You are here

Park Road Medical Practice Outstanding

Inspection Summary


Overall summary & rating

Outstanding

Updated 25 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Park Road Medical Practice on 19 May 2016. Overall the practice is rated as outstanding.

Our key findings were as follows:

  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
  • 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.
  • Patients said they were able to get an appointment with a GP when they needed one, with urgent appointments available the same day.
  • The practice was integrated in the local community; managers were aware of the housing problems faced by some people and provided appropriate support.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure in place and staff felt supported by management. The practice proactively sought feedback from staff and patients, which they acted on.
  • Staff worked well together as a team and there were processes in place to manage staff training effectively.

We saw several areas of outstanding practice including:

  • Following a suggestion made by the practice’s patient participation group, the practice developed and implemented a ‘discharge and handover’ policy. Every patient who had been discharged from hospital was contacted to ask how they were and if they needed any support or help with medication.
  • There was a system in place to invite patients in for a teenage health check once they reached their 16th birthday; in the past year 21 patients had taken up the offer. A practice leaflet had been produced for patients between the ages of 13 and 19; this provided contact details and pictures of all of the GPs and information about the dedicated young people’s services offered by the practice. The practice had carried out a survey of eight young people to ascertain whether they found the leaflet relevant and easy to understand, all patients responded and all reported the leaflet was useful.
  • A ‘new baby pack’ had been developed by the practice; this was sent out to all new parents and provided information about baby clinics and how to seek medical advice for young families. Each day, a number of ‘sick children’ appointments were embargoed for booking babies or young children with a GP. Many of these appointments were held until mid-afternoon when children had finished school for the day.

The area where the provider should make improvements is:

  • Take steps to ensure the infection control action plan is completed; with regard to replacing the carpet in one of the nurse’s clinical rooms with appropriate flooring.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 25 July 2016

The practice is rated as good for providing safe services.

The nationally reported data we looked at as part of our preparation for this inspection did not identify any risks relating to safety. Staff understood and fulfilled their responsibilities with regard to raising concerns, recording safety incidents and reporting them both internally and externally. Risks to patients were assessed and well managed.

Good infection control arrangements were in place and the practice was clean and hygienic. There was evidence of good medicines management. Effective staff recruitment practices were followed and there were enough staff to keep patients safe.

Effective

Outstanding

Updated 25 July 2016

The practice is rated as outstanding for providing effective services.

The practice used proactive methods to improve patient outcomes and worked with other local practices to share best practice. Staff were actively engaged in activities to monitor and improve quality and outcomes.

Nationally reported data showed that outcomes for patients were consistently better than national averages. The practice used the Quality and Outcomes Framework (QOF) as one method of monitoring its effectiveness and had achieved 98.5% of the points available. This was above the local and national averages of 96.7% and 94.7% respectively. The practice had achieved at least 99% of the total points available in all but one of the 19 clinical indicators, and 100% for all public health indicators.

Arrangements had been made to support clinicians with their continuing professional development.

The continuing development of staff skills, competence and knowledge was recognised as integral to ensuring high quality care. The practice had a long track record as a training practice. Two of the GPs were accredited GP trainers. At the time of the inspection there were two trainee GPs in post. One of the GP partners had recently undertaken, and the practice manager was in the process of completing a leadership skills course.

Staff, teams and services were committed to working collaboratively; multi-disciplinary team (MDT) meetings took place on a weekly basis to ensure patients with complex needs were supported to receive co-ordinated care. Staff had access to the information and equipment they needed to deliver effective care and treatment.

Caring

Good

Updated 25 July 2016

The practice is rated as good for providing caring services.

Patients said they were treated with compassion, dignity and respect and they felt involved in decisions about their care and treatment. Information for patients about the services available was available. We saw that staff treated patients with kindness and respect, and maintained confidentiality.

The National GP Patient Survey published in January 2016 showed the satisfaction scores in relation to staff were generally above local and national averages. Results showed that 98% of respondents had confidence and trust in their GP, compared to 95% nationally; 90% of respondents said the last GP they saw was good treating them with care and concern, compared to the national average of 85%. 99% of respondents said they had confidence and trust in the last nurse they saw, which was above the national average of 97%. Of those who responded, 95% said they found the receptionists at the practice helpful, compared to the national average of 87%.

Responsive

Outstanding

Updated 25 July 2016

The practice is rated as outstanding for providing responsive services.

The practice had good facilities and was well equipped to treat patients and meet their needs. The practice contacted every patient who had been discharged from hospital to ask how they were and if they needed any support or help with medication.

Services were planned and delivered in a way that met the needs of the local population. The practice was situated in a relatively deprived area with a high incidence of poor quality housing. Managers had considered the impact on patients’ health and well-being and were part of the local authority’s ‘safe and healthy homes’ pilot. This provided advice and guidance to help patients to solve health-related housing issues and improve their physical and mental health through referrals to relevant services and organisations.

There was a system in place to invite patients in for a teenage health check once they reached their 16th birthday. A practice leaflet had been produced for patients between the ages of 13 and 19; this provided contact details and pictures of all of the GPs and information about the dedicated young people’s services offered by the practice.

A ‘new baby pack’ had been developed by the practice; this was sent out to all new parents and provided information about baby clinics and how to seek medical advice for young families. Each day, a number of ‘sick children’ appointments were embargoed for booking babies or young children with a GP.

The practice scored well in relation to access in the National GP Patient Survey. The most recent results (January 2016) showed 90% of respondents were able to get an appointment to see or speak to someone the last time they tried, compared with a local average of 86% and a national average of 85%.

