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  • GP practice

Archived: St. Andrew's Medical Practice

Overall: Good read more about inspection ratings

St Andrews Lane, Spennymoor, County Durham, DL16 6QA (01388) 817777

Provided and run by:
St. Andrew's Medical Practice

Latest inspection summary

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Background to this inspection

Updated 21 February 2018

St Andrew’s Medical Practice is registered with the Care Quality Commission to provide primary care services. The practice provides services to around 11,000 patients from two locations;

  • St Andrew’s Lane, Spennymoor, Co Durham, DL16 6QA
  • Byer’s Green Surgery, Green Rise, Byers Green, DL16 7PL

We visited only the main surgery at St Andrew’s Lane as part of this inspection. The practice had recently consulted with patients and staff and put together a business case regarding the closure of Byers Green Surgery. The practice is under used by patients, there were only 84 consultations at this location in the last year. We did not visit this location as part of this inspection.

St Andrew’s Medical Practice is situated in a purpose-built building with full disabled access. The practice was able to offer dispensing services to those patients on the practice list who lived more than one mile (1.6km) from their nearest pharmacy.

The practice is currently registered as a GP partnership with CQC. Although there is still a partnership in place none of the partners currently registered with CQC at the practice are working there. We advised that the registration for the practice was now incorrect and that they would now be required to add and remove the partners as appropriate.

The practice has four GP partners (three male and one female), all of whom work full time. There are four advanced nurse practitioners, whole time equivalent (WTE) 2.2, an advanced paramedic practitioner (WTE 1), two practice nurses (WTE 1.66), and three healthcare assistants (WTE 2.32). There is a practice manager and assistant practice manager. There are 11 (WTE 9.08) staff who undertake administration duties and three dispensing staff (WTE 1.15). The practice trains Foundation level (F2) doctors. An F2 is a qualified doctor spending 4 months in a GP practice (undertaking a medical training programme which forms the bridge between medical school and specialist/general practice training).

The opening times at St Andrew’s Medical Practice are from 8am Monday to Friday; on Mondays the practices closes at 7:30pm and Tuesday to Friday at 6pm. Consulting times are 8:30am to 11:15am, 2pm until 4:30pm or 3pm until 5:30pm and on Monday evenings until 7:30pm.

Byers Green is open Tuesday and Friday mornings 10:30am to 11:30am, the consulting times are the same, a GP provides appointments on a Tuesday and an advanced nurse practitioner on a Friday.

The practice provides late evening, weekend and bank holiday appointments;

they are part of the local GP federation of GP practices who work together to provide appointments with GPs, nurses or health care assistants outside of their normal working hours. Patients can contact the practice reception team to arrange appointments. When this service is not provided patients requiring urgent medical care can contact the out of hours provided by the NHS 111 service.

The practice is part of NHS Durham Dales and Sedgefield clinical commissioning group (CCG). The practice provides services based on a Personal Medical Services (PMS) contract agreement for general practice.

Information from Public Health England placed the area in which the practice is located in the fourth most deprived decile. The income deprivation score for the practice was 26 compared to the CCG average of 30 and the national average of 24. In general, people living in more deprived areas tend to have greater need for health services. Average male life expectancy at the practice is 79 years which is the same as the national average. Average female life expectancy at the practice is 82 years compared to the national average of 83 years.

Overall inspection

Good

Updated 21 February 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 28 June 2016 – Good)

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at St Andrew’s Medical Practice on 11 January 2018. We inspected this service as part of our comprehensive inspection programme.

At this inspection we found:

  • Staff understood and fulfilled their responsibilities to raise concerns, and report incidents and near misses.
  • Outcomes for patients who use services were good.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance.
  • Staff were consistent and proactive in supporting patients to live healthier lives through a targeted approach to health promotion. Information was provided to patients to help them understand the care and treatment available.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • The practice had recently reviewed the appointment system and were able to provide 13% more appointments than the year before. The skill mix of the clinical staff had been enhanced to free up GP time.
  • There was a leadership structure in place and staff felt supported by management. The practice sought feedback from staff and patients, which they acted on.
  • The practice was aware of and complied with the requirements of the duty of candour.
  • There was a focus on continuous learning and improvement at all levels of the organisation.

We saw one area of outstanding practice:

  • The practice ran a dedicated nurse led weekly drop in clinic for teenagers. This was funded by the practice and was also available to patients who were not registered with the practice. The service provided targeted support to teenagers including matters relating to sexual health and drug and alcohol abuse.

The areas where the provider must make improvements as they are in breach of regulations are; (See Requirement Notice Section at the end of this report for further detail).

  • Ensure care and treatment is provided in a safe way to patients

The areas where the provider should make improvements are:

  • Review Standard Operating Procedures to ensure they are fit for purpose and reflect current practices.
  • Review the management of controlled stationery having due regard to national guidance.
  • Carry out a risk assessment for staff who had not received a Disclosure and Barring Service (DBS) check.
  • Review the arrangements in place for infection control.
  • Introduce a system to ensure patient safety alerts have all been followed up and actioned where appropriate.
  • Assure themselves that patients know how they can complain to the Parliamentary Health Service Ombudsman (PHSO).

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice