St Georges & Riverside Medical Group

Updated 9 June 2017

St Georges & Riverside Medical Group is registered with the Care Quality Commission to provide primary care services. The practice provides services to around 7,200 patients from two locations and we visited both of these addresses as part of the inspection.

• St Georges Medical Practice, New George Street, South Shields, Tyne and Wear, NE33 5DU.
• Riverside Medical Practice, Flagg Court Medical Centre, Dale Street, South Shields, Tyne and Wear, NE33 2PG.

The practices were taken over in March and April 2015 by Intrahealth Limited, which is a corporate provider of NHS primary care services. The practices merged when they were taken over and patients can now access care at either address.

St Georges Medical Practice and Riverside Medical Practice are both situated in purpose-built premises in South Shields which are shared with other services. All reception and consultation rooms are fully accessible for patients with mobility issues. An onsite car park is available which includes dedicated disabled parking bays.

The practice has three salaried GP’s (two male, one female), whole time equivalent (WTE) of 1.84. The practice employs a practice manager WTE 1, there is a vacancy for one advanced nurse practitioner WTE 1, there are two practice nurses WTE 1.43. There are three pharmacists, WTE 0.99, including a senior clinical pharmacist who works at the practice. There are two health care assistants WTE 0.78. There are nine staff who undertake reception and administrative duties, WTE 7.68. The practice provides services based on an Alternative Provider Medical Services (APMS) contract agreement for general practice.

St Georges Medical Practice is open at the following times:

• Monday, Wednesday and Thursday and Friday 8am to 6:30pm.
• Tuesday, 8am to 7:30pm.

Riverside Medical Practice is open at the following times:

• Monday to Friday 8am to 6:30pm.
• Saturday 9am to 12noon.

The telephones are answered by the practice during their opening times. When the practice is closed patients are directed to the NHS 111 service. This information is also available on the practices’ website and in the practice leaflet.

Appointments are available at St Georges Medical Practice at the following times:

• ​Monday 8:45am to 12 noon and 12:30pm to 5:10pm
• Tuesday 8:30am to 12 noon and 12:30pm to 7:20pm
• Wednesday 8:15am to 11:45pm and 1pm to 6pm
• Thursday 8:30am to 11.50pm and 12.30pm to 5pm
• Friday 8:15am to 11:45pm and 1:15pm to 6pm

Appointments are available at Riverside Medical Practiceat the following times:

• ​​Monday 8:15am to 11:45am and 13:15pm to 6pm
• Tuesday 8:15am to 12:30am and 1:15pm to 6pm
• Wednesday 9:30am to 11:45am and 1pm to 5pm
• Thursday 8:15am to 11:50am and 12:30pm to 6pm
• Friday 9am to 11:45am and 1pm to 5:10pm
• Saturday 9am to 12 noon

Extended hours appointments are available until 7:20pm on a Tuesday at St Georges Medical Practice and from 9am to 12 noon on a Saturday at Riverside Medical Practice. These appointments were pre-bookable; however, walk in patients would be seen if an appointment was available.

The practice is part of NHS South Tyneside clinical commission group (CCG). Information from Public Health England placed the area in which the practice is located in the second most deprived decile. The income deprivation score for the practice was 38 compared to the CCG average of 31 and the national average of 22. In general, people living in more deprived areas tend to have greater need for health services. Average male life expectancy at the practice is 76 years compared to the national average of 79 years. Average female life expectancy at the practice is 81 years compared to the national average of 83 years.

The service for patients requiring urgent medical care out of hours is provided by the NHS 111 service and Vocare, which is locally known as Northern Doctors Urgent Care Limited.

Updated 9 June 2017

Letter from the Chief Inspector of General Practice

On 6 September 2016 we carried out an announced comprehensive inspection at St George’s and Riverside Medical Group. The overall rating for the practice was requires improvement, having being judged as requires improvement for Safe, Effective and Well Led. The full comprehensive report on the September 2016 inspection can be found by selecting the ‘all reports’ link for St George’s and Riverside Medical Group on our website at www.cqc.org.uk. After the comprehensive inspection the practice wrote to us to say what they would do to meet the following legal requirements set out in the Health and Social Care Act (HSCA) 2008:

• Regulation 17 Health & Social Care Act 2008 (Regulated Activities) Regulations 2014 Good governance.

