Background to this inspection
Updated
26 April 2018
Skerne Medical Group is registered with the Care Quality Commission to provide primary care services. The practice provides services to around 15,500 patients from four locations, three of which are branch surgeries, we visited all of these locations as part of this inspection;
- Harbinson House, Front Street, Sedgefield, Stockton on Tees, Cleveland, TS21 3BN
- Fishburn Surgery, Beveridge House, Buterwick Road, Fishburn, TS21 4A
- Trimdon Village Surgery, 18 Wynyard Road, Trimdon Village, TS29 6JH
- Trimdon Colliery Surgery, Carroll House, Grosvenor Terrace, Trimdon Colliery, TS29 6DH
Harbinson House is located in purpose built premises. There is a car park beside the practice, dedicated disabled parking bays and step free access.
Fishburn Surgery and Trimdon Colliery surgeries are in purpose built premises. Trimdon Village surgery is in a converted semi-detached property.
The practice has six GP partners (two male and four female), three are full time and three part time whole time equivalent (WTE) 5. There are five salaried GPs (WTE 3.75). There is one practice pharmacist (WTE 0.18), there are three nurse practitioners (WTE 2.08), six practice nurses (WTE 4.09), three healthcare assistants (WTE 2.2), a receptionist who also works as a phlebotomist (WTE 0.55). There is a practice manager (WTE 1), finance manager (WTE 0.60) and an assistant practice manager (WTE 1). There are 17 (WTE 14.1) administration and reception staff.
The practice is a training practice which has GP trainees allocated to the practice (trainees are fully qualified doctors allocated to the practice as part of a three-year postgraduate general practice vocational training programme). The practice teaches medical students (third and fifth year) and offers student nurse placements.
The opening times at Harbinson House, Sedgefield are from 8:30am to 1pm and 2pm until 6pm Monday to Friday. There is a telephone line open from 8am to 8:30am when a duty doctor is available for emergencies. Consulting times are the same as the opening times.
The opening times at Beveridge House, Fishburn are 8:30am to 12:30pm Monday to Friday and 2pm to 6pm every week day except Wednesday afternoon when the surgery is closed. Consulting times are the same as the opening times.
The opening times at Trimdon Village Surgery are 8:30am to 12:30pm Monday to Friday. Consulting times are the same as the opening times.
The opening times at Trimdon Colliery Surgery are 8:30am to 12:30pm and 1:30pm to 6pm every weekday except Thursday when the surgery is closed. Consulting times are the same as the opening times.
Late evening appointments are available between 6:30pm and 8pm two nights a week, the location is varied to offer the service between the four surgeries.
The practice is part of a local federation of GP practices which provides extended opening hours for patients; appointments are available late evening, weekend and bank holidays. Patients can contact the practice reception team to arrange appointments. When this service is not provided patients requiring urgent medical care can contact the out of hours service provided by NHS 111.
The practice is part of NHS Durham Dales and Sedgefield clinical commissioning group (CCG). The practice provides services based on a Personal Medical Services (PMS) contract agreement for general practice.
Information from Public Health England places the area in which the practice is located in the sixth most deprived decile. The income deprivation score for the practice is 19 compared to the CCG average of 30 and the national average of 24. In general, people living in more deprived areas tend to have greater need for health services. Average male life expectancy at the practice is 79 years which is the same as the national average. Average female life expectancy at the practice is 82 years compared to the national average of 83 years.
Updated
26 April 2018
This practice is rated as Good overall.
At our previous inspection on 11 July 2016 the practice was rated as good overall, with requires improvement for providing safe services and good for providing effective, caring, responsive and well-led services.
The key questions are rated as:
Are services safe? – Good
Are services effective? – Good
Are services caring? – Good
Are services responsive? – Outstanding
Are services well-led? - Good
As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:
Older People – Good
People with long-term conditions – Good
Families, children and young people – Good
Working age people (including those recently retired and students – Good
People whose circumstances may make them vulnerable – Good
People experiencing poor mental health (including people with dementia) - Outstanding
We carried out an announced comprehensive inspection at Skerne Medical Group on 15 February 2018
. This was to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 11 July 2016. W
e inspected this service as part of our comprehensive inspection programme.
At this inspection we found:
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Staff understood and fulfilled their responsibilities to raise concerns, and report incidents and near misses.
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Outcomes for patients who use services were good.
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Patients’ needs were assessed and care was planned and delivered following best practice guidance.
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The skill mix of the clinical team had been enhanced, with the addition of advanced nurse practitioners with different clinical interests. This allowed for better access for patients and freed up GP time to focus on more complex issues.
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Staff were consistent and proactive in supporting patients to live healthier lives through a targeted approach to health promotion. Information was provided to patients to help them understand the care and treatment available.
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Staff involved and treated patients with compassion, kindness, dignity and respect.
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The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.
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The practice was the second lowest dermatology referrers in the locality. They had in house expertise of dermatology from the GPs. They had the facility to use a dermatology service where photographs of skin lesions were sent to the dermatologist for opinion which saved on hospital referrals.
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Patients said they were able to get an appointment with a GP when they needed one, with urgent appointments available the same day.
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There was a leadership structure in place and staff felt supported by management. The practice sought feedback from staff and patients, which they acted on.
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The practice was aware of and complied with the requirements of the duty of candour.
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There was a focus on continuous learning and improvement at all levels of the organisation.
We saw two areas of outstanding practice:
- The practice had a primary care mental health specialist on site for patients between the ages of 18 and 65 who presented with common mental health problems. The practice could refer patients directly to the service and they were generally seen within 48 to 72 hours. The practice currently had 44 open cases, since June 2017, which had been referred. Waiting times for patients to be referred to secondary care for this type of service were three months.
- Following a review of ENT referrals at the practice a support group was set up to provide counselling for patients who had tinnitus. This was for 12 patients on a six week programme. This covered the cause of tinnitus, what makes symptoms worse, equipment that may help, coping with stress and information on alternative therapies. Following the success and positive patient feedback from this group a second group was organised for March 2018. This ran with maximum numbers of patients. Data from August – October 2016 when compared to the same period in 2017 shows that referrals for tinnitus to secondary care reduced from thirteen to four.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice