Eastgate Medical Group

Updated 27 May 2016

Eastgate Medical Group is located close to the centre of Hornsea and is close to local bus routes. There is parking, including disabled parking available at the practice. The practice is in a modern purpose built health centre and is situated in the grounds of the community hospital. Consulting and treatment rooms are available on the ground floor and there is lift access to the first floor. There is one branch site at Aldbrough and this was visited during the inspection.

The practice provides services under a General Medical Services (GMS) contract with the NHS North Yorkshire and Humber Area Team and has a patient list of 12399, covering patients of all ages. The practice is a ‘dispensing practice’ and is able to dispense medicines for patients who live more than one mile from the nearest pharmacy.

The proportion of the practice population in the 65 years and over age group is above the England average. The practice population in the under 18 age group is similar to the England average. The practice scored six on the deprivation measurement scale, the deprivation scale goes from one to ten, with one being the most deprived. People living in more deprived areas tend to have a greater need for health services.

The practice has seven GP partners and one salaried GP, five full time and three part time. There are six male and two female GPs. There is one nurse practitioner, three practice nurses and two health care assistants (HCA), the nurses are all female and there is one male HCA. There is a HCA post currently vacant. There is a practice manager, an office supervisor and a team of administration, reception and secretarial staff.

The Eastgate site is open between 8.30am to 6pm Monday to Friday. Appointments are available from 8.30am to 11.30am and 4pm to 6pm Monday to Friday. The Aldbrough surgery is open 8.30am to 6pm Monday, Tuesday, Thursday and Friday and 2.30pm to 6pm on Wednesday. Appointments are available from 8.30am to 11.30am and 4pm to 6pm. Information about the opening times is available on the website.

The practice, along with all other practices in the East Riding of Yorkshire CCG area have a contractual agreement for the Out of Hours provider to provide OOHs services from 6.00pm. This has been agreed with the NHS England area team.

The practice has opted out of providing out of hours services (OOHs) for their patients. When the practice is closed patients use the 111 service to contact the OOHs provider. Information for patients requiring urgent medical attention out of hours is available in the waiting area, in the practice information leaflet and on the practice website.

The practice is a teaching practice for 3rd, 4th and 5th year medical students from the Hull York Medical School. The practice is also a training practice for GP registrars and student nurses.

Updated 27 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Eastgate Medical Group on 14 & 15 March 2016. 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.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff had the skills, knowledge and experience to deliver effective care and treatment.
• 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 were able to get same day appointments however some patients told us it could be difficult to make appointments. GPs had ‘personal lists’ providing all patients with a named GP and continuity of care.
• 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.

We saw an area of outstanding practice.

The practice had identified that direct access referral for CT Scans of head, chest, abdomen and pelvis would improve the quality of referrals and reduce the need for patients to attend unnecessary hospital appointments. This was discussed with the hospital radiology department and it was agreed to run a small pilot scheme with three practices to allow them direct access referral. After six months feedback from the pilot was positive and it was agreed that all the practices in the area would be enrolled onto the community CT access scheme.

An audit showed that of the 72 practice patients who had been referred through the direct access scheme 18% had had an improved referral and 46% had had an unnecessary referral prevented.

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

Importantly the provider should:

• Ensure there is an audit trail of blank prescriptions forms.

• Ensure all staff are up to date with mandatory training.

• Implement a carers register.

• Ensure the practice has a written strategy and supporting business plan which outlines their vision and plans for the future.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 May 2016

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

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

• Nationally reported data for 2014/2015 showed that outcomes for patients with long term conditions were good. For example, the percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months was 85.8%. This was 2.5% below the local CCG and England average.

• Longer appointments and home visits were available when needed.

• Patients with LTCs had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 27 May 2016

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 A&E attendances or who failed to attend hospital appointments.

• Immunisation rates were high for all standard childhood immunisations. For example, rates for all but one immunisation given to children aged 12 months, 24 months and five years were 95% or above.

• 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.

• Nationally reported data from 2014/2015 showed the practice’s uptake for the cervical screening programme was 95.2%. This was 10.3% above the local CCG average and 13.4% above the England average.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw good examples of joint working with midwives, health visitors and school nurses.

  The practice monitored any non-attendance of babies and children at vaccination clinics and worked with the health visiting service to follow up any concerns.

Updated 27 May 2016

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population. Patients over the age of 75 had a named GP.

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

• Nationally reported data for 2014/2015 showed that outcomes were good for conditions commonly found in older people. For example, performance for heart failure indicators was 100%; this was 1.9% above the local CCG average and 2.1% above the England average.

• The practice was delivering ‘The Care Home Scheme’. This ensured patients living in care homes had structured annual reviews which included a review of medication by a pharmacist, review of clinical care and advanced care planning.

Updated 27 May 2016

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.

• Telephone consultations were available every day with a call back appointment arranged at a time to suit the patient, for example during their lunch break.

Updated 27 May 2016

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

• Nationally reported data from 2014/2015 showed 76.1% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the preceding 12 months. This was 8.1% below the local CCG average and 7.9% below the England average.

• Nationally reported data from 2014/2015 showed the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive care plan documented in their record in the preceding 12 months was 98.2%. This was 7.3% above the local CCG average and 9.9% above the England average.

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

• The practice carried out advanced 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 people with mental health needs and dementia. Staff had recently undergone dementia training to become ‘dementia friends’. (A dementia friend is someone who learns more about what it is like to live with dementia and turns that understanding into action).

Updated 27 May 2016

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 which included those with a learning disability.

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

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• The practice 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.

• Telephone interpretation services were available and information leaflets in different languages were provided when required.