patients medical record and test results which could help patients manage their condition.
Families, children and young people
Updated
12 November 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 accident and emergency attendances. Immunisation rates were relatively high for all standard childhood immunisations. Appointments were available outside of school hours and the premises were suitable for children and babies.
The practice had weekly antenatal clinics ensuring good liaison with midwifery staff. Tuesdays were called ‘child health day’ as there was access to the midwife, health visitor, practice nurse and GP for child health checks. There were appointments available outside of school hours and same day urgent appointments at the parents request.
Updated
12 November 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. They 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. These patients were offered an enhanced summary care record, which provided healthcare staff treating patients in an emergency or out-of-hours facility with faster access to key clinical information.
The practice was responsive to the needs of older people, including offering home visits and rapid access appointments for those with enhanced needs. Patients over the age of 75 had a named GP and were offered annual health checks. Prescriptions could be sent to any local pharmacy electronically.
The practice had a close relationship with the care homes where their patients lived. They were involved with the local CCG care homes project and visited them weekly and had developed individual care plans for 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 and provided flu vaccinations to older people as a priority.
Working age people (including those recently retired and students)
Updated
12 November 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 which included appointment booking, test results and ordering repeat prescriptions. Text reminders for appointments were available to patients. There was a full range of health promotion and screening that reflected the needs for this age group. There were flexible appointments available including telephone consultations and extended opening hours on a Monday evening and every fourth Saturday when minor surgery clinics were available.
People experiencing poor mental health (including people with dementia)
Updated
12 November 2015
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). There was a lead GP for patients experiencing poor mental health and for people with dementia. All patients experiencing severe mental health had agreed care plans in place. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health. They carried out advanced care planning for patients with dementia. 82.3% of patients identified as living with dementia had received an annual review in 2013/14 (national average 83.8%) and had agreed care plans in place. The practice also worked together with their carers to assess their needs.
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.
People whose circumstances may make them vulnerable
Updated
12 November 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 carried out annual health checks for people with a learning disability.
The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It 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.