Archived: White Medical Group

Updated 24 June 2016

The White Medical Group provides care and treatment to 1,793 patients of all ages, based on a General Medical Services (GMS) contract. The practice is part of the NHS Northumberland clinical commissioning group (CCG) and provides care and treatment to patients living in Wylam and the surrounding areas. We visited the following location as part of our inspection:

The Surgery, Jackson Road, Wylam, Northumberland, NE41 8EL.

The practice serves an area where deprivation is lower than the England average. The practice population includes fewer patients who are under 18 years of age than the England average, and more patients aged over 65 years of age, than both the local CCG and England averages. The practice had a low proportion of patients who are from ethnic minorities.

The surgery is located in a building that has been adapted to meet patients’ needs.The practice has four GP partners (two male and two female), two salaried GPs (female), two practice nurses (female), three healthcare assistants/phlebotomists, a practice manager, an administrative/medicines manager, a reception/medicines manager, a clinical manager and a small team of administrative and reception staff. When the practice is closed patients can access out-of-hours via Northern Doctors Urgent Care Limited, and the NHS 111 service.

The practice and dispensary opening hours are:

Monday, Wednesday and Friday: 8:45am to 12:50pm.Tuesday and Thursday: 8:45am to 12:50pm and 2:30pm to 6pm.

Appointment times are as follows:

Monday and Friday: 8:45am to 11:15am.

Tuesday and Thursday: 8:45am to 11:15am and 3pm to 5:30pm.

Wednesday: 9am to 11:30am.

Updated 24 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the White Medical Group on 11 April 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. The staff team took the opportunity to learn from all internal and external incidents.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. They had the skills, knowledge and experience to deliver effective care and treatment.

• Overall, risks to patients and staff were assessed and well managed, and there was evidence of good governance arrangements.

• Services were tailored to meet the needs of individual patients and were delivered in a way that ensured flexibility, choice and continuity of care. All staff were actively engaged in monitoring and improving quality and patient outcomes. Staff were committed to supporting patients to live healthier lives, through a targeted and proactive approach to health promotion.

• Outcomes for patients were . Data from the Quality and Outcomes Framework (QOF) showed that patient outcomes in the clinical and public health indicators covered were above average, when compared to the local clinical commissioning group (CCG) and England averages. The practice had also performed well in respect of their cervical screening uptake rate, which was higher

• Patients’ emotional and social needs were seen as being as important as their physical needs, and there was a strong, person-centred culture. Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their treatment.

• The practice had very good facilities and was well equipped to treat patients and meet their needs.

The areas where the provider must make improvement are:

• Ensure medicines are managed safely and appropriately. This includes making sure there is a rigorous system for recording actions taken in response to medicines safety alerts, and ensuring that all medicines requiring cool storage are stored securely.

However, there were also areas where the provider needs to make improvements. The provider should:

• Ensure the practice’s significant event reports, and ‘near-miss’ dispensary events, include more detail regarding the lessons to be learned from what happened, and what needs to change to achieve this.

• Carry out regular checks to confirm that nursing staff continue to be registered with their professional body. Ensure there is documentary evidence to confirm this.

• Provide information about complaints and opportunities for patients to provide feedback, in the patient waiting areas.

• Make sure sharps bins are signed and dated by the member of staff who sets them up.

• Provide staff with access to a defibrillator.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 June 2016

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

Nationally reported QOF data, for 2014/15, showed the practice had performed well in relation to providing care and treatment for the clinical conditions commonly associated with this population group. For example, the practice had obtained 100% of the total points available to them, for providing care and treatment to patients with diabetes. This was 5% above the local CCG average and 10.8% above the England average. Patients with long-term conditions were offered a structured annual review, to check their health needs were being met and that they were receiving the right medication. Clinical staff were very good at working with other professionals, to deliver a multi-disciplinary package of care to patients with complex needs.

