Archived: Lintonville Medical Group

Updated 12 August 2016

Lintonville Medical Group provides care and treatment to 13,185 patients of all ages, based on a Personal Medical Services (PMS) contract. The practice is part of the NHS Northumberland clinical commissioning group (CCG) and provides care and treatment to patients living in Ashington, Ellington and the surrounding areas. We visited the following location as part of inspection: Lintonville Terrace, Ashington, Northumberland, NE63 9UT. The practice serves an area where deprivation is higher than the England average. In general, people living in more deprived areas tend to have greater need for health services. Most patients live in the Wansbeck ward, which is acknowledged as having higher than average national death rates. Many patients also have complex medical conditions. The practice population includes fewer patients who are under 18 years of age, and more patients aged over 65 years of age, than the England average. National data showed that 1.4% of the population are from an Asian ethnic minority background.

The practice consists of an original building which now houses the administrative team. A ground floor extension was added to this building in 1995. The extension contains 17 consultation rooms, as well as emergency, treatment and minor surgery rooms, and a large health education room. Other healthcare professionals are able to use the consultation rooms when required. There is also a pharmacy within the practice.

The practice has five GP partners (three male and two female), three salaried GPs (one male and two female), a nurse practitioner and two practice nurses (female.) The practice was also using a long-term nurse locum to support the nursing team. There were three healthcare assistants (female), an executive manager, a practice manager, a practice administrator and a large team of administrative and reception staff.

The practice is an approved training practice where qualified doctors gain experience in general practice. A GP registrar and two Foundation (Year 2) doctors were on placement at the time of our visit. The practice also offers training placements for student nurses.

The practice is open Monday to Friday between 8:30am and 6pm, and GP appointment times are Monday to Friday between 8:30am and 5:50pm.

When the practice is closed patients can access out-of-hours care via the Northern Doctors Urgent Care Limited On-Call service, and the NHS 111 service.

Updated 12 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Lintonville Medical Group on 14 April 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 a highly effective system for reporting and recording significant events. The staff team took the opportunity to learn from all internal and external incidents.

• Risks to patients and staff were assessed and well managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. They had the skills, knowledge and experience to deliver effective care and treatment.

• The practice worked closely with other organisations, when planning how services were provided, to ensure patients’ needs were met.

• Patients’ emotional and social needs were seen as being as important as their physical needs, and there was a strong, visible, person-centred culture. Patients said they were treated with compassion, dignity and respect and that they were involved in decisions about their treatment.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• Services were tailored to meet the needs of individual patients and were delivered in a way that ensured flexibility, choice and continuity of care. All staff were actively engaged in monitoring and improving quality and patient outcomes. Staff were highly committed to supporting patients to live healthier lives through a targeted and proactive approach to health promotion.

• The leadership, governance and management of the practice assured the delivery of good quality person-centred care, supported learning, and promoted an open and fair culture. Staff had a clear vision and strategy for the development of the practice and they had invested in the practice doing well.

However, there were also areas where the provider needs to make improvements. The provider should:

• Continue to review and improve the practice’s telephone access and appointment system.

• Provide those nursing staff who are prescribers with regular and appropriate clinical supervision.

• Keep a written record of any fire drills that take place.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 August 2016

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

Nationally reported QOF data, for 2014/15, showed the practice had performed well in relation to providing care and treatment for the clinical conditions commonly associated with this population group. For example, the practice had obtained 99.8% of the total points available to them, for providing care and treatment to patients with diabetes. This was 4.8% above the local CCG average and 10.6% above the England average. The practice’s multi-disciplinary team approach to managing long-term conditions enabled clinicians to offer co-ordinated appointments, so that patients with several medical conditions did not have to attend the practice more often than necessary. Patients with long-term conditions were offered annual reviews to check their health needs were being met and that they were receiving the right medication. Clinical staff were very good at working with other professionals to deliver a multi-disciplinary package of care to patients with complex needs. For example, they had worked in collaboration with other health and social care professionals to ensure emergency health care plans were in place to help keep this group of patients safe.

