NPC North Tyneside – Spring Terrace

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination.

At our last assessment, we rated this key question as good. At this assessment, the rating remains the same.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

The practice recognised and responded to people’s cultural, communication and individual needs through a range of measures, including interpreter support, and translated information.

The practice implemented proactive approaches to support frail and housebound patients, including comprehensive GP reviews, medication reviews and opportunities to discuss advance care planning. A quality improvement project undertaken between June and November 2025 demonstrated improvements in access to GP reviews from 52% to 76% and medication reviews from 84% to 96%, helping to ensure care was tailored to patients' individual needs and circumstances.

The project report noted that informal feedback from patients and relatives was overwhelmingly positive. Patients reported greater confidence in their primary care provider and improved awareness of how to access support services, including social prescribing, frailty services, acute services and social care.

The provider understood the diverse health and care needs of people and local communities, enabling care to be coordinated, flexible and responsive. The practice used population health data and community engagement to better understand the needs of its population and inform service delivery, including targeted work with Bangladeshi and Black, Asian and Minority Ethnic communities.

NPC North Tyneside implemented a proactive frailty model to support people living with frailty, housebound patients and care home residents through multidisciplinary working and coordinated care.

We were told improving continuity of care was a key focus within the provider’s operating model. Across the Whitley Bay practices, systems had been introduced to allocate patients a named GP and support them to see or speak with the same clinician where appropriate. The provider told us this approach aimed to strengthen continuity of care, particularly for people with frailty, complex needs and long-term conditions, and there were plans to extend this model across the North Shields practices.

The provider supplied appropriate, accurate and up-to-date information in formats tailored to people's individual needs. The practice recognised and responded to communication needs through interpreter services, including British Sign Language interpreters, translated information and other reasonable adjustments where required.

The practice used population health data and community engagement to better understand the needs of its local population, including the Bangladeshi community. Through this work, the practice identified language and communication needs, barriers to accessing healthcare and preventative services, and opportunities to improve support for people living with long-term conditions. This informed the development of tailored health information and targeted health promotion initiatives designed to address identified health inequalities. We saw examples of culturally relevant translated resources for Bangladeshi patients, including information about managing Type 2 diabetes during Ramadan. This helped people access information in a way that reflected their language, culture and beliefs and supported them to make informed decisions about their health and treatment.

Information was shared through a range of communication channels, including social media, the practice website, noticeboards and the Patient Participation Group. The practice also produced a regular staff newsletter to support communication and keep staff informed about practice updates and services.

People's communication needs were identified, recorded and supported in line with the Accessible Information Standard, helping people to understand information about their health, care and treatment and participate in decisions about their care.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

We saw complaints were managed in line with the provider’s policy. Learning from complaints and feedback was evident, and staff were able to identify changes made as a result. For example, staff told us that patients had requested a dedicated children’s area within the waiting room, particularly for children with additional needs. In response, a sensory and play area was introduced at 1 site to better support children and families attending appointments. Patients registered at any of the provider’s sites could choose to attend this location if this environment better met their needs.

The provider made sure that people could access the care, support and treatment they needed when they needed it. Extended access appointments were available, supporting patients who required flexibility outside of core hours. People could access the service in a way that suited their needs, including online, in person and by telephone.

The practice implemented a proactive frailty model to support older people, frail patients, care home residents and those who were housebound. This approach helped ensure that vulnerable patients were identified and received regular clinical oversight, reducing potential barriers to accessing planned care and support.

Results from the 2026 National GP Patient Survey showed feedback on access was mostly positive A total of 76% of respondents said they found it easy to contact the practice by phone, compared with a national average of 57%, and 62% said it was easy to use the practice website, compared with a national average of 58%.

The provider took steps to reduce barriers to accessing care. Facilities included wheelchair-accessible and automatic doors, wheelchairs for patient use, hearing loops and downstairs consulting rooms at multi-storey sites to support patients with mobility needs.

Staff and leaders actively sought to understand and address inequalities in experience and outcomes. The practice used population health data, community engagement and quality improvement activity to identify groups at increased risk of poorer health outcomes and implemented targeted interventions to reduce barriers and promote equitable outcomes.

