Archived: Elsdon Avenue Surgery

Updated 24 April 2017

Elsdon Avenue Surgery is registered with the Care Quality Commission to provide primary care services. The practice provides services to around 3,600 patients from one location. We visited this address as part of the inspection:

• Elsdon Avenue, Seaton Delaval, Whitley Bay, Tyne and Wear, NE25 0BW

Elsdon Avenue Surgery is situated in a converted one-story building. Access to the building is via a ramp. All reception and consultation rooms are fully accessible for patients with mobility issues. Car parking is available close to the practice.

The practice has three part-time GP partners (all female). There were no regular arrangements in place for patients to be able to see a male GP if they wanted to.

The practice employs a part-time strategic manager, a nurse practitioner, two health care assistants with additional administrative duties, an office supervisor and three staff who undertake reception and administrative duties. The practice provides services based on a General Medical Services (GMS) contract agreement for general practice.

The practice is a teaching and training practice where third year medical students and registrars gain experience of primary care.

Elsdon Avenue Surgery is open at the following times:

• Monday, Tuesday, Thursday and Friday 8:30am to 12:30pm then 1pm to 5:30pm.
• Wednesday 7:15am to 12:30pm then 1pm to 5:30pm.

The telephones are answered by the practice during their opening hours. This information is also available on the practice’s website and in the practice leaflet. The service for patients requiring urgent medical care out of hours is provided by the NHS 111 service and Vocare, which is locally known as Northern Doctors Urgent Care Limited.

Appointments are available at Elsdon Avenue Surgery at the following times:

• Monday 8:30am to 11:30am and 2pm to 5pm
• Tuesday 8:30am to 11:30am and 2pm to 5:20pm
• Wednesday 8:30am to 11:30am and 2pm to 5pm
• Thursday 8:30am to 11:30am and 2pm to 5pm
• Friday 8:30am to 11:30am and 2pm to 5pm

Extended hours appointments are available from 7:20am to 8am each Wednesday morning with a GP, nurse practitioner or healthcare assistant.

The practice is part of NHS Northumberland clinical commission group (CCG). Information from Public Health England placed the area in which the practice is located in the seventh less deprived decile. In general, people living in more deprived areas tend to have greater need for health

The proportion of patients with a long-standing health condition is slightly below average (50% compared to the national average of 52%). The proportion of patients who are in paid work or full-time employment or education is slightly below average (61% compared to the national average of 63%). The proportion of patients who are unemployed is below average (3.1% compared to the national average of 4.4%).

Updated 24 April 2017

Letter from the Chief Inspector of General Practice

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We carried out an announced comprehensive inspection at Elsdon Avenue Surgery 16 February 2017. Overall, the practice is rated as good.

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

• Staff understood their responsibilities to raise concerns and report incidents and near misses in the practice.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• The practice used the information collected for the Quality and Outcomes Framework (QOF), to monitor and improve outcomes for patients. The practice’s overall achievement, for 2015/16, was better than the local clinical commissioning group (CCG) and England averages.
• 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 found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. This was underpinned by strong, cohesive teamwork and good levels of staff satisfaction.
• The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour regulation.

We saw two areas of outstanding practice:

• New partners had become involved in the practice and they had been very active in engaging their staff with the changes that were required. The practice kept a “staff worry list” that recorded staff issues so that the practice could set priorities and support staff during the any changes required. Staff we met were engaged and supportive of this process.
• The practice recognised how critical it was to support patients who were also carers. The practice had identified 3.8% of their patient list were carers and this had increased over the past 12 months from 1.9% of their patient list.

There was an area where the provider needs to make improvements.

The provider should:

• Review their risk assessment that led to their decision not to have a defibrillator on the premises.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 24 April 2017

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

• The practice nurses had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority and supported by the practice, comprehensive care plans were in place and regularly reviewed.
• Nationally reported data showed that outcomes for patients with conditions commonly found in this population group were generally above local and national averages. For example, the practice had achieved 100% of the QOF points available for providing the recommended care and treatment for patients with rheumatoid arthritis. This was 2.3% above the local CCG average and 4.3% above the national average.
• Home visits were available when needed and longer appointments were available if requested.
• All patients with a long-term condition had a named GP and were offered a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• The practice held regular clinics for long terms conditions, for example for patients with diabetes.

