Archived: Dr Ne Win

Updated 24 August 2016

The practice is based within Flagg Court Health Centre in South Shields, Tyne and Wear. The practice serves people living in South Shields itself. The practice provides services to patients from one location: Flagg Court, South Shields, Tyne and Wear, NE33 2LS. We visited this address as part of the inspection.

The practice is located in a purpose built two storey building and provides services to patients at ground floor level. They offer on-site parking including disabled parking, accessible WC’s and step-free access. They provide services to just over 1,900 patients of all ages based on a Primary Medical Services (PMS) contract agreement for general practice.

The practice has one male GP, one nurse practitioner, one healthcare assistant, a practice manager, a deputy manager and three medical receptionists.

Information taken from Public Health England placed the area in which the practice was located in the third more deprived decile. In general, people living in more deprived areas tend to have greater need for health services. The practice’s age distribution profile is weighted towards a slightly younger population than national averages. There are more patients registered with the practice between the ages of 0-18 years than the national averages.

The service for patients requiring urgent medical attention out-of-hours is provided by the 111 service and Northern Doctors Urgent Care Limited.

Updated 24 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Ne Win on 23 June 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing effective, caring, responsive and well-led services. It was also good for providing services for the following population groups: Older people; People with long-term conditions; Families, children and young people; Working age people (including those recently retired and students); People whose circumstances may make them vulnerable; People experiencing poor mental health (including people with dementia). It required improvement for providing safe services.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• 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 offered pre-bookable early evening appointments one day per week with the GP or nurse practitioner, which improved access for patients who worked full time.
• The practice had good facilities and was well equipped to treat patients and meet their 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.

However there were areas of practice where the provider needs to make improvements.

The area where the provider must make improvements is:

• The practice must take action to ensure care and treatment is provided in a safe way for service users through the proper and safe management of medicines.

In addition the provider should:

• Ensure that all clinical audits include at least two cycles. The practice should aim to demonstrate an on-going audit programme where they have made continuous improvements to patient care in a range of clinical areas as a result of clinical audit.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 10 September 2015

The practice is rated as good for the care of people with long-term conditions. Staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients were offered a structured review at least annually to check that their health and medication needs were being met. For those people with the most complex needs, the practice worked with relevant health and care professionals to deliver a multidisciplinary package of care. A traffic light system was used to highlight those patients that required more intense input from the clinical team. The list was reviewed on a regular basis and discussed at multidisciplinary meetings.

Patients with more than one long term condition were offered longer appointment slots. Patients who were unable to attend the practice were visited by the nurse practitioner at home in an attempt to maintain continuity of care. A medicines optimisation pharmacist supported the practice and kept them updated on medication guidelines.

Updated 10 September 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. They had initiated regular meetings with the health visitor and midwife. This allowed them to monitor families and children who may be experiencing difficulties and intervene quickly if necessary.

The practice held a weekly baby clinic and arranged antenatal checks, baby checks, childhood immunisations and mothers’ post-natal checks on the same day. A designated member of staff co-ordinated the clinic and all patient appointments. This helped to reduce the need for mothers, babies and young children to attend on more than one occasion. Immunisation rates were generally in line with or slightly higher than the averages for the local CCG. For example, and Men C vaccination rates for one year old children were 96.7% compared to 84.8% across the CCG and Men C Booster vaccination rates for two year old children were 100% compared to 98.2% across the CCG. The practice had achieved slightly lower cervical screening rates (75.2%) compared to the national average (81.9%).

Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals. Appointments were available outside of school hours and the premises were suitable for children and babies.

The nurse practitioner had completed a foundation level sexual health course, followed by the integrated sexual health pathway to degree level. As a result of this, the practice was able to provide a full level two sexual health service. This was particularly relevant to the practice, as their patient list showed they had a young demographic population. They also signposted female patients to a smartphone application which prompted them to take their oral contraceptives and reminded them when their contraceptive injections were due.

Updated 10 September 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. The practice was responsive to the needs of older people, including offering home visits and rapid access appointments for those with enhanced needs. The practice offered annual health checks to all of their patients over the age of 75.

The practice was linked with a local care home and the GP visited the home at least once per week.

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 people in their own homes if they were housebound.

Updated 10 September 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 and flexible. The practice offered some online services as well as a full range of health promotion and screening which reflects the needs for this age group. GP appointments could be booked in advance online.

The practice offered extended opening hours one evening per week. Patients could pre-book appointments to see the GP and nurse practitioner at these times. Telephone consultations with clinicians could also be booked on a daily basis. The nurse practitioner ran three walk in clinics on a daily basis, as well as offering telephone triage. This made it easier for people of working age to access the service. NHS health checks were offered to patients between the ages of 40 and 74.

Updated 10 September 2015

The practice is rated as good for the care of people experiencing poor mental health (including people living with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those living with dementia. The practice maintained a register of patients who were living with dementia and invited those patients to attend the practice for annual reviews.

Patients experiencing poor mental health were routinely recalled for an annual check-up by a designated member of the administrative team. Any patients who failed to attend were followed up by the GP. The practice had informed patients experiencing poor mental health about how to access various support groups and voluntary organisations. A wide range of leaflets were available in the practice’s own patient waiting area for patients to take.

Updated 10 September 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. Patients with learning disabilities were invited to attend the practice for annual health checks. Any patients who failed to attend were followed up by the GP. All of the practice’s patients on their learning disability register had received an annual health check last year. The practice offered longer appointments for people with a learning disability, if required.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. They made vulnerable patients aware of 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.

Interpreting services were available for patients whose first language was not English. The practice’s patient list included a significant number of patients from within the local Bangladeshi community. The practice had recognised and embraced this and a number of patient information leaflets were available for patients in this language.