The Weardale Practice

Updated 6 April 2017

The Weardale Practice, Stanhope Health Centre, Dales Street, Stanhope, County Durham, DL13 2XD, is a purpose built premise. It is located close to the centre of Stanhope where there are a range of local amenities. They also operate two branch surgeries; St John’s Chapel Surgery, Hood Street, St Johns Chapel, DL13 1QW, which was purpose built and Wolsingham Surgery, Market Place, Wolsingham, DL13 3AB, which is a converted property. The St John’s Chapel Surgery and Wolsingham Surgery were owned by the practice, whilst Stanhope Health Centre was owned by NHS Properties Services.

The proportion of the practice population in the 65 years and over age group is above the England average. The practice population in the under 18 age group is below the England average. The practice scored seven on the deprivation measurement scale, the deprivation scale goes from one to ten, with one being the most deprived. People living in more deprived areas tend to have a greater need for health services.

The practice has a clinical team of a five GP partners and one salaried GP, three male and three female. There is a lead nurse, three practice nurses and three healthcare assistants and a phlebotomist. The practice has a clinical team of a five GP partners and one salaried GP, three male and three female.  There is a lead nurse, three practice nurses and three healthcare assistants and a phlebotomist. The Practice is led by a Practice Business Manager with support from an Assistant Practice Manager and Assistant Business Manager.  They are supported by a range of administration and reception staff. This is a teaching practice who take medical students

There are also two branch practices, each of which has a branch manager who are supported by an admin team and in one of the branches by dispensing staff.

The practice provides services under a General Medical Services (GMS) contract with the NHS Durham, Dales, Easington and Sedgefield CCG. The practice services a patient list of 7203, 2.5% of which are registered carers.

The practice is readily accessible for people who use wheelchairs and by parents with pushchairs. A portable hearing loop system is available. and there are quiet waiting facilities for patients who find the main waiting area to cause anxiety. Private space is available for breast-feeding.

At main practice at Stanhope Health Centre, appointments are from 8 am to 7.30 pm on Mondays and from 8 am to 6 pm Tuesdays to Fridays. At St John’s Chapel Surgery appointments are available between 8.30 am and 12.30 pm Mondays, Wednesdays and Fridays and 1.30 pm to 6 pm Tuesdays and Thursdays. At Wolsingham Surgery appointments are from 8.30 am to 12.15 pm and 1.30 pm to 6 pm on Mondays; 8.30 am to 12.15 pm Tuesdays to Thursday and 1.30 pm to 6 pm on Fridays.

The practice, along with all other practices in the Durham, Darlington, Easington and Sedgefield CCG area have a contractual agreement for the Out of Hours provider to provide OOHs services from 6.00pm. This has been agreed with the NHS England area team. The practice has opted out of providing out of hours services (OOHs) for their patients. When the practice is closed patients use the NHS 111 service to contact the OOHs provider. Information for patients requiring urgent medical attention out of hours is available in the waiting area, in the practice information leaflet and on the practice website.

Updated 6 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Weardale Practice on 22 August and 2 September 2016. Both of the branch surgeries were also visited.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. The practice proactively identified opportunities for learning in all interactions with patients and service providers.
• Risks to patients were assessed and well managed based on national best practice guidance.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients 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. Improvements were made to the quality of care as a result of complaints and concerns.
• There was a consistent focus on continuity of care through named GPs for families and adherence to Royal College of General Practitioner guidance for older people. Urgent appointments were available the same day and patients whose condition meant they were unlikely to adhere to booked appointments were seen opportunistically.
• 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. 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.

We saw areas of outstanding practice:

• The practice worked closely with a local voluntary driving service to enable their less mobile patients to attend the practice to see the practice nurses and /or GPs. There were 832 journeys had been made for various appointments in the past 12 months which saved home visits and also provided care for patients nearer to home.

• The continuous improvement work that specific GP’s were involved in, which benefitted both their patients and the wider community. For example, to address the increasing rates of pre-diabetes in the local population as well as the risks of social isolation, the practice worked the Durham Dales Health Federation to help support an integrated diabetes service.

• The senior team had a demonstrable commitment to staff wellbeing and welfare. For example, they arranged team ‘away days’ that also included the family members of staff.

The area where the provider should make improvements was;

Ensure the choice of medicines for emergency use are in line with national guidance and embed processes to ensure they are checked for their fitness to use.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 6 April 2017

The practice is rated as good for this population group.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Each long term condition had a lead GP who had the required knowledge and skill.For example, one of the GP led up on diabetes.They had completed the Warwick diabetes course.One of the practice nurses had been trained as has diabetes as their lead responsibility.

• The practice works closely with the specialist nurse and local diabetologist, initiated insulin and have adopted the new diabetes pathway.

• Longer appointments and home visits were available when needed.

• Patients with chronic obstructive pulmonary disease, diabetes, asthma or heart failure had 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 responded to an increase in lifestyle-related diabetes in the local population by increasing the number of appointments available with a nurse who could managed oral medicines and insulin.

Updated 6 April 2017

The practice is rated as good for this population group.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances.

• 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, including a private breast-feeding room.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

• The practice had achieved Young Carers Charter Status, which meant young people who acted as carers were offered structured support and access to appointments in the practice.

Updated 6 April 2017

The practice is rated as good for this population group.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• Clinical staff conducted proactive and opportunistic screening for dementia and cardiovascular disease.

• The practice participated in the unplanned admissions enhanced service. This meant the most vulnerable 2% of patients were monitored to ensure care and treatment was delivered in a way that reduced the risk they would be admitted to hospital. The practice has employed their own care co-ordinator to provide this service specifically for their patients, working to help avoid admissions and to support them after discharge.

• The practice was part of the Vulnerable Adults Wrap Around Service (VAWAS). This was a service provided to vulnerable patients living in nursing or care homes, the housebound or those at high risk of admission. They were cared for by a GP in conjunction with Advanced Nurse Practitioners and district nurses. This was a Federation initiative through the CCG to ensure the needs assessment of vulnerable patients remained up to date.

• There is also a lead GP who regularly visits local care homes where patients have comprehensive care plans and they are available to provide informal advice.

• Practice staff worked with multidisciplinary teams to ensure end of life care plans were appropriate and met the needs of each individual.

• The practice worked closely with a local voluntary driving service to enable less mobile patients to attend a variety of appointment, both at the practice and other health provision.

The practice provided medical cover to the local community hospital.  A GP partner was available for five sessions per week at the hospital, with them also being available 8am to 6pm Monday to Friday. 

Updated 6 April 2017

The practice is rated as good for this population group.

• 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. For example,.

• The practice was proactive in offering online services as well as a full range of health

  promotion and screening that reflected the needs for this age group.

• During flu season the practice offered Saturday morning clinics and walk-in appointments.

• Health trainers, counselling, physiotherapy and drug and alcohol advice services were available on-site.

Updated 6 April 2017

The practice is rated as good for this population group.

• 82% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the clinical commissioning group average of 83% and the national average of 84%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. Clinical staff could refer patients directly to talking therapies services and in-house cognitive behaviour therapy and bereavement services were available.

• Clinical staff were able to conduct depression assessments and followed up accordingly.

• The practice carried out advance care planning for patients with dementia and there were care plans in place.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. Support group information was available within the practice and on the practice website.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia and the practice was working towards ‘Dementia Friendly’ status.

Updated 6 April 2017

The practice is rated as good for this population group.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

• The practice offered longer appointments or home visits, annual reviews, flu vaccines and health action plans for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• 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.