This announced comprehensive inspection was carried out on the 27 April 2017 in order to review the action by the practice to be compliant with the regulations. Overall the practice is now rated as good.

• Staff understood and fulfilled their responsibilities to raise concerns, and report incidents and near misses; improvements had been made to the significant event reporting process.
• Risks to patients were assessed and well managed.
• Outcomes for patients who use services had improved and there was a programme of clinical audit in place.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff were consistent and proactive in supporting patients to live healthier lives through a targeted approach to health promotion. Information was provided to patients to help them understand the care and treatment available.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice had a system in place for handling complaints and concerns and responded quickly to any complaints.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a leadership structure in place and staff felt supported by management. The practice sought feedback from staff and patients, which they acted on.
• The practice was aware of and complied with the requirements of the Duty of Candour regulation.

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

In addition the provider should:

• Liaise with the landlord of the premises to repair or replace the damaged seats in the reception area.
• Follow the Public Health Guidelines in relation to the record keeping of the stock control of vaccines.
• Update the locum induction pack with more comprehensive information, for example, safeguarding arrangements for the practice and locality.
• Complete the process for appointing a registered manager for the merged practice in line with CQC guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 June 2017

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

Nursing staff had lead roles in chronic disease management. Patients at risk of hospital admission were identified as a priority for care and support by the practice.

The practice provided data that showed that outcomes for patients with long-term conditions had improved recently, for example, the practice had recently received maximum points (100%) for the clinical indicator for asthma in the Quality and Outcomes Framework (QOF). This was as a result of the practice improving their recall system for patients with long term conditions.

Longer appointments and home visits were available when needed. All patients with a long-term condition had a named GP and were offered a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. There were monthly integrated care meetings.

Updated 9 June 2017

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

There were processes in place for the regular assessment of children’s development. This included the early identification of problems and the timely follow up of these. Systems were in place for identifying and following-up children who were considered to be at-risk of harm or neglect. For example, the needs of all at-risk children were regularly reviewed at practice multidisciplinary meetings involving child care professionals such as health visitors. Appointments were available outside of school hours and the premises were suitable for children and babies.

There were arrangements for new babies to receive the immunisations they needed. Childhood immunisation rates for the vaccinations given were in line with CCG/national averages. For example, childhood immunisation rates for the vaccinations given to five year olds were at 98%, compared to CCG averages of 96% to 99%. Urgent appointments for children were available on the same day. Pregnant women were able to access an antenatal clinic provided by healthcare staff attached to the practice. The practice provided emergency contraceptive and sexual health advice.

Updated 9 June 2017

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. For example, patients at high risk of hospital admission and those in vulnerable circumstances had care plans in place. All patients over the age of 75 had an allocated named GP. The practice maintained a palliative care register and end of life care plans were in place for those patients they were appropriate for. They offered immunisations against pneumonia and shingles to older people and in their own home where necessary. Prescriptions could be sent to any local pharmacy electronically. The practice had recently introduced a phlebotomy service.

Updated 9 June 2017

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. Patients could order repeat prescriptions and routine healthcare appointments online. Telephone appointments were available. A text message reminder service was available.

The practice offered a full range of health promotion and screening which reflected the needs for this age group. The practice’s uptake for cervical screening was 76%, which is below the national average of 81%. The practice had recently improved their uptake on health checks for those patients aged over 40.

Extended hours appointments were available until 7:20pm on a Tuesday at St Georges Medical Practice and from 9am to 12 noon on a Saturday at Riverside Medical Practice. 

Updated 9 June 2017

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

The practice maintained a register of patients experiencing poor mental health and recalled them for regular reviews. Patients were advised how to access various support groups and voluntary organisations. Where appropriate patients with complex conditions were discussed amongst the clinicians at their regular MDT meetings.

Updated 9 June 2017

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

The practice regularly worked with multi-disciplinary teams (MDT) in the case management of vulnerable people. 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. Where appropriate, patients with complex conditions were discussed amongst the clinicians at their regular MDT meetings.

The practice had increased the number of patients who had a learning disability review in the last year from eight to 30.

The practice’s computer system alerted GPs if a patient was a carer. There were 296 coded on the practice system which was 4.1% of the practice population.

The practice had begun to carry out searches of the clinical system to identify patients who had no contact with the practice in the last year to identify patients who are potentially socially isolated.