Over 86% of respondents said they were satisfied with opening hours (compared to the national and local averages of 75% and 80% respectively). The practice also scored highly on the ease of getting through on the telephone to make an appointment (95% of patients said this was easy or very easy, compared to the national average of 73% and the local average of 81%).

The survey showed that some patients felt they waited too long to be called in for their appointment. A review had been undertaken and the gaps between appointments had been introduced to allow GPs to ‘catch up’.

Information about how to complain was available and easy to understand and evidence showed that the practice responded quickly to issues raised. Learning from complaints was shared with staff.

Well-led

Outstanding

Updated 25 July 2016

The practice is rated as outstanding for providing well-led services.

The leadership, governance and culture of the practice were used to drive and improve the delivery of high-quality person centred-care.

The practice had a clear vision with quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff. High standards were promoted and owned by all practice staff and teams worked together across all roles.

Governance and performance management arrangements had been proactively reviewed and took account of current models of best practice. There was a strong focus on continuous learning and improvement at all levels within the practice. The practice team was forward thinking and had implemented a number of innovative systems.

There was a high level of constructive engagement with staff and a high level of staff satisfaction. Staff spoke very highly of managers; several staff had worked at the practice for many years. Team working within the practice between clinical and non-clinical staff was good.

The leadership and culture of the practice was used to drive and improve the delivery of high quality care. Several of the GP partners also had lead roles across North Tyneside. For example, one of the GPs was chair of the CCG; another of the GPs was the chair of the local GP federation.

The practice had an active patient participation group, which met on a regular basis and submitted proposals for improvements to the management team.

Checks on specific services

People with long term conditions

Outstanding

Updated 25 July 2016

The practice is rated as outstanding for the care of patients with long-term conditions, as the practice is rated as outstanding overall.

  • Nursing staff had lead roles in chronic disease management and patients at risk of admission to hospital were identified as a priority.
  • Longer appointments and home visits were available when needed. The practice’s electronic system was used to flag when patients were due for review. This helped to ensure the staff with responsibility for inviting people in for review managed this effectively.
  • Patients had regular reviews to check with health and medicines needs were being met.
  • For those people with the most complex needs, GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Families, children and young people

Outstanding

Updated 25 July 2016

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

  • The practice had identified the needs of families, children and young people, and put plans in place to meet them.
  • 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. Immunisation rates were relatively high for all standard childhood immunisations.
  • Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
  • 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.
  • The practice’s uptake for the cervical screening programme was 83.1%, which was in line with the local average of 83.1% but above the national average of 81.8%.
  • Pregnant women were able to access an antenatal clinic provided by healthcare staff attached to the practice.
  • A ‘new baby pack’ had been developed by the practice; this was sent out to all new parents and provided information about baby clinics and how to seek medical advice for young families. Each day, a number of ‘sick children’ appointments were embargoed for booking babies or young children with a GP.
  • The practice was in the process of completing the ‘You’re Welcome’ project (this had the aim of making health services young people friendly). There was a system in place to invite patients in for a teenage health check once they reached their 16th birthday.

Older people

Outstanding

Updated 25 July 2016

The practice is rated as outstanding for the care of older people, as the practice is rated as outstanding overall.

  • The practice offered proactive, personalised care to meet the needs of the older people in its population. For example, all patients over the age of 75 had a named GP. Patients at high risk of hospital admission and those in vulnerable circumstances had care plans.
  • The practice was responsive to the needs of older people and offered home visits and urgent appointments for those with enhanced needs. Doctors carried out a weekly ward round and had regular phone contact with staff at a local nursing home.
  • A palliative care register was maintained and the practice offered immunisations for pneumonia and shingles to older people.

Working age people (including those recently retired and students)

Outstanding

Updated 25 July 2016

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

  • 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 and flexible. Extended hours surgeries were offered on Tuesday evenings with doctors and nurses for working patients who could not attend during normal opening hours.

  • The practice offered a full range of health promotion and screening which reflected the needs for this age group. Patients could order repeat prescriptions and book appointments on-line. Appointments could also be booked via a mobile device ‘App’.

  • Additional services were provided such as health checks for the over 40s and travel vaccinations.

People experiencing poor mental health (including people with dementia)

Outstanding

Updated 25 July 2016

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

  • The practice worked closely with multi-disciplinary teams in the case management of people experiencing poor mental health including those with dementia. Care plans were in place for patients with dementia.
  • Patients experiencing poor mental health were sign posted to various support groups and third sector organisations.
  • The practice kept a register of patients with mental health needs which was used to ensure they received relevant checks and tests.
  • The practice was the first in the North Tyneside area to register with the Dementia Action Alliance and staff within the practice had been trained as ‘dementia friends’.

People whose circumstances may make them vulnerable

Outstanding

Updated 25 July 2016

The practice is rated as outstanding 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.
  • Patients with learning disabilities were invited to attend the practice for annual health checks and were offered longer appointments, if required.
  • The practice had effective working relationships with multi-disciplinary teams in the case management of vulnerable people.
  • 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 and out of hours.
  • Good arrangements were in place to support patients who were carers. The practice had systems in place for identifying carers and ensuring that they were offered a health check and referred for a carer’s assessment.
  • The practice was part of the local authority’s ‘safe and healthy homes’ pilot. This provided advice and guidance to help patients to solve health-related housing issues and improve their physical and mental health through referrals to relevant services and organisations.