Archived: Portugal Place Health Centre

Updated 20 October 2016

Portugal Place Health Centre is registered with the Care Quality Commission to provide primary care services. It is located in the town of Wallsend, Tyne and Wear.

The practice provides services to around 11,700 patients from one location: Portugal Place, Wallsend, Tyne and Wear, NE28 6RZ. We visited this address as part of the inspection. The practice has eight GP partners (five female and three male), one salaried GP (female), a trainee GP (male), a nurse manager, a nurse practitioner and three practice nurses (all female), a healthcare assistant, a practice manager, and 21 staff who carry out reception and administrative duties.

The practice is a training practice and one of the GPs is an accredited GP trainer. At the time of the inspection there was one trainee GP working at the practice.

The practice is part of North Tyneside clinical commissioning group (CCG). The age profile of the practice population is broadly in line with CCG and national averages. Information taken from Public Health England placed the area in which the practice is located in the fourth more deprived decile. In general, people living in more deprived areas tend to have greater need for health services.

The practice is located in a purpose built two storey building. All patient facilities are on the ground floor. There is on-site parking, a disabled WC, wheelchair and step-free access.

Opening hours are between 8am and 6pm on Mondays, Tuesdays and Fridays and between 8am and 8pm Wednesday and Thursday, appointments are available at all times during opening hours. Patients can book appointments in person, on-line or by telephone.

A duty doctor is available each afternoon until 6.30pm.

The practice provides services to patients of all ages based on a General Medical Services (GMS) contract agreement for general practice.

The service for patients requiring urgent medical attention out of hours is provided by the NHS 111 service and Vocare which is also known locally as Northern Doctors Urgent Care.

Updated 20 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Portugal Place Health Centre on 7 September 2016. Overall the practice is rated as good.

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. Although it was not always clear what action had been taken to improve safety in the practice, and prevent a reoccurrence of incidents and significant events.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Many patients were unhappy with the appointments system; managers were aware of this and were taking action to improve access.
• 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.
• There were effective arrangements in place to ensure all staff received training appropriate to their role.
• Staff throughout the practice; and the other external agencies based in the same building, worked well together as a team.

The area where the provider should make improvements is:

• Take steps to ensure that learning from significant events is identified and appropriate action taken to reduce the risk of similar incidents occurring in the future.
• Take action to ensure that the refrigerators used to store vaccines are serviced in line with manufacturer’s guidelines.
• Develop arrangements for identifying patients who are carers so they can be offered appropriate care and support.
• Take steps to improve the system for investigating and responding to complaints, including providing advice on what to do if the complainant was unhappy with the response to their complaint.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 20 October 2016

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

• 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 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.
• Performance in the Quality and Outcomes Framework (QOF) for peripheral arterial disease (a circulatory problem) indicators was above the national average (100% compared to 96.7% nationally). For example, the percentage of patients with peripheral arterial disease with a record in the preceding 12 months that aspirin or an alternative anti-platelet was being taken was 96.5%, compared to the national average of 92.7
• QOF performance for asthma related indicators was below the national average (82.1% compared to 97.4% nationally). For example, the percentage of patients with asthma who had had an asthma review in the preceding 12 months that included an assessment of asthma control using the 3 RCP questions was 65.7%, compared to the national average of 75.3%. However, action had been taken, including further training for clinicians and the implementation of a new protocol on dealing with suspected asthma in the under 16s. Data, provided by the practice, for 2015/2016 showed that performance had improved and the practice had achieved all of the points available for the asthma related indicators.

Updated 20 October 2016

The practice is rated as good 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.
• Appointments were available outside of school hours and the premises were suitable for children and babies. The practice hosted open access baby clinics every week.
• We saw positive examples of joint working with midwives, health visitors and school nurses.
• The practice’s uptake for the cervical screening programme was 80.6%, which was slightly below the CCG average of 83.1 and the national average of 81.8%.
• Pregnant women were able to access an antenatal clinic provided by healthcare staff attached to the practice.

Updated 20 October 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. 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.
• A palliative care register was maintained and the practice offered immunisations for pneumonia and shingles to older people.

Updated 20 October 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 and flexible. Extended hours surgeries were offered on Wednesday and Thursday evenings until 8pm 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.
• Additional services were provided such as health checks for the over 40s and travel vaccinations.

Updated 20 October 2016

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

• 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.

Updated 20 October 2016

The practice is rated as requires improvement 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.
• The practice had a comprehensive system for recording child safeguarding concerns; there was a shared electronic document which was regularly reviewed and updated by the health visiting team.
• There was no specific written information available for carers to ensure they understood the various avenues of support available to them. Patients were invited to register as a carer when they registered with the practice. Staff told us the clinical staff would ask those patients who they considered may have been carers but there were no plans to reach out to the wider practice population.