Burn Brae Medical Group

Updated 19 November 2015

Burn Brae Medical Group are based in Hexham, a rural market town and civil parish in Northumberland, which is located south of the River Tyne. The practice provides services to just over 8,900 patients. Burn Brae is based at Hexham Primary Care Centre, Hexham Northumberland, NE46 1QJ and we visited the practice as part of this inspection

The practice provides services to patients of all ages based on a Personal Medical Services (PMS) contract agreement for general practice. The catchment area for the practice covers approximately 200 square miles.

The practice is open between 8am and 8pm Monday to Wednesday. On Thursday and Fridays they are open between 8am and 6:30pm. Extended hours surgeries are offered until 8pm Monday to Wednesday.

The practice is a training practice with five GP partners (two female and three male). There are also two salaried GPs (both female), three practice nurses, one healthcare assistant and a team of administrative support staff.

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

The practice serve an area with lower levels of deprivation affecting children and people aged 65 and over, when compared to the England average. While the practice area is within the second least deprived decile in England, the proportion of people in paid work or full time employment is 51.4% and this is lower than England as a whole where the average is 60.25% of people being in paid employment. However, there is also a smaller proportion of people who were unemployed (1% compared to 6.2% England average) and a lower proportion of disability allowance claimants (at 37.7 per 1000 population, compared to an England average of 50.3 per 1000 population).

There are a higher proportion of patients over the age of 65, 75 and 85 when compared to England averages. The average male life expectancy is 80 years, which is higher than the England average of 79 years. The average female life expectancy is the same as the England average at 83.

The number of patients reporting with a long-standing health condition is slightly higher than the national average (practice population is 55.8% compared to a national average of 54.0%). The number of patients with health-related problems in daily life is higher than the national average (50.6% compared to 48.8% nationally). There is a smaller proportion of patients with caring responsibilities at 15.7% compared to 18.2% nationally.

Updated 19 November 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Burn Brae Medical Group on 30 July 2015. Overall the practice is rated as outstanding.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, they had a robust patient focussed approach to reviewing the health needs of patients with long term conditions.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG).
• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand
• The practice had a clear vision which had quality and safety as its top priority. A business plan was in place, was monitored and regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

We saw numerous areas of outstanding practice including:

• The practice made sure all staff had the knowledge and skills to identify and act upon safeguarding concerns. In addition to the training appropriate to their roles, the practice held an annual safeguarding training event to give the staff the opportunity to discuss different safeguarding scenarios and to ensure they were skilled and confident in safeguarding.

• The practice was innovative and reflective of how they could improve the health outcomes for patients. This was evidenced through the active approach to clinical and other audits, and being at the forefront nationally in the care planning approach for long term conditions. The practice performed higher than local and national averages on a number of the indicators in the Quality Outcomes Framework, including those related to hypertension, mental health, dementia and diabetes mellitus.

• The practice took patient involvement in health and well-being very seriously. They took an active approach to involving patients in monitoring and improving their health. This was evidenced in the care planning approach for patients with long-term conditions.

• Following consultation with young people, the practice had implemented a young patient drop in service one afternoon a week, outside school hours, to encourage them to access primary health services. The practice had conducted a further survey to seek young people’s views on what barriers there were to accessing services. To help the practice plan how they could overcome these barriers. The practice developed a leaflet aimed at young people to inform and encourage them about the services offered by the practice. They had achieved accreditation in the ‘You’re Welcome’, the Department of Health ‘Quality criteria for young people friendly health services’.

• There was strong evidence throughout the practice that team spirit and motivation was high. Of particular note was the general feeling of ‘no one is left behind’ and the emphasis on improving health outcomes for all.

• There was a strong focus on continuous learning and improvement at all levels within the practice. The practice had an ethos of patient empowerment and this was evident across a number of areas, such as reviewing the health of patients with long-term conditions and engagement with young people.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 November 2015

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

There were aspects of the practice which were outstanding and this related to all population groups. Nursing 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 had a named GP and a structured annual review to check that their health and medication needs were being met. The practice was at the forefront nationally in the care planning approach for long term conditions and took an approach that supported patient engagement and empowerment in their health outcomes. For those people 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 an annual health fair to promote healthier living, self-management of chronic diseases and minor illnesses and to help patients and the general public better understand the work of the practice. This promoted local organisations to patients which could offer them support.

Updated 19 November 2015

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

There were aspects of the practice which were outstanding and this related to all population groups. 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. Immunisation rates were relatively high for all standard childhood immunisations. Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

The practice had taken action to overcome barriers to young people accessing services, and had achieved accreditation in the ‘You’re Welcome’, the Department of Health ‘Quality criteria for young people friendly health services’.

Updated 19 November 2015

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

There were aspects of the practice which were outstanding and this related to all population groups. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 19 November 2015

The practice is rated as outstanding for the care of working age people (including those recently retired and students).

There were aspects of the practice which were outstanding and this related to all population groups. 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 that reflects the needs for this age group.

The practice held a health fair annually to promote healthier living; self-management of chronic diseases and minor illnesses, to help patients and the general public better understand the work of the practice and to help patients to know about local organisations which could offer them support.

Updated 19 November 2015

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

There were aspects of the practice which were outstanding and this related to all population groups. The practice held a register of patients experiencing poor mental health and there was evidence they carried out annual health checks for these patients. The practice regularly worked with the multi-disciplinary teams in case management of people experiencing poor mental health, including those with dementia.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations including MIND and SANE. They had systems in place to follow up patients who had attended Accident and Emergency (A&E).

Updated 19 November 2015

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

There were aspects of the practice which were outstanding and this related to all population groups. The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability. It offered longer appointments for people with a learning disability and had carried out annual health checks by the GP lead in this area.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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.