You are here

Newburn Surgery Partnership Good Also known as Newburn Surgery

Inspection Summary


Overall summary & rating

Good

Updated 12 November 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr M E Scott & Partners on 6 October 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • Risks to patients were assessed and well managed.
  • Significant events were recorded, investigated and learned from. However, staff awareness of significant events was limited.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles.
  • 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 in the process of securing more suitable premises for the surgery to operate from. The practice management team had done as much as they could to modify the premises to suit patients’ needs.
  • There was a clear leadership structure in place and staff felt supported by management. The practice sought feedback from staff and patients, which they acted on.
  • Staff throughout the practice worked well together as a team.

We saw an area of outstanding practice:

  • The practice had been involved in local CCG projects to improve the care of those patients with long term conditions. This included a chronic obstructive pulmonary disease (COPD) project which ensured the identification and management of patients with this condition. There was also a social prescribing project, Ways to Wellness, which provides support to patients with certain long-term health conditions. A Link Worker works with each person referred, on a one-to-one basis, in the areas where they most need support.

The areas where the provider should make improvements are:

  • Consider training staff on the significant event process.
  • Set up a system to ensure the relevant staff have seen and read patient safety alerts.
  • Carry out disclosure and barring checks (DBS) for staff who carry out the role of chaperone.
  • Set up a system to record clinical audit and ensure the audits have clear standards and evidence of audit cycle.
  • Consider replacement of carpets within treatment rooms adjacent to consulting rooms with easy clean flooring.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 12 November 2015

The practice is rated as good for providing safe services. We found significant events were recorded, investigated and learned from. However, staff awareness of significant events was limited. Risks to patients were assessed and well managed. Disclosure and Barring Service (DBS) checks had been completed for all staff that required them, other than those who acted as chaperones. There were infection control arrangements in place and the practice was clean and hygienic. There were systems and processes in place for the safe management of medicines. There was enough staff to keep patients safe.

Effective

Good

Updated 12 November 2015

The practice is rated as good for providing effective services. Data showed patient outcomes were above average for the locality. Staff referred to guidance from the National Institute for Health and Care Excellence and used it routinely. Patients’ needs were assessed and care was planned and delivered in line with current legislation. This included assessing capacity and promoting good health. Staff had received training and any further training needs had been identified. There was evidence of appraisals for all staff. Staff worked with multidisciplinary teams.

Caring

Good

Updated 12 November 2015

The practice is rated as good for providing caring services. Data showed that patients rated the practice higher than others for several aspects of care. Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment. Information for patients about the services available was easy to understand and accessible. We also saw that staff treated patients with kindness and respect, and maintained confidentiality.

Responsive

Good

Updated 12 November 2015

The practice is rated as good for providing responsive services. It reviewed the needs of its local population and engaged with the clinical commissioning group (CCG) in an attempt to secure improvements to services where these were identified. Patients said they found it easy to make an appointment with a GP and that there was continuity of care, with urgent appointments available the same day. The practice were in the process of securing more suitable premises for the surgery to operate from. The practice management team had done as much as they could to modify the premises to suit patients’ needs. 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

Good

Updated 12 November 2015

The practice is rated as good for being well-led. They had a clear vision for the future and staff were clear about their responsibilities in relation to these. There was a clear leadership structure and staff felt supported by management. The practice had a number of policies and procedures to govern activity and held regular governance meetings. There were systems in place to monitor and improve quality and identify risk. The practice proactively sought feedback from staff and patients, which it acted on. The practice had a patient participation group (PPG) which was active. Staff had received inductions, regular performance reviews and attended staff meetings and events.

Checks on specific services

People with long term conditions

Outstanding

Updated 12 November 2015

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

The practice had been involved in local clinical commissioning group (CCG) projects to improve the care of those patients with long term conditions. These included;

  • A chronic obstructive pulmonary disease (COPD) project which ensured the identification and management of patients with this condition.
  • A social prescribing project, Ways to Wellness, which provides support to patients with certain long-term health conditions who are referred by their GP in the local area. A Link Worker works with each person referred, on a one-to-one basis, in the areas where they most need support.

The practice were also involved in the diabetes year of care project in providing personalised results to patients to provide shared goals and action plans for patients.

Nationally reported data showed that outcomes for patients with long term conditions were good for example, performance for asthma related indicators was above the national average (100% compared to 97.2% nationally). Current QOF results for 2013/14 were 99.6% of the total number of points available.

There practice had a register for patients with long term conditions; this was not only for conditions defined by QOF but for other conditions for example gout. There were allocated clinical lead roles in chronic disease management. Patients were provided an annual review in their birthday month check that their health and medication needs were being met.

The practice offered flu vaccines to all patients with long term conditions. There were flexible appointments including telephone appointments and home visits where necessary.

The practice had recently enabled on line access to patients medical record and test results which could help patients manage their condition.

Families, children and young people

Good

Updated 12 November 2015

The practice is rated as good 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 accident and emergency 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 had weekly antenatal clinics ensuring good liaison with midwifery staff. Tuesdays were called ‘child health day’ as there was access to the midwife, health visitor, practice nurse and GP for child health checks. There were appointments available outside of school hours and same day urgent appointments at the parents request.

Older people

Good

Updated 12 November 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. They offered proactive, personalised care to meet the needs of the older people in its population. For example, patients at high risk of hospital admission and those in vulnerable circumstances had care plans. These patients were offered an enhanced summary care record, which provided healthcare staff treating patients in an emergency or out-of-hours facility with faster access to key clinical information.

The practice was responsive to the needs of older people, including offering home visits and rapid access appointments for those with enhanced needs. Patients over the age of 75 had a named GP and were offered annual health checks. Prescriptions could be sent to any local pharmacy electronically.

The practice had a close relationship with the care homes where their patients lived. They were involved with the local CCG care homes project and visited them weekly and had developed individual care plans for patients.

The practice maintained a palliative care register and end of life care plans were in place for those patients it was appropriate for. They offered immunisations for pneumonia and shingles to older people and provided flu vaccinations to older people as a priority.

Working age people (including those recently retired and students)

Good

Updated 12 November 2015

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 which included appointment booking, test results and ordering repeat prescriptions. Text reminders for appointments were available to patients. There was a full range of health promotion and screening that reflected the needs for this age group. There were flexible appointments available including telephone consultations and extended opening hours on a Monday evening and every fourth Saturday when minor surgery clinics were available.

People experiencing poor mental health (including people with dementia)

Good

Updated 12 November 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). There was a lead GP for patients experiencing poor mental health and for people with dementia. All patients experiencing severe mental health had agreed care plans in place. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health. They carried out advanced care planning for patients with dementia. 82.3% of patients identified as living with dementia had received an annual review in 2013/14 (national average 83.8%) and had agreed care plans in place. The practice also worked together with their carers to assess their needs.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. They had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

People whose circumstances may make them vulnerable

Good

Updated 12 November 2015

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 those with a learning disability. They carried out annual health checks for people with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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.