Updated 12 August 2016

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

There were good systems in place to protect children who were at risk and living in disadvantaged circumstances. For example, where clinicians had concerns about the safety of vulnerable children, they took appropriate action by consulting local safeguarding professionals and sharing their concerns. Monthly multi-disciplinary safeguarding meetings were held where the needs of vulnerable children and families were discussed. All clinical staff had completed safeguarding training that was relevant to their roles and responsibilities.

Appointments were available outside of school hours and the practice’s premises were suitable for children and babies. The practice provided a full programme of childhood immunisations. Publicly available information showed they had performed well in this area. For example, childhood immunisation rates for the vaccinations given to under two years old ranged from 95.2% to 98.2% (CCG average 95.3% to 98.1%). For five year olds rates ranged from 97.2% to 99.3% (CCG average 94.9% to 98.5%). The practice worked to encourage uptake of screening and immunisation programmes with the patients at the practice. The practice offered contraceptive and sexual health advice, and information was available within the practice, and on its website, about how patients could access specialist sexual health services. Nationally reported data showed the practice’s uptake of cervical screening was, at 87%, was higher than the national average of 81.4%. A good range of health promotion leaflets was available in the patient waiting area, including information about the practice being breastfeeding friendly.

Updated 12 August 2016

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

Nationally reported Quality and Outcomes Framework (QOF) data, for 2014/15, showed the practice had performed very well in relation to providing care and treatment for the clinical conditions commonly associated with this population group. For example, the practice had obtained 100% of the total points available to them, for providing care and treatment to patients who had heart failure. This was 1.1% above the local clinical commissioning group (CCG) average and 2.1% above the England average. 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. Staff had worked in partnership with specialist health care professionals to ensure that older patients received the care and treatment they needed, so that where possible, emergency admissions into hospital could be avoided.

Updated 12 August 2016

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 this group of patients. Nationally reported data showed the practice had performed well in providing recommended care and treatment to this group of patients. For example, the QOF data, for 2014/15, showed the practice had obtained 100% of the overall points available to them for providing care and treatment to patients who had hypertension. This was 0.3% above the local CCG average and 2.2% above the England average. Extended hours appointments were not routinely provided, although plans were being made to provide this service later in the year. Information on the practice’s website, and on display in their patient waiting areas, directed patients to the out-of-hours service. 

Updated 12 August 2016

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

There were good arrangements for meeting the needs of patients experiencing poor mental health. Nationally reported QOF data, for 2014/15, showed the practice had performed well in obtaining 100% of the total points available to them, for providing recommended care and treatment to this group of patients. Nationally reported data analysed by the CQC showed the practice’s performance with regards to carrying out reviews for patients experiencing poor mental health was comparable with other practices. For example, the data showed that the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in their record, in the preceding 12 months, was comparable to other practices. (93.4% compared to the national average of 88.4%.) There were clinical leads for mental health and dementia, who provided staff with guidance and expertise. Patients experiencing poor mental health were provided with advice about how to access various support groups and voluntary organisations. Community psychiatric nurse appointments were available at the practice.

The arrangements for meeting the needs of patients with dementia were overall good. Nationally reported QOF data, for 2014/15, showed the practice had performed well in obtaining 100% of the total points available to them, for providing recommended care and treatment to this group of patients. Nationally reported data analysed by the CQC showed the practice’s performance with regards to the percentage of patients diagnosed with dementia, whose care had been reviewed in a face-to-face review, in the preceding 12 months, was comparable with other practices. However, the percentage of patients receiving a review was lower at 76.7% when compared to the national average of 84%. The practice kept a register of patients who had dementia to help make sure they received the support they required. The practice’s clinical IT system clearly identified these patients to ensure staff were aware of their specific needs.

Updated 12 August 2016

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

There were good arrangements for meeting the needs of vulnerable patients and there were good systems in place to help reduce emergency admissions into hospital. For example, staff had been provided with clear and thorough guidance about how to manage the needs of the practice’s most vulnerable patients. The practice maintained a register of patients with learning disabilities which they used to ensure they received an annual healthcare review. Extended appointments were offered to enable this to happen. Systems were in place to protect vulnerable children from harm. Staff understood their responsibilities regarding information sharing and the documentation of safeguarding concerns. Good arrangements had been made to meet the needs of patients who were also carers.