Archived: The Medical Centre

Updated 9 July 2015

The Medical Centre is registered with the Care Quality Commission to provide primary care services and is located in South Tyneside.

The practice provides services to around 5,850 patients from two locations:

• Horsley Hill Road, South Shields, Tyne and Wear, NE33 3ET
• The Medical Centre, Wear Street, Jarrow, Tyne and Wear, NE32 3JN

We visited both addresses as part of the inspection.

The practice has one GP partner, one salaried GP (one male and one female), two practice nurses (both female), a healthcare assistant, a practice manager, and 12 staff who carry out reception and administrative duties. The salaried GP was in the process of applying to become a partner in the practice.

The practice is part of South Tyneside clinical commissioning group (CCG). The practice is situated in areas of relatively high deprivation. The population in the Jarrow area is made up of a higher than average proportion of patients over the age of 50. The practice population profile at South Tyneside is in line with national averages.

The South Shields surgery is located in a converted two storey building. The Jarrow branch is within a purpose built two storey building. All patient facilities at both sites are located on the ground floor. On-site parking, disabled parking, a disabled WC, wheelchair and step-free access is available.

Opening times at South Shields are between 8:00am and 6:00pm every weekday except Thursday when the surgery is open between 8:00am and 1:00pm. The Jarrow branch is open between 8:00am and 6:00pm everyday weekday except Tuesday when it is open between 8:00am and 8:00pm. Patients can book appointments in person, on-line or by telephone.

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

The service for patients requiring urgent medical attention out of hours is provided by the NHS 111 service and Northern Doctors Urgent Care (NDUC).

Updated 9 July 2015

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of The Medical Centre on 2 June 2015

Overall, we rated the practice as good. Specifically, we found the practice was good for providing caring, effective, responsive services and well led services. However, improvements are required to ensure safe services are provided.

Our key findings were as follows:

• Feedback from patients was positive; they told us staff treated them with respect and kindness;
• Patients reported good access to the practice. The proportion of patients who were able to get an appointment when they wanted was above average (78% compared to the national average of 73%);
• Patients we spoke with told us they felt they had sufficient time during their appointment;
• Patients’ needs were assessed and care was planned and delivered following best practice guidance;
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, reviewed and addressed;
• There was a clear leadership structure and staff felt supported by the management team. The practice actively sought feedback from patients;
• The practice was clean and hygienic, and good infection control arrangements were in place.

There were some areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Ensure relevant recruitment checks are carried out on new staff;
• Ensure staff receive training relevant to their role, including fire safety and infection control.

In addition the provider should:

• Review the business continuity plan to ensure it reflects current arrangements;
• Take steps to monitor equipment to ensure it is in date and suitable for use;
• Maintain clear records on prescription stationery stock, in line with guidance from NHS Protect.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 9 July 2015

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

The practice had a high proportion of patients with multiple long-term conditions and had planned for, and made arrangements to deliver, care and treatment to meet their needs. Patients with long-term conditions were offered regular reviews and an annual check of their health and wellbeing, or more often where this was judged necessary by the clinical staff. One of the GPs was the lead for long-term conditions and so kept an overview of the patients and their treatment needs. A ‘shared care’ model had been implemented where patients were engaged in the decision making pathways.

Where possible, those patients with multiple conditions were offered a ‘combination review’ whereby all of their health conditions were monitored at one consultation. There were urgent appointments available at each nurse clinic in order to give rapid access to nursing support and reassurance.

Nationally reported QOF data (2013/14) showed the practice had achieved generally good outcomes in relation to the conditions commonly associated with this population group. For example, the practice had obtained 100% of the points available to them for providing recommended care and treatment for patients with asthma This was 0.3 percentage points above the local CCG average and 2.8 points above the national average. However, there were some conditions where the scores were below average. For example, for peripheral arterial disease. The practice achieved 83.2% of the available points, which was 2.6 points below the CCG average and 8.0 points below the national average.

Updated 9 July 2015

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

Systems were in place to identify and follow-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, which involved child care professionals such as school nurses and health visitors.

Appointments were available outside of school hours and reception staff had been trained to take note of any urgent problems and notify the doctor about an unwell child or parental concern. The premises were suitable for children and babies. Arrangements had been made for new babies to receive the immunisations they needed. Vaccination rates for 12 month and 24 month old babies and five year old children were generally in line with the local CCG area.

Pregnant women were able to access an antenatal clinic provided by healthcare staff who were attached to the practice. Nationally reported QOF data (2013/14) showed that the practice had obtained 100% of the QOF points available for providing recommended maternity services. The data also showed that child development checks were offered at intervals consistent with national guidelines.

Updated 9 July 2015

The practice is rated as good for the care of older people.

Nationally reported data showed the practice had good outcomes for conditions commonly found amongst older people. For example, the practice had obtained 100% of the points available to them for providing recommended care and treatment for patients with heart failure. This was 2.0 percentage points above the local clinical commissioning group (CCG) average and 2.9 points above the England average.

The practice offered personalised care to meet the needs of the older people in its population. The practice had written to patients over the age of 75 years to inform them who their named GP was. The practice was responsive to the needs of older people, and offered home visits for health checks and flu vaccinations. GPs had good links to the local care home and regularly visited patients living there.

One of the practice nurses carried out holistic home visits to older people. This was more convenient for patients and gave them more time to discuss any concerns.

Staff within the practice worked closely with other health professionals to provide care and support for older people, including, district nurses and social workers.

Updated 9 July 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 as well as 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. The practice was open between 8:00am and 6:00pm Monday and Friday. There were extended opening hours at the Jarrow branch on a Tuesday between 6:00pm and 8:00pm.

The practice provided additional services such as health checks for the over 40’s, smoking cessation advice clinics and travel vaccinations.

Updated 9 July 2015

The practice is rated as good for the care of people experiencing poor mental health.

The practice kept a register of patients with mental health needs which was used to ensure they received relevant checks and tests. Patients suffering new episodes of depression were regularly reviewed and encouraged to attend the practice to plan the best treatment options with the clinicians.

Nationally reported QOF data (2013/14) showed the practice had obtained 89.2% of the points available to them for providing recommended care and treatment for patients with dementia. This was slightly below the local CCG and England averages.

The practice worked closely with multi-disciplinary teams in the case management of people experiencing poor mental health including those with dementia. The practice had care plans in place for patients with dementia. Patients experiencing poor mental health were sign posted to various support groups and third sector organisations.

Updated 9 July 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

Systems were in place in place to identify patients, families and children who were at risk or vulnerable. The practice held a register of patients living in vulnerable circumstances including those with learning disabilities. These patients were offered regular reviews. Staff worked with the local learning disability team and took on board suggestions for better communication methods. ‘Easy read’ letters had been created to welcome patients to the practice.

The practice worked 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.