Archived: Dr Annie Thomas Also known as Dr. Annie Thomas

Updated 18 February 2016

Dr Annie Thomas is registered with the Care Quality Commission to provide primary care services.

The practice provides services to approximately 2,640 patients from one location at the Health Centre, Victoria Road, Washington, NE37 2PU. This is the location we visited on the day of our inspection.

The practice is based in a purpose-built surgery shared with four other GP practices and other local healthcare providers. The building is owned and managed by NHS Property Services Limited and has level-entry access and a car park for patients to use. All the services provided to patients by Dr Annie Thomas were on the ground floor.

The practice has seven members of staff, comprising one GP (female), one practice nurse (female), a practice manager and four reception/administrative staff. The practice also regularly recruits a male locum GP who provides one session each week.

The practice is part of Sunderland clinical commissioning group (CCG). Information taken from Public Health England placed the area in which the practice was located in the fifth most deprived decile. In general, people living in more deprived areas tend to have greater need for health services. The practice population broadly reflects the national average in terms of age distribution.

The surgery is open from 7.30am to 7.15pm on Mondays, and from 8am until 6pm from Tuesday to Friday. The telephone lines operate at all times during these opening times. Outside of these times, a message on the surgery phone line directs patients to out of hours care, NHS 111 or 999 emergency services as appropriate. Appointments with a GP are available as follows:

• Monday: 7.30am to 11am and 4.20pm to 7pm
• Tuesday: 8am to 11am and 4pm to 6pm
• Wednesday: 8am to 11am, 12.30pm to 2.30pm and 3pm to 6pm
• Thursday: 8am to 11am and 4pm to 6pm
• Friday: 8am to 10.30am, 1.30pm to 2.30pm and 4pm to 6pm
• Weekends: closed

The practice provides services to patients of all ages based on a General Medical Services (GMS) contract agreement for general practice. The practice population includes a much higher-than-average number of 15-19 year old males. The number of men and women aged between 55 and 69 who are registered with the practice is also higher than the national average, while the number of patients between 25 and 39 is lower. The service for patients requiring urgent medical attention out of hours is provided by the NHS 111 service and Northern Doctors Urgent Care Limited.

Updated 18 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Annie Thomas on 5 January 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 an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day. For example, in the National GP Patient Survey 96.2% patients said they could get through easily to the surgery by phone (CCG average 79.3%, national average 73.3%).
• Information about services and how to complain was available and easy to understand.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw some areas of outstanding practice:

• The practice was rated outstanding for the care of families, children and young people. The GP telephoned all new mothers within the first 10 days after the birth of their child to offer support and assess their risk of post-natal depression. The practice demonstrated a proactive approach to identifying young carers, and participated in innovative projects in the local area aimed at managing childhood ailments. Furthermore, the practice had achieved a 100% immunisation rate for all but one routine childhood vaccination. Local clinical commissioning group averages ranged from 31.6% to 100%.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 February 2016

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

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Quality and Outcomes Framework (QOF) performance for diabetes related indicators was better than national averages. For example, the percentage of patients on the diabetes register with a record of a foot examination and risk classification within the preceding 12 months (01/04/2014 to 31/03/2015) was 91.1% compared to a national average of 88.3%.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and 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.
• The practice nurse helped to train staff and residents at a local care home to use inhalers and spacers correctly to improve management of asthma.

Updated 18 February 2016

The practice is rated as outstanding 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.
• Young people who frequently attended appointments with their siblings or parents were identified and asked if they were acting as young carers. Those identified were referred for appropriate support.
• The practice had contributed to a locality-wide innovation project on the development and subsequent promotion of a booklet and accompanying smartphone app for managing minor childhood illnesses. This project had won a national “GP Recognition” award.
• The GP telephoned all new mothers within the first 10 days after the birth of their child to offer support and assess their risk of post-natal depression.
• The practice had achieved a 100% immunisation rate for all immunisations given to children routinely at 12, 24 and 60 months, with the exception of MMR at 24 months (92%). Local clinical commissioning group averages ranged from 31.6% to 100%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 18 February 2016

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.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice had access to beds at a local inpatient unit which it could use for patients as an intermediary step between hospital and community care, either to avoid an admission to hospital or to aid their return home post-discharge.

Updated 18 February 2016

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.
• As well as early morning and evening appointments one day a week, additional ‘lunchtime’ appointments were also available from 12.30pm to 2.30pm on Wednesdays and 1.30pm to 2.30pm on Fridays.
• 84.2% of women aged 25-64 had had a cervical screening test in the preceding 5 years (01/04/2014 to 31/03/2015) compared to a national average of 81.8%.

Updated 18 February 2016

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

• The practice had carried out audits on their consultations with patients with depression to improve their clinical assessment of this group.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff had a good understanding of how to support patients with mental health needs and dementia. Staff had undertaken “Dementia Friends” training to increase their awareness of issues which affect people with dementia.

Updated 18 February 2016

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, for example those with a learning disability.
• The practice offered longer appointments for patients to people who needed them.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• The practice informed 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.