Dr McManners and Partners

Updated 18 August 2016

Dr McManners and Partners is registered with the Care Quality Commission to provide primary care services. It is located in the coastal town of Whitley Bay, Tyne and Wear.

The practice provides services to around 12,800 patients from one location: The Health Centre, Whitley Road, Whitley Bay, Tyne and Wear, NE26 2ND. We visited this address as part of the inspection. The practice has seven GP partners (two female and five male), two senior practice nurses and one practice nurse (all female), a practice manager, and 15 staff who carry out reception, administrative and dispensing 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 (21.92% compared to the national average of 18.9%). Information taken from Public Health England placed the area in which the practice is located in the second less deprived decile. In general, people living in more deprived areas tend to have greater need for health services.

The practice is located in a purpose built two storey building. All patient facilities are on the ground floor. There is on-site parking, disabled parking, a disabled WC, wheelchair and step-free access.

Opening hours are between 8.30am and 8.40pm every Monday and between 8.30am and 6pm Tuesday to Friday. Patients can book appointments in person, on-line or by telephone. Appointments were available at the following times:

• Monday - 8.30am to 11.10am; then from 1.30pm to 8pm
• Tuesday – 9am to 11.20am; then from 3.05pm to 5.20pm
• Wednesday – 9am to 11.20am; then from 3.05pm to 5.20pm
• Thursday – 9am to 11.20am; then from 3.05pm to 5.20pm
• Friday – 9am to 11.20am; then from 3.05pm to 5.20pm

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 18 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr McManners and Partners on 5 July 2016. Overall the practice is rated as outstanding.

Our key findings were as follows:

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Effective arrangements were in place to ensure GPs kept up to date with new guidance. GPs prepared clinical protocols, which took into account national and local guidelines, which all clinical staff followed. At the time of the inspection there were 32 clinical protocols in place.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• Feedback from patients was continually positive.
• 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 used proactive methods to improve patient outcomes.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.
• 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. Many staff were longstanding members of the team and had worked at the practice for many years.
• Information about services and how to complain was available and easy to understand.

We saw the following area of outstanding practice:

• Relationships between patients and staff were strong. The practice operated a personalised list service, where each GP had an individual list of patients. Many patients told us they liked the personalised list system, this meant they were able to see the same GP each time and felt the practice offered good continuity of care. The practice scored extremely well in the National GP Patient Survey in relation to patients being able to see their preferred GP. The practice’s score in that category was the highest in the CCG and was the seventh highest nationally (from a total of over 7,300 practices).

The area where the provider should make improvements is:

• Continue to review the Quality and Outcomes Framework (QOF) clinical exception reporting rates and take action to reduce rates where appropriate to do so.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 18 August 2016

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

• The practice had established a computer services team; their role was to co-ordinate patients’ long term condition reviews. They worked with clinical staff and highlighted when patients had declined to attend review appointments.
• Patients at risk of admission to hospital were identified as a priority.
• The practice had adopted the ‘Year of Care’ initiative (the Year of Care is about improving care for people with long-term conditions. It is about putting people with long term conditions firmly in control of their care, and supports them to self-manage).
• Longer appointments and home visits were available when needed.
• 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 18 August 2016

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

• 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. For example, childhood immunisation rates for the vaccinations given to under two year olds ranged from 98.2% to 99.1% (compared to the CCG averages of between 97.3% and 98.7%) and for five year olds from 93.4% to 97.1% (compared to the CCG averages of between 92.2% and 98.4%).
• Staff had received training in identifying female genital mutilation and forced marriage.
• 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 latest publicly available data showed the practice’s uptake for breast and bowel screening was above average. For example, the uptake for females aged between 50 and 70 screened for breast cancer within six months of invitation was 79.9%, compared to the local average of 76.2% and the national average of 72.2%.
• Further, 63.1% of patients aged 60-69 had been screened for bowel cancer within the last 30 months, compared to the local average of 58.3% and the national average of 58.7%.
• Pregnant women were able to access an antenatal clinic provided by healthcare staff attached to the practice.

Updated 18 August 2016

The practice is rated as outstanding for the care of older people, as the practice is rated as outstanding overall.

• The practice offered proactive, personalised care to meet the needs of the older people in its population. 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.
• A palliative care register was maintained and the practice offered immunisations for pneumonia and shingles to older people.
• The practice had effective arrangements in place to provide person centred pathways of care, particularly for people with complex needs. There was a higher proportion of patients over the age of 65. The practice took part in the CCG’s admission avoidance scheme, and had identified those patients at high risk of admission to hospital. Staff closely monitored this group of patients; all hospital attendances and admissions were reviewed and patients had enhanced access to appointments. These arrangements, in conjunction with the personalised list system, meant that despite having a higher number of older patients, the practice had a lower number of unplanned admissions to hospital than both the CCG and regional averages.

Updated 18 August 2016

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

• 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. Extended hours surgeries were offered on Monday evenings until 8.40pm for working patients who could not attend during normal opening hours.
• 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. . In 2015/2016, 26.8% of the practice’s population was registered for on-line access; the highest in the clinical commissioning group (CCG) area.
• Additional services were provided such as health checks for the over 40s and travel vaccinations.

Updated 18 August 2016

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

• 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 18 August 2016

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

• 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 and were offered longer appointments, if required.
• 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.