The Adderlane Surgery

Updated 12 October 2018

The Adderlane Surgery is located in the Prudhoe area of Northumberland and provides care and treatment to 2,006 patients of all ages, based on a Personal Medical Services (PMS) contract. The practice is part of NHS Northumberland Clinical Commissioning Group. We visited the following location as part of the inspection:

The Adderlane Surgery, Adderlane Road, Prudhoe, Northumberland, NE42 5HR.

The practice serves an area where, overall, deprivation is lower than the England average. However, the provider told us that over 600 of the practice’s patients live in an area where there is significant deprivation. In general, people living in more deprived areas tend to have a greater need for health services. The Adderlane Surgery has fewer patients aged under 18 years of age, and more patients over 65 years, than the England average. The percentage of people with a long-standing health condition is above the England average, but the percentage of people with caring responsibilities is below this. Life expectancy for women and men is similar to the England average. National data showed that 1.4% of the population are from non-white ethnic groups.

The practice occupies a purpose-built, single-storey building. Disabled access is provided via a ramp at the front of the premises. The practice has two GP partners (one male and one female), a practice nurse (female), a part-time practice manager and three administrative staff.

The practice is open as follows:

• Monday and Tuesday between 8:30am and 12:30pm and 2pm and 6pm.
• Wednesday and Friday between 8:30am and 12 noon and 3:30pm and 6pm.
• Thursday between 8:30am and 1pm.
• Friday between 8:30am and 12 noon and 3:30pm and 6pm.

Arrangements have been put in place to provide cover between 6pm and 6:30pm. The practice is closed at weekends.

The practice provides a mixture of open access surgeries and booked appointment surgeries. Surgery times are between 8:50am and 10am each weekday morning and between 4pm and 5:30pm on a Monday, Tuesday, Wednesday and Friday. Telephone consultations are provided daily between 11:30am and 12 noon each morning. Patients were able to access appointments out-of-hours via an extra care hub based in a local healthcare centre.

When the practice is closed patients can access out-of-hours care via Vocare, known locally as Northern Doctors, and the NHS 111 service.

Updated 12 October 2018

We carried out an announced comprehensive inspection at Adderlane Surgery on 10 October 2017. The overall rating for the practice was good, with all population groups also being rated as good. The practice was rated as requires improvement for the safe key question. The full comprehensive report on the October 2017 inspection can be found by selecting the ‘all reports’ link for Adderlane Surgery on our website.

This inspection was an announced focussed inspection, carried out on 30 August 2018, to confirm that the practice had met the legal requirements in relation to the breach of regulation that we identified in our previous inspection.

This report covers our findings in relation to this requirement and some additional improvements made since our last inspection.

Overall the practice is still rated as good; and is now good for the safe key question.

At this inspection we found:

• The breach of legal requirement we identified during our previous inspection had been addressed.
• The provider had taken steps to address some of the other improvements we asked them to consider making.

The areas where the provider should still make improvements are:

• Improve ways to identify and support carers.
• Develop a supporting business plan, with input from all staff, to help the provider achieve their priorities.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Updated 28 November 2017

• The practice nurse had a lead role in long-term disease management and patients at risk of hospital admission were identified as a priority.

• The practice had obtained 97% of the overall points available to them for providing recommended care and treatment to patients with diabetes. Performance for the diabetes related indicators was higher than most of the national averages. For example, the percentage of patients with diabetes, in whom the last blood pressure reading, in the period during the period from 1 April 2015 to 31 March 2016, was 140/80 mmHg or less, was higher when compared to the England average (84.6% compared to 77.6%).

• Patients with long-term conditions were offered annual reviews, to check that their health needs were being met and they were receiving the right medication. Consultation times for annual healthcare reviews were flexible to meet each patient’s specific needs. Structured clinic times were, however, provided for patients with diabetes.

• Longer appointments and home visits were available when needed.

• The clinical team met regularly with other healthcare professionals to discuss and manage the needs of patients with complex medical issues .

Updated 28 November 2017

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

• There were systems in place to protect children who were at risk and living in disadvantaged circumstances. For example, regular ‘supporting families’ meetings were held, where the needs of any vulnerable patients were discussed. Staff had completed appropriate child and adult safeguarding training. Appointments were available outside of school hours and the practice’s premises were suitable for children and babies.

• The practice worked with midwives and health visitors to support this population group when, for example, providing ante-natal and post-natal care.

• The practice had a comprehensive screening programme. Nationally reported information showed the practice’s performance was comparable with the national averages. For example, the uptake of cervical screening by females aged between 25 and 64, attending during the target period, was in line with the national average, 83.4% compared to 81.8%.

• The practice offered a full range of childhood immunisations and immunisation rates were relatively high for all standard childhood immunisations. For example, the practice had achieved 100% coverage in relation to 13 of the 18 immunisations given to children under five.

Updated 28 November 2017

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

• The Quality and Outcome Framework (QOF) data, for 2015/16, showed the practice had performed either above, or similar to, most of the clinical commissioning group (CCG) and national averages, in relation to providing care and treatment for the clinical conditions commonly associated with this population group.

• The practice offered proactive, personalised care which met the needs of older patients. For example, all patients over 75 years of age had a named GP who was responsible for their care. Home visits were provided for those who needed them. However, older patients over 75 years of age were not offered an annual healthcare check.

• Staff worked in partnership with other health care professionals to ensure that older patients received the care and treatment they needed. The practice team participated in the local High Risk Patient Pathway, to help reduce unplanned admissions into hospital for patients with the most complex needs.

Updated 28 November 2017

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The practice was proactive in offering online services, as well as a full range of health promotion and screening that reflected the needs of their patients.

• Patients were able to use on-line services to request prescriptions.

• The practice did not provide access to appointments outside of their core contract hours. However, patients were able to access the local out-of-hours service.

Updated 28 November 2017

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

• The practice had obtained 90.1% of the overall points available to them for providing recommended care and treatment to patients with mental health needs. Performance for the mental health related indicators was variable when compared to the national averages. For example, the percentage of patients with the specified mental health conditions, who had had a comprehensive, agreed care plan documented in their medical record, during the period from 1 April 2015 to 31 March 2016, was higher when compared with the England average (100% compared to 89%). The percentage of patients on lithium therapy with a record of lithium levels in the therapeutic range, during the proceeding four months, was lower when compared to the England average (50% compared to 89.8%).

• The practice had also obtained 89.7% of the overall points available to them for providing recommended care and treatment to patients with dementia. The QOF data also showed that 70.6% of patients diagnosed with dementia, had their care reviewed in a face to face meeting, during the last 12 months, which was below the national average of 83.8%.

• Recently published QOF data, for 2016/17, provided evidence that the practice had improved their performance in relation to these concerning clinical indicators.

• Patients experiencing poor mental health had access to information about how to access various support groups and voluntary organisations.

Updated 28 November 2017

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

• The practice held registers of patients living in vulnerable circumstances, including those with learning disabilities, so clinical staff could take this into account when providing care and treatment to these patients. Patients with learning disabilities were provided with access to an annual review of their needs to help ensure they were receiving the support they needed.

• Practice meetings were held to review the needs of end of life patients, to help ensure they were receiving appropriate care and support.

• Systems were in place to protect vulnerable children and adults from harm. Staff understood their responsibilities regarding information sharing and the documentation of safeguarding concerns, and they regularly worked with multi-disciplinary teams to help protect vulnerable patients. Staff were aware of how to contact relevant agencies in normal working hours and out-of-hours.

• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.