Updated 24 April 2017

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

• There were processes in place for the regular assessment of children’s development. This included the early identification of problems and the timely follow up of these. Systems were in place for identifying and following-up children who were considered to be at-risk of harm or neglect. For example, the needs of all at-risk children were regularly reviewed at practice multidisciplinary meetings involving child care professionals such as health visitors.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• There were arrangements for new babies to receive the immunisations they needed. Practice childhood immunisation rates were above national averages. The practice had scored 10/10 compared with the national average score of 9.1/10 in respect of the vaccinations given to two year olds.
• Urgent appointments for children were available on the same day.
• Pregnant women were able to access an ante-natal clinic provided by healthcare staff attached to the practice.

• Nationally reported data showed that outcomes for patients with asthma were above average. The practice had achieved 100% of the QOF points available for providing the recommended care and treatment for patients with asthma. This was 1.1% above the local CCG average and 2.6% above the national average.

• The practice provided contraceptive and sexual health advice.
• The practice had a policy advising young people of their rights in relation to capacity and confidentiality.

Updated 24 April 2017

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 their population. All patients over the age of 75 had a named GP and patients over the age of 75 were offered an annual health check if required.
• The practice was responsive to the needs of older people; they offered home visits and urgent appointments for those with enhanced needs.
• Nationally reported data showed that outcomes for patients with conditions commonly found in older people were above local and national averages. For example, the practice had achieved 100% of the Quality and Outcomes Framework (QOF) points available for providing the recommended care and treatment for patients with hypertension. This was 1.2% above the local clinical commissioning group (CCG) average and 2.7% above the national average.
• The practice maintained a palliative care register and offered immunisations for shingles and pneumonia to older people.

Updated 24 April 2017

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 website enabled patients to completed online asthma, depression and alcohol questionnaires. Submitted questionnaires were received by the strategic manager and then reviewed by a clinician who made a decision on the action required.

• Patients could order repeat prescriptions and routine healthcare appointments online.

• Telephone appointments were available.
• The practice offered a full range of health promotion and screening which reflected the needs for this age group.
• The practice’s uptake for cervical screening was 79.1%, and slightly below CCG average of 83.8% and the national average of 81.4%.
• Additional services such as new patient health checks, travel vaccinations and joint injections were available.
• The practice website provided a good range of health promotion advice and information.

Updated 24 April 2017

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

• The practice had identified 0.9% of their population with enduring mental health conditions on a patient register to enable them to plan and deliver relevant services. Thirty-four patients were on this register, 63% of those had an annual review, 44% had an influenza vaccination. The practice had recently reviewed this register to ensure it was accurate and had taken steps to ensure vulnerable patients and patients unable to leave the house due to illness and/or old age had access to vaccinations.
• Nationally reported data showed that outcomes for patients with mental health conditions were above average. The practice had achieved 100% of the QOF points available for providing the recommended care and treatment for patients with mental health conditions. This was 3.7% above the local CCG average and 7.2% above the national average.
• Nationally reported data showed that outcomes for patients with dementia were above average. The practice had achieved 100% of the QOF points available for providing the recommended care and treatment for patients with dementia. This was 0.9% above the local CCG average and 3.4% above the national average.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. They carried out advance care planning for patients with dementia. The practice had taken steps to ensure that the practice environment was suitable for patient with dementia, for example we saw signs used pictures and arrows.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• Staff had a good understanding of how to support patients with mental health needs. Staff at the practice had undertaken dementia training to ensure they were aware of the needs of patients with dementia.
• The practice used the services of trainee counsellors to reduce the waiting time for appointments with the counselling service. Patients were made aware they were being seen by a trainee and consented to this.

Updated 24 April 2017

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 patients with a learning disability; patients with learning disabilities had been invited to the practice for an annual health check. Sixteen patients were on this register, 56% had an annual review and 63% had an influenza vaccination.
• The practice offered longer appointments for patients with a learning disability if requested.
• The practice used ‘easy read’ letters and appropriate health related information for patients with learning disabilities who were invited for a cervical screening test, this ensured patients could understand the tests and treatment they were offered.
• The practice regularly worked with multi-disciplinary teams (MDT) in the case management of vulnerable people.
• The practice informed 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.
• Good arrangements were in place to support patients who were carers.