Northgate Medical Practice

Updated 11 August 2016

Northgate Medical Practice is located in a residential area in the city of Canterbury, Kent. There are approximately 16.500 patients on the practice list. Canterbury is a University city and this is reflected in the practice’s patents’ age profile. There are more patients in the age group 15 to 29 years than the national average. For example approximately 5% of the patients are aged between 20 and 24 compared with a national average of 3%. The majority of the patients were white British. The practice as a whole is not in an area of deprivation though there are pockets of urban deprivation within it.

The practice holds a General Medical Services contract (a contract between NHS England and general practices for delivering general medical services) The practice is a partnership of 10 GPs. The practice employs other GPs and has trainee GPs working under supervision. There are 10 male GPs and five female GPs. There are two nurse practitioners, one male one female. There are four practice nurses all female. There are four healthcare assistants, all female. The practice employs a male clinical pharmacist.

As a training practice, alongside their clinical roles, the GPs and nurses provide training and mentorship opportunities for trainee GPs, student nurses and allied healthcare professionals.

The GPs and nurses are supported by a practice manager, a human resources manager and a team of administration and reception staff.

The practice is open 8.00am to 6.30pm Monday to Friday. There are extended hours with both GP and nursing staff appointments from 6.30pm to 8pm Tuesday, Wednesday and Thursday.

The practice does not provide out of hours services to its patients and there are arrangements with another provider, Integrated Care 24 (IC24), to deliver services when the practice is closed. Details of how to access this service are available at the practice and on the website.

Services are delivered from:

1 Northgate ,

Canterbury,

Kent,

CT1 1WL

and a branch surgery at

11 Tyler Hill Road

Blean

Canterbury

Kent

CT2 9HP.

We visited both premises as part of the inspection process. The branch surgery at Blean is dispensing, that is, it is able to provide pharmaceutical services to those patients on the practice list who live more than one mile (1.6km) from their nearest pharmacy premises.

Updated 11 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Northgate Medical Practice on 24 May 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 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 experience and had been trained to provide them with the skills and knowledge 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.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent treatment available the same day.
• 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 two areas of outstanding practice:

The practice had a team of health trainers who had focussed on providing healthy living guidance to patients mostly living in areas of greater deprivation.

The practice vision included environmental sustainability and the practice had received an NHS silver gilt award for their work in this field.

We saw one area where the provider should make improvements:

The practice should consider recording medication error near misses as reviewing these helps to reduce the risk of errors in the future.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 August 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.
• Performance for diabetes related indicators was comparable to the national average, with the practice achieving a QOF score 90% compared to a national average of 89%.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and most had had 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 results, for patients with long term condidtions were consistently better than the national results sometimes markedly so. For example performance for osteoporosis management was 100% against a national score of 81%

Updated 11 August 2016

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

• There were systems to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had had a high number of A&E attendances. Immunisation rates for all standard childhood immunisations were comparable to local and national averages.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.
• The practice’s uptake for the cervical screening programme was 84% which was comparable to the CCG average of 83% and the national average of 82%.
• 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 11 August 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.
• There was a home visiting anti- coagualant monitoring service, mainly for the benefit of this age group.
• The branch surgery dispensed medicines to a small number of patients and staff often delivered medicines to to the most vulnerable and elderly housebound.

Updated 11 August 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.

Updated 11 August 2016

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

• Performance for mental health related indicators was better than the national average with the practice achieving a QOF score 100% compared to a national average of 93%.
• 97% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is markedly better than the local and national averages of 82% and 84%..
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients 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 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.

Updated 11 August 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 including homeless people, travellers and those with a learning disability.
• 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 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.