Archived: Stockton NHS Healthcare Centre

Updated 13 March 2017

Stockton NHS Health Care Centre ,Tithebarn House, High Newham Road, Hardwick Estate, Stockton-On-Tees, Cleveland, TS19 8RH has an alternative provider medical services contract and provides services to registered and non-registered patients. There is a GP practice and a walk-in centre. It is a location of the corporate provider Virgin Care Stockton. It is open from 8am – 8pm, 365 days of the year. The purpose built premises is owned by the local authority and also houses other services such as social care teams.

The health care centre is situated in Stockton in an area measured as having high levels of deprivation. The practice and walk-in centre were established in 2009 in order to try to reduce health inequalities in the area. Only patients who live in the immediate area surrounding the health care centre are able to register and the registered list has approximately 2000 patients. The walk-in centre is available to all patients whether they are registered at the practice or not.

The health care centre is situated in a housing estate and within walking distance to the University Hospital of North Tees. Transport links and parking facilities are good, however most patients live within walking distance of the health care centre.

The health care centre has seen a high turnover of staff. They have a contract with the Clinical Commissioning Group which states that they must have a GP on site at all times. At present they are using locum GPs as they have been unable to recruit a permanent GP. They have recently been successful in recruiting a clinical lead, who is an advanced nurse practitioner and a permanent member of staff. Agency practice nursing staff are used at present.

The health care centre is currently working through an exit plan as the contract has been awarded to another provider from April 2017. The walk-in centre is due to move to the University Hospital of North Tees and another GP practice will take over the list of registered patients. Staff have been told that they will continue to be employed by the new provider.

When the centre is closed patients are advised to contact the out of hours service (111) which is provided by North East Ambulance Services.

Updated 13 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stockton NHS Health care Centre on 7 December 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• The practice and walk-in centre had experienced problems with staff recruitment and had been mainly staffed by locum GPs and nurses; however they had just recruited an advanced nurse practitioner into the clinical lead role.

• Risks to patients were assessed and managed, however due to staffing issues multi-disciplinary team meetings regarding safeguarding and palliative care had not been taking place.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Mainly 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment, although not with a named GP, 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 and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.
• The practice was in an exit period as the contract to provide care to patients for the GP practice and the walk-in centre had been awarded to another provider from April 2017.

The areas where the provider should make improvement are:

Safeguarding and palliative care multi-disciplinary meetings should be reinstated.

All staff should be aware of the safeguarding lead.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 March 2017

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

• The practice had a lower number than average of patients registered with a long term condition.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• The percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) was 5 mmol/l or less (01/04/2015 to 31/03/2016) was 91% which was above local figures of 83% and above national figures of 80% (however exception reporting for these patients was 24% which was 10% above local and 11% above national averages).

• Longer appointments and home visits were available when needed.

• All these patients had a structured annual review to check their health and medicines needs were being met.

Updated 13 March 2017

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

• The practice had a higher than average number of patients in this age group.

• 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.

• Staff considered that joint working with midwives, health visitors and school nurses had suffered due to staff capacity issues at the practice and a lack of continuity of staff. The newly appointed clinical lead had an action plan and this included the re-introduction of multi-disciplinary team meetings.

Updated 13 March 2017

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

• The practice had a lower than average percentage of older patients who were registered.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 13 March 2017

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 that reflected the needs for this age group.

Updated 13 March 2017

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

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 13 March 2017

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.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed 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, however some staff were unaware of the safeguarding lead in the practice.