Updated 24 June 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 who were at risk. For example, appointments were available outside of school hours and the main practice and branch surgeries were suitable for children and babies. The practice offered a range of contraceptive services and sexual health advice. The GPs worked in partnership with the community midwife team, to provide patients with access to ante-natal clinics and post-natal care. The practice had performed well in delivering childhood immunisations. Publicly available information showed that the majority of their immunisation rates were above 90%. Nationally reported data also showed the practice had performed very well in the delivery of their cervical screening programme. The uptake for their cervical screening programme was higher, at 87.07%, than the national average of 81.83%.

Updated 24 June 2016

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

Nationally reported Quality and Outcomes Framework (QOF) data, for 2014/15, showed the practice had performed well in relation to providing care and treatment for the clinical conditions commonly associated with this population group. For example, the practice had obtained 100% of the total points available to them, for providing care and treatment to patients who had heart failure. This was 1.1% above the local clinical commissioning group (CCG) average and 2.1% above the England average.

The practice offered proactive, personalised care which met the needs of the older patients. For example, all patients over 75 years of age had a named GP who was responsible for their care. Clinical staff undertook home visits for older patients who would benefit from these. There were good systems in place to help reduce unplanned emergency admissions into hospital. Older patients on the high-risk register were discussed at the practice’s monthly multi-disciplinary meeting, and patients discharged from hospital were reviewed weekly. Arrangements had been made for housebound patients, living a mile or more from the nearest pharmacy, to have their medicines delivered on a weekly basis.

Updated 24 June 2016

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

Nationally reported data showed the practice had performed well in providing recommended care and treatment to this group of patients. For example, the QOF data, for 2014/15, showed the practice had obtained 100% of the overall points available to them for providing care and treatment to patients who had hypertension. This was 0.3% above the local CCG average and 2.2% above the England average. The practice had assessed the needs of this group of patients and developed their services to help ensure they received a service which was accessible, flexible and provided continuity of care. The practice was proactive in offering online services, as well as a full range of health promotion and screening that reflected the needs of this group of patients. Extended hours appointments were offered to make it easier for working patients to access appointments.

Updated 24 June 2016

The practice is rated as good for the care of people experiencing poor mental health.

There were good arrangements for meeting the needs of patients with mental health needs. For example, nationally reported QOF data, for 2014/15, showed the practice had performed very well in obtaining 100% of the total points available to them for providing recommended care and treatment to this group of patients. The data showed that 93.3% of these patients had a documented care plan, which had been agreed with their carers during the preceding 12 months. This was 19% above the local CCG average and 16.1% above the England average. Patients experiencing poor mental health were provided with advice about how to access various support groups and voluntary organisations. The practice hosted a range of in-house services, including those provided by community psychiatric nurses, consultant psychiatrists and staff from the Recovery Partnership (Alcohol and Drugs). Patients were able to access in-house counselling and ‘Talking Therapies’ services. Staff kept a register of patients who had dementia, and the practice’s clinical IT system clearly identified them, to help make sure clinical staff were aware of their specific needs. Clinical staff actively carried out opportunistic dementia screening, to help ensure their patients were receiving the care and support they needed to stay healthy and safe. The practice had signed up to a dementia friendly initiative being promoted by a national charity and had two Dementia Champions.

Updated 24 June 2016

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

There were good arrangements for meeting the needs of vulnerable patients. Staff demonstrated they had good knowledge of their patients with learning disabilities, and had planned services to meet their needs. This included providing patients with learning disabilities with access to an extended annual review to help make sure they received the healthcare support they needed. The practice allocated a minimum of two half-day sessions each year to enable clinical staff to carry out these reviews. A local social worker attended the practice’s monthly clinical meeting to help staff keep up-to-date with the needs of their patients with learning disabilities. Staff were in the process of updating the practice’s clinical IT system to ensure appropriate alerts had been added. Systems were in place to protect vulnerable children from harm. Staff understood their responsibilities regarding information sharing and the documentation of safeguarding concerns. Good arrangements had been made to meet the needs of patients who were also carers.