In 2025, the practice developed a dedicated health inequalities workstream for its Bangladeshi population. A population health assessment identified 254 Bangladeshi patients (5.3% of the practice population at that time) and established baseline measures relating to long-term conditions, preventative healthcare uptake and communication needs. This identified 33 patients with Type 2 diabetes, of whom 15 (45.5%) had completed an annual diabetes review, and flu vaccination uptake of 36.2% amongst eligible patients. In response, the practice introduced translated health information, interpreter support, culturally tailored diabetes information, support during Ramadan and targeted initiatives to improve access to screening, vaccination and long-term condition reviews. As this was a newly established workstream, a full re-audit had not yet been completed. However, leaders had started putting the planned interventions in place and established a framework for monitoring outcomes through quarterly governance meetings, supported by 6-monthly and annual re-audit activity.

The practice actively engaged with ethnic minority communities to understand barriers to accessing healthcare and used feedback to inform service development. Between March and April 2024, 9 community conversation workshops involving over 30 people identified barriers including language difficulties, understanding healthcare information, appointment access and digital exclusion. Learning from this work informed improvements to communication, access and community outreach.

Targeted work was also undertaken to improve cervical screening uptake amongst women from Black, Asian and Minority Ethnic (BAME) communities. Community engagement identified language and information barriers, leading to the development of multilingual communications and direct booking opportunities. Following targeted searches and invitations, 2 women attended cervical screening appointments, including 1 woman in her 50s who had never previously attended screening. Participants reported the sessions improved their understanding of available services and health promotion opportunities.

The provider also told us it had undertaken a wider programme of work to improve cervical screening uptake, including personalised invitations, additional reminders, direct follow-up by the Primary Care Network (PCN) Cancer Care Co-ordinator, text message booking links and additional screening clinics. Unverified Quality and Outcomes Framework (QOF) data for 2025/26 indicated cervical screening coverage of 81.9% for women aged 25 to 49 years and 81.6% for women aged 50 to 64 years, meeting the national target in both age groups.

Services were adapted to meet the needs of vulnerable and underserved groups. The practice operated a flexible registration process for people with no fixed address and asylum seekers and provided reasonable adjustments, including interpreter services, longer appointments and tailored support for people with communication needs.

The practice demonstrated a commitment to equality and inclusion through Pride in Practice Gold Accreditation and Veteran Friendly Accreditation, reflecting its work to meet the needs of LGBTQ+ people and military veterans. The practice also acted as a dedicated practice and correspondence address for people accessing women's refuge and domestic abuse services across North Tyneside where a protected address was required. These arrangements helped reduce barriers to healthcare, protect confidentiality and support vulnerable people.

People were supported to plan for important life changes and future care needs, including decisions relating to end-of-life care. The practice encouraged discussions about people's wishes and preferences, ensuring they had sufficient time and information to make informed decisions about their future care and treatment.

Our records review showed people were supported to consider and document their wishes for end-of-life care, including decisions relating to cardiopulmonary resuscitation. Information about people's preferences was shared with other services where appropriate to support coordinated and person-centred care. A quality improvement project undertaken between June and November 2025 for a cohort of frail, housebound patients also demonstrated improvements in advance care planning. Within this cohort, documented DNACPR decisions increased from 13 of 64 patients (20%) to 23 of 72 patients (32%), while Emergency Health Care Plans increased from 4 of 64 patients (6%) to 11 of 72 patients (15%). A further 9 patients (13%) had declined advance care planning discussions.

Annual end-of-life audits were undertaken to review the quality-of-care planning and the identification of patients approaching the end of life. The audits assessed performance against recognised standards and demonstrated that the practice consistently met its target for identifying and supporting patients requiring palliative care.

The audits also reviewed whether patients' wishes and preferences had been discussed and documented. Across the last 3 audit cycles, between 53% and 62% of patients had a preferred place of death recorded. Where a preference had been documented, 100% of patients died in their stated preferred place of death. This demonstrated that people's wishes and preferences were recognised, recorded and respected when planning their future care, helping to ensure care at the end of life was provided in accordance with what mattered most to them.

Feedback received from care homes was positive, with staff describing the practice as providing excellent care and support for residents approaching the end of life.