Archived: Dr Funmilayo Nixon Also known as Westoe Surgery

Updated 30 July 2015

The practice is based within Stanhope Parade Health Centre in South Shields, Tyne and Wear. The practice serves people living in South Shields. The practice provides services to patients from one location: Stanhope Parade Health Centre, Gordon Street, South Shields, Tyne and Wear, NE33 4JP. We visited this address as part of the inspection.

The practice is located in a purpose built two storey building and provides services to patients at ground floor level. They offer on-site parking including disabled parking, accessible WC’s and step-free access. They provide services to just under 2,800 patients of all ages based on a Primary Medical Services (PMS) contract agreement for general practice.

The practice has two GPs in total (both female); the lead GP and one salaried GP. They also employ a long term male locum GP. There is also one practice nurse, one healthcare assistant, a practice manager, a secretary, a senior administrator and four receptionists.

Information taken from Public Health England placed the area in which the practice was located in the fourth more deprived decile. In general, people living in more deprived areas tend to have greater need for health services. The practice’s age distribution profile is weighted towards a slightly older population than national averages. There are fewer patients registered with the practice between the ages of 0-19 years than the national averages.

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

Updated 30 July 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Funmilayo Nixon (also known as Westoe Surgery) on 9 June 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led services. It was also good for providing services for the following population groups: Older people; People with long-term conditions; Families, children and young people; Working age people (including those recently retired and students); People whose circumstances may make them vulnerable; People experiencing poor mental health (including people with dementia).

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• 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.
• The majority of 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 offered pre-bookable early evening appointments one day per week with a GP, practice nurse and healthcare assistant, which improved access for patients who worked full time.
• 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.

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

Importantly the provider should:

• Ensure that all clinical audits include at least two cycles. The practice should aim to demonstrate an on-going audit programme where they have made continuous improvements to patient care in a range of clinical areas as a result of clinical audit.
• Continue the work already in progress to review and improve health and safety arrangements, policies and procedures within the practice.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 30 July 2015

The practice is rated as good for the care of people with long-term conditions. Staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients were offered a structured review at least annually to check that their health and medication needs were being met. For those people with the most complex needs, the practice worked with relevant health and care professionals to deliver a multidisciplinary package of care. A traffic light system was used to highlight those patients that required more intense input from the clinical team. The list was reviewed on a regular basis and discussed at multidisciplinary meetings.

The practice held regular chronic disease management clinics in diabetes and for patients with respiratory conditions. The practice had also taken part in a respiratory research day, run by the local district hospital. A medicines optimisation pharmacist supported the practice and kept them updated on medication guidelines.

Updated 30 July 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. They had initiated regular meetings with the health visitor and midwife. This allowed them to monitor families and children who may be experiencing difficulties and intervene quickly if necessary.

The practice held a weekly baby clinic and arranged baby checks, immunisations and mothers’ post-natal checks on the same day. The secretary co-ordinated the clinic and all patient appointments. This helped to reduce the need for mothers, babies and young children to attend on more than one occasion. Immunisation rates were generally higher than the averages for the local CCG. For example, Men C Booster vaccination rates for two year old children were 100% compared to 98.2% across the CCG and Hib/Men C Booster rates for five year old children were 92.6% compared to 90.7% across the CCG.

Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals. Appointments were available outside of school hours and the premises were suitable for children and babies. The practice was working towards achieving ‘You’re Welcome’ accreditation. 'You're Welcome' is the Department of Health's quality criteria for young people friendly health services.

The practice had achieved slightly lower cervical screening rates (80.2%) compared to the national average (81.9%).

Updated 30 July 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, 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, including offering home visits and rapid access appointments for those with enhanced needs.

The practice carried out annual checks for all of their patients over the age of 75. They had 265 patients of this age registered and had consulted with 263 of these (99%) in the last year.

The practice was linked with a local care home and the lead GP completed a ward round at the home once per week. They had received a letter from the care home manager on behalf of the staff, residents and their families thanking them for their work, professionalism and personal approach. The lead GP was accredited with a special interest in Elderly Care.

The practice maintained a palliative care register which included around 1% of their registered patients. They offered immunisations for pneumonia and shingles to older people.

The practice leaflet was printed in a large, easy to read font. This helped to make it easier for those patients who may have sight or reading difficulties to read and understand it.

Updated 30 July 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 and flexible. The practice offered some online services as well as a full range of health promotion and screening which reflects the needs for this age group. GP appointments could be booked in advance online. The practice had been actively promoting its online services and the number of patients registered for these had increased from 195 to 321 in the last three months; an increase of 65%.

The practice offered extended opening hours one evening per week. Patients could pre-book appointments to see a GP, practice nurse and healthcare assistant at these times. Telephone consultations with clinicians could also be booked on a daily basis. This made it easier for people of working age to get access to the service. NHS health checks were offered to patients between the ages of 40 and 74.

Updated 30 July 2015

The practice is rated as good for the care of people experiencing poor mental health (including people living with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those living with dementia. They carried out advance care planning for patients living with dementia. The practice had 40 patients on their register as living with dementia and 36 of those patients (90%) had received an annual review of their care in the last 12 months.

The practice had 28 patients on their register as experiencing poor mental health and 21 of those patients (75%) had received an annual health check in the last 12 months.

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

Updated 30 July 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. 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. The GPs completed regular training in this area to ensure they were offering the best care to those who may not always be in the best position to ask for it themselves.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. They supported vulnerable patients and helped them 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.

There was a women’s refuge located close to the practice and the practice offered support to patients from there when they registered with them. This included providing them with assurances that all of their details would be kept confidential.

Staff at the practice had completed ‘Stonewall’ training and the practice was classed as ‘Stonewall friendly’. Stonewall is a lesbian, gay, bisexual and transgender (LGBT) rights charity. The staff we spoke with said it had raised their awareness of the need to treat people equally and to ensure there was no discrimination based on gender or sexual orientation within the practice.

Patients with drug and alcohol dependencies could see support workers at the surgery and the practice also worked closely with the local domestic abuse link worker.

The practice leaflet was printed in a large, easy to read font. This helped to make it easier for those patients who may have sight or reading difficulties to read and understand it.