Archived: Newtown Surgery

Updated 1 May 2018

Newtown Surgery is located in Widnes in a large resource centre that is purpose built and close to local facilities, with access to a large car park. It is registered with CQC to provide primary care services. The practice has a General Medical Services (GMS) contract with a registered list size of 7500 patients (at the time of desk-based review).

The practice has one lead GP (male), one salaried GP (Male) and three long term locum GPs (two male and one female), one advanced nurse practitioner (female) and a clinical pharmacist (female). They are also supported by three practice nurses. At the time of this desk-based review the practice administration team was overseen by an interim practice manager and a staff supervisor.  The interim practice manager is on site one day a week and offers support through daily phone calls and can attend the surgery at any time if requested to do so.

The practice is open from 7.30am to 6.30pm on Monday and Wednesday and 8am to 6.30pm on Tuesday, Thursday and Friday.

Patients requiring GP services outside of normal working hours are referred to the local out of hours provider. Patients can book appointments in person, via the telephone or online. The practice provides telephone consultations, pre-bookable consultations, urgent consultations and home visits.

The practice is part of Halton Group Clinical Commissioning Group (CCG). The practice offers a range of enhanced services including, minor surgery, flu vaccinations and learning disability health checks.

We previously inspected Newtown Surgery on 5 April 2017. The overall rating for the practice was good, with a rating of requires improvement for the key question of responsive.

The full comprehensive report on 5 April 2017 inspection can be found by selecting the ‘all reports’ link for Newton Surgery on our website at www.cqc.org.uk.

This desk-based review was carried out on 11 April 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulation that we identified in our previous inspection on 5 April 2017.

This report covers our findings in relation to that requirement made at our last inspection.

Updated 1 May 2018

We previously carried out an announced comprehensive inspection at Newtown Surgery on 5 April 2017.

The overall rating for the practice was good with a rating of requires improvement for the key question of responsive. The full comprehensive report on 5 April 2017 inspection can be found by selecting the ‘all reports’ link for Newton Surgery on our website at www.cqc.org.uk.

This desk-based review was carried out on 11 April 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulation that we identified in our previous inspection on 5 April 2017. This report covers our findings in relation to that requirement made at our last inspection.

Overall the practice is still rated as good and rated as good for providing a responsive service.

Our key findings were as follows:

The practice had made improvements and addressed the issues identified in the previous inspection. Improvements included:

• Action had been taken to improve capacity for the provision of clinical appointments and improve patient experience of access to the service:
• The practice had extended its operating hours to include Thursday afternoons.
• There had been an increase on online appointments available.
• There had been an increase of advanced booking online appointments.
• There had been an increase of on the day online appointments before 9am and after 5pm.
• Following the last inspection a prescription phone line had been introduced.

At our previous inspection on 5 April 2017, we rated the practice as requires improvement for providing responsive services because some of the patients we spoke with and patient survey results identified that it was difficult to make an appointment and patients struggled to get through on the telephone lines for the surgery. At this desk-based review we found that improvements had been made to patient access and the number of available appointments had increased. The practice is now rated as good for providing responsive services.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 23 May 2017

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

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

• They operated a rolling programme to review patients on their chronic disease register. In the last year they offered patients with several long term conditions a single, longer appointment to avoid multiple visits to the surgery.

• Data from 2016 showed that the practice was performing in comparison with other practices nationally for the care and treatment of people with chronic health conditions. .

• All these patients had a named GP. For those patients with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 23 May 2017

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

• The practice worked with health visitors to support this population group. From the sample of documented examples we reviewed we found there were systems to identify and follow up children living in disadvantaged circumstances and who were at risk.

• A full Immunisation service is provided by the practice nurses for children and young people.

• Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.

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

• Ante-natal and eight week baby checks were completed by the nurses and clinicians.

• The practice had emergency processes for acutely ill children and young people.

• The local family planning service was located in the building and patients were signposted to it when needed.

The practice has a refuge located close to the surgery. They encouraged people from there to register, so these patients and their families had adequate health care provision.

Updated 23 May 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population. The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• Where older patients had complex needs, the practice shared summary care records with local care services. They supported 36 patients in local care homes.

• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible. The practice had started to send birthday cards to patients over 75 who had not been to the practice to help encourage them to attend a full review and check-up. They had developed templates including specific topics to discuss with patients such as frailty, loneliness and screening for dementia. They had integrated medication reviews by their own clinical pharmacist with reviews carried out by their practice nurses. This provided a one stop shop for each person’s appointment with an integrated approach from staff.

The practice had access to a Wellbeing service commissioned by the CCG to offer support to patients. They also had access to a Social Care in practice (SCIP) worker allocated to the surgery to help facilitate care for older patients.

Updated 23 May 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations had been identified. The practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example, extended opening hours from 7.30am to 8am Monday to Wednesday.

• 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.

• They provided a weekly clinic run by one of the Health Improvement Team to offer health checks and to also offer lifestyle advice to those who need this.

• They had recently set up a weekly clinic run by the Citizens Advice Office, to offer help and advice to those who may be in need of this type of service.

Updated 23 May 2017

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

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  The practice specifically considered the physical health needs of patients with poor mental health and dementia.

• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs. They employed their own clinical pharmacist who regularly carried out medicine reviews for patients.

• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations. They utilised the local psychiatric services including IAPT (Improving Access To Psychological therapies) homecare and crisis teams to help them to manage this group of patients.

• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia. They have an active case finding system for dementia. All chronic disease templates have a screening question for dementia. Patients at risk of dementia were identified and offered an assessment.

Updated 23 May 2017

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 a learning disability.

• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

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

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.

• Staff interviewed, knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.