Avenue Medical Practice

Updated 25 July 2022

Avenue Medical Practice is located in Jesmond, Newcastle Upon Tyne at:

5 Osborne Avenue, Newcastle Upon Tyne, NE2 1PQ

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures; family planning; maternity and midwifery services; treatment of disease, disorder or injury; and, surgical procedures.

The practice was situated within the Newcastle Gateshead Clinical Commissioning Group (CCG) and delivers General Medical Services (GMS) for a patient population of about 2,700. This is part of a contract held with NHS England. As of 1 July 2022, clinical commissioning groups were closed down when integrated care boards were established on a statutory basis.

The provider of this service is Newcastle General Practice Services Ltd. This is the local GP federation across Newcastle Upon Tyne. They also provide other supporting primary care functions, such as urgent and extended access services, COVID-19 vaccinations, ambulatory blood pressure monitoring, sexual health and echocardiograms in GP practices across the city. They also have another GP practice, Elswick Family Practice. You can find reports for this location by searching for Elswick Family Practice on our website at www.cqc.org.uk.

At the time of the inspection the practice were in the process of a re-procurement exercise, but the timescales and outcome of this were not known.

The practice is part of a wider network of GP practices covering Jesmond and Lower Gosforth, with three other GP practices.

Information published by Public Health England shows that deprivation within the practice population group is in the ninth most deprived decile (9 of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 8.7% Asian, 87.3% White, 1.2% Black, 1.9% Mixed, and 0.9% Other.

The age distribution of the practice population shows there are more people of working age living in the area (at 76.7%) than the average for the local CCG (66.2%) and England (62.4%). There are less people in the older and younger age ranges.

There is a team of two GPs (both male) and an advanced nurse practitioner (female). The practice has one practice nurse who provide nurse led clinics for patients living with a long-term health condition. The GPs are supported at the practice by a practice manager and team of reception/administration staff.

There is an extended urgent care service with access to a GP across the Newcastle area, with provision in emergency departments, walk-in centres and urgent care treatment centres. Patients can see GPs from 8am to 10pm Monday to Sunday, 365 days of the year. These appointments are a mix between walk-in appointments and re-referral from 111 and emergency departments.

Out of hours services are provided by Vocare Limited accessed via the 111 service.

Updated 25 July 2022

We carried out an announced inspection at Avenue Medical Practice on 17 and 27 June 2022. Overall, the practice is rated as Good.

The ratings for each key question are:

Safe - Requires Improvement

Effective - Good

Caring - Good

Responsive - Good

Well-led - Good

This is the first time we have inspected this practice under the current registered provider.

It was inspected under a different registered provider in October 2015 and was rated as good overall.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Avenue Medical Practice on our website at www.cqc.org.uk.

Why we carried out this inspection

This inspection was a comprehensive inspection to check how the practice was meeting essential standards and to inspect and rate it following the new registration with the Care Quality Commission.

• As this was an inspection of a new registration we inspected all five key questions. These are; is the practice safe, effective, caring, responsive and well led?

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting staff interviews using video conferencing
• Completing clinical searches on the practice’s patient records system and discussing findings with the provider
• Reviewing patient records to identify issues and clarify actions taken by the provider
• Requesting evidence from the provider
• A short site visit

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as Good overall

We rated the practice as requires improvement for being safe because:

• The process for handling of requests for repeat medicines and structured medicines reviews was not always effective.
• The practice had not ensured that some aspects needed to support good safeguarding arrangements were in place, for example, up to date policies and procedures; update training to the appropriate level for staff; and, regular formal multi-disciplinary (MDT) meetings.

We also found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
• The practice were in the process of managing change, as a new provider was being commissioned to provide the service going forward.
• Some aspects of governance had not been prioritised during the pandemic. As we come out of the pandemic the practice had started to identify and address these areas to ensure the practice continued to operate effectively.

Whilst we found no breaches of regulations, the provider should:

• Review and improve the approach to conducting medicine reviews to ensure they are comprehensive and clearly document what was considered as part of the review. This includes considering the process for monitoring patients who have asthma to identify and address those who have high use of first step rescue medicines, which might indicate either misuse or an exacerbation of their asthma.
• Continue with the planned reintroduction of formal multi-disciplinary team meetings to support good communication between the practice and other healthcare professionals.
• Continue to implement and monitor the training plan to ensure staff have the relevant knowledge and skills required to do their job.
• Continue with the plan to review practice policies and procedures to ensure they reflect current guidance, regulations and best practice.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care