Fell Tower Medical Centre

Updated 3 January 2017

Fell Tower Medical Centre is registered with the Care Quality Commission to provide primary care services. It is located in the centre of Low Fell, Gateshead.

The practice provides services to around 7,400 patients from one location: 575-583 Durham Road, Low Fell, Gateshead, Tyne and Wear, NE9 5EY. The practice has three GP partners (one female and two male), one salaried GPs (male), a nurse practitioner and three practice nurses (all female), two healthcare assistants, a practice manager and a number of staff who carry out reception and administrative duties.

The practice is part of Newcastle Gateshead clinical commissioning group (CCG). The practice population is made up of a higher than average proportion of patients over the age 65 (19.5% compared to the national average of 17.1%). Information taken from Public Health England placed the area in which the practice is located in the fifth less deprived decile. In general, people living in more deprived areas tend to have greater need for health services.

The practice is based in purpose built premises which are accessible from the main street or from the car park behind the surgery. There is level access for patients entering the building from the car park. Patient services are delivered from the ground and first floors, with lift or stair access between the two floors. There is on-site parking, disabled parking, a disabled WC, wheelchair and step-free access.

Surgery opening times are Monday, Tuesday, Thursday and Friday 8:30am to 6pm, with extended hours on a Wednesday from 7am to 7:30pm. Patients can book appointments in person, on-line or by telephone.

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 Gateshead Community Based Care Limited, which is also known locally as Gat Doc.

Updated 3 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Fell Tower Medical Centre on 15 January 2015, which resulted in the practice being rated as good overall but as requiring improvement for the well led domain and the people experiencing poor mental health population group. This was because:

• The practice needed to improve their governance arrangements to ensure a strong link between analysis of their performance and continuous quality improvement, including use of audits, significant events and incidents analysis.
• The performance on the Quality and Outcomes Framework (QOF) indicators was lower than other practices.

In November 2016 we commenced a focussed inspection where we asked the practice to send us information to demonstrate how they had responded to the issues previously identified.

This report only covers our findings in relation to these issues. You can read the report from our last comprehensive inspection by selecting the ‘all report’ link for Fell Tower Medical Centre on our website at www.cqc.org.uk.

Our key findings were as follows:

• The practice had developed a formal business plan. This reflected the vision and values, included a summary of goals and objectives and was regularly monitored.
• A programme of staff meetings was in place. The practice had completed or was in the progress of completing a number of audits since the last inspection.
• Staff had received training on reporting significant events; and the number reported by nursing and administration staff subsequently increased.

The area where the provider should make improvements is:

• Take steps to ensure the care plans for patients with dementia are reviewed.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 9 April 2015

The practice is rated as good for the care of people with long-term conditions. There were emergency processes in place and referrals were made for patients whose health deteriorated suddenly. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 9 April 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, 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. 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. Emergency processes were in place and referrals were made for children and pregnant women whose health deteriorated suddenly.

Updated 9 April 2015

The practice is rated as good for the care of older people. Nationally reported data showed the practice had good outcomes for conditions commonly found amongst older people. The practice offered personalised care to meet the needs of the older people in its population. The practice had written to patients over the age of 75 years to inform them who their named GP was. The practice was responsive to the needs of older people, including offering home visits and rapid access appointments for those with enhanced needs.

Updated 9 April 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, 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 reflects the needs for this age group.

Updated 3 January 2017

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

During our inspection in January 2015 we found that the practice’s performance on mental health related Quality and Outcomes Framework (QOF) indicators was below average. For example, the practice had achieved 77.2% of the points compared to the national average of 90.4% and the percentage of patients with dementia whose care had been reviewed was below average, 68.8% compared to the national average of 83.8%.

We reviewed the latest QOF data for 2015/2016; this showed that although performance was still below average, the practice had improved and had achieved 84.1% of the points available (compared to the national average of 92.8%). Managers told us their exception rate was below local and national averages, which contributed to the lower overall scores (the QOF scheme includes the concept of ‘exception reporting’ to ensure that practices are not penalised where, for example, patients do not attend for review, or where a medication cannot be prescribed due to a contraindication or side-effect).

However, the 2015/2016 showed that the percentage of patients with dementia whose care had been reviewed was still below average, 72.5%, compared to the national average of 83.7%.

Updated 9 April 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 learning disabilities. The practice had carried out health checks for people with learning disabilities. The practice offered longer appointments for people, if required.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. They provided health services to two local services, Elizabeth House and Southern Wood Promoting Independence Care Centre, where patients would otherwise be at risk of poor access to primary medical care. They had 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.