Southlands Medical Group

Updated 11 June 2015

Southlands Medical Group is registered with the Care Quality Commission to provide primary care services. It is located in the Ryhope area of Sunderland.

The practice provides services to around 5,300 patients from one location; Ryhope Health Centre, Black Road, Ryhope, Sunderland, SR2 0RX. We visited this address as part of the inspection. The practice has two GP partners, two salaried GPs, a nurse practitioner, two practice nurses, a practice manager, and seven staff who carry out reception and administrative duties.

The practice is part of Sunderland Clinical Commissioning Group (CCG). The practice is situated in an area where there are pockets of high deprivation. The practice population is made up of a higher than average proportion of patients over the age 65.

The practice is located in a purpose built single storey building. It also offers on-site parking, disabled parking, a disabled WC, wheelchair and step-free access.

Surgery opening times at the practice are between 8:00am and 6:00pm Monday to Friday. 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 111 service and Primecare.

Updated 11 June 2015

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of Southlands Medical Group on 1 April 2015

Overall, we rated the practice as good. Specifically, we found the practice to be good for providing safe, effective, responsive and well led services; and outstanding for providing caring services.

Our key findings were as follows:

• Feedback from patients was overwhelmingly positive; they told us staff treated them with respect and kindness;
• We reviewed 49 completed CQC comment cards and spoke with 14 patients. They were all very complimentary about the care provided by the practice. Results from the National GP Patient Survey were well above local and national averages;
• Patients reported good access to the practice, with urgent appointments available the same day;
• 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.

We saw some areas of outstanding practice including:

• The practice had undertaken a significant amount of work in relation to access to the service. Separate systems were in place for patients to book planned (routine) and urgent appointments. There were daily clinics which were run by the nurse practitioner; patients did not need to book in advance to attend. The practice was part of a group of ten local GP practices taking part in an extended hours pilot. Patients from those surgeries were able to access services at a local health centre between 8:00am and 8:00pm weekdays and between 9:00am and 5:00pm at weekends.

• There was a well-defined vision within the practice to put patients first. Staff understood that it may have been difficult for patients to make decisions about possible treatment during a 10 minute consultation. Patients were encouraged to go and consider their options and make a further appointment for a later date to discuss with a clinician. Despite the time constraints and pressures on appointments across GP practices nationally, the practice prioritised the welfare of patients and did not put pressure on people to make an immediate decision.

• The practice actively reviewed complaints and had recently reviewed its arrangements for managing and responding to complaints. The revised approach demonstrated the people who use services were involved in the review of complaints. A decision had been taken to share (anonymised) details of all complaints with the Patient Reference Group (PRG), to promote openness and transparency. The PRG members we spoke with confirmed these arrangements were in place and told us they welcomed the opportunity to be involved in the process.

However, there was also an area of practice where the provider needs to make improvements.

The provider should:

• put plans in place to ensure clinical audit cycles are completed.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 11 June 2015

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

The practice had planned for, and made arrangements to deliver, care and treatment to meet the needs of patients with long-term conditions. Patients with long-term conditions such as asthma and diabetes, were offered regular reviews and an annual check of their health and wellbeing, or more often where this was judged necessary by the nursing team.

Nationally reported QOF data (2013/14) showed the practice had achieved 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 2.0 percentage points above the local CCG average and 2.8 points above the national average.

Updated 11 June 2015

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

The practice had identified the needs of families, children and young people, and put plans in place to meet them. We saw the practice had processes in place for the regular assessment of children’s development. This included the early identification of problems and the timely follow up of these. Systems were in place for identifying and following-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 involving 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, of 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 in line with the local CCG area.

Pregnant women were able to access an antenatal clinic provided by healthcare staff attached to the practice. The practice had obtained 100% of the QOF points available to them for providing recommended maternity services and carrying out specified child health surveillance interventions. Nationally reported QOF data (2013/14) showed antenatal care and screening were offered in line with current local guidelines. The data also showed that child development checks were offered at intervals consistent with national guidelines.

Updated 11 June 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 1.5 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, including offering home visits.

Updated 11 June 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. All of the nurses were trained in cervical cytology.

Patients could order repeat prescriptions and book appointments on-line. The practice was open between 8:00am and 6:00pm. However, the practice was taking part in a local extended hours service which meant that their patients were able to access appointments seven days a week. Appointments were available until 8:00pm on weekdays and between 9:00am and 5:00pm at weekends at a local health centre.

We saw health promotion material was made easily accessible through the practice’s website. This included signposting and links to other websites including those dedicated to weight loss, sexual health and smoking cessation. The practice provided additional services such as smoking cessation advice clinics, travel vaccinations and minor surgery.

Updated 11 June 2015

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

Nationally reported QOF data (2013/14) showed the practice had achieved good outcomes in relation to patients experiencing poor mental health. For example, the practice had obtained 100% of the points available to them for providing recommended care and treatment for patients with mental health needs. This was 9.7 percentage points above the local CCG average and 9.6 points above the England average. The practice kept a register of patients with mental health needs which was used to ensure they received relevant checks and tests.

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 11 June 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.

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.