Dr Corbett, Dr Garget & Dr Mendis Also known as Park Lane Surgery

Updated 9 February 2017

Dr Little, Dr Lingutla & Dr Corbett (also known as Park Lane Surgery) is located in Redmarshall Street, Stillington, Stockton On Tees, Cleveland. The practice is a dispensing practice situated in a rural area on the outskirts of Stockton and is a purpose built surgery. There is parking available at the practice and there is another small car park opposite the practice. The practice covers a large catchment area of a 40 mile radius with a mixed rural and urban population. Many of the patients live within walking distance of the practice and there is some access to public transport.

There are 4390 patients on the practice list. The practice scored eight 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.

There are two GPs, one female and one male. Another partner recently left and the practice has been able to recruit a new partner who will start in August. There are two practice nurses one of which a nurse prescriber and one health care assistant (HCA) (all female). There is a practice manager, dispensary and administrative staff.

The practice is a teaching practice (Teaching practices take medical students and training practices have GP trainees and F2 doctors). One of the GPs is undertaking further training to enable the practice to provide a placement for GP trainees.

The practice is open from 8am to 6pm, Monday to Friday. The practice provides some early morning appointments with one of the GPs providing 8am appointments. Appointments can be booked by walking into the practice, by the telephone and on line. Patients requiring a GP outside of normal working hours are advised to contact the GP out of hour’s service provided by Northern Doctors via the NHS 111 service. Arrangements had been made for Northern Doctors to answer emergency calls between 6pm and 6.30pm. The practice holds a General Medical Service (GMS) contract.

Updated 9 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on17 July 2016. A breach of legal requirements was found. After the comprehensive inspection the practice wrote to us to say what they would do to meet the following legal requirements set out in the Health and Social Care Act (HSCA) 2008:

• Regulation 12 HSCA 2008 (Regulated Activities) Regulations 2010 Safe care and treatment.

Care and treatment was not provided in a safe way for service users because some aspects of the management of medicines were unsafe.

Specifically:

Prescriptions must be checked and signed by GPs before medicines are dispensed and issued to patients

The arrangements for storing and recording controlled drugs must be reviewed and strengthened to comply with schedule 2 of the Misuse of Drugs (Safe Custody) Regulations 1973

We undertook this focused inspection on 26 October 2016 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Park Lane Surgery on our website at www.cqc.org.uk

Our key findings were as follows:

• Care and treatment was provided in a safe way for service users through the proper and safe management of medicines for the purposes of the regulated activity.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 November 2016

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

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

• Nationally reported data for 2014/2015 showed that outcomes for patients with long term conditions were good. For example, the percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) was 5mmol/l or less was 82%. This was1% below the local CCG average and 2% above the England average.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicine needs were being met.

• The practice promoted self-management for some long term conditions.

• The practice was involved in the healthy lung and healthy heart checks.

Updated 10 November 2016

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, 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.

• Nationally reported data from 2014/2015 showed the practice’s uptake for the cervical screening programme was 83% compared to the local CCG average of 83% and national average of 81%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with health visitors and school nurses. The practice hosted health visiting clinics in the practice every fortnight.

• Young people were able to access contraception and screening for sexually transmitted diseases (STD).

Updated 10 November 2016

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population. Patients over the age of 75 had an annual review.

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

• The practice was delivering ‘The Care Home Scheme’ locally. This scheme ensured patients living in care homes had structured annual reviews, regular GP visits and telephone consultations with the care team to address concerns.

• The practice was part of a local initiative with the Clinical Commissioning Group (CCG) to develop a frailty register of older people. This assessed the individual’s frailty and the support they may require to maintain their health and mobility.

• The practice had identified and reviewed the care of those patients at highest risk of admission to hospital. Those patients who had an unplanned admission or presented at Accident and Emergency (A&E) had their care plan reviewed and patients were contacted within three days of hospital discharge. All discharges were reviewed to identify areas for improvement.

The practice had visited and worked with the local schools promoting health awareness and were involved in a recent promoting care of older people national project.

Updated 10 November 2016

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 offered early morning appointments.

• 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.

Updated 10 November 2016

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

• Nationally reported data from 2014/2015 showed 100% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the previous 12 months, which was 5%above the national average and 6% above the national average.

• Nationally reported data from 2014/2015 showed the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive care plan documented in their record in the preceding 12 months was 94%, which was comparable to the CCG area and above the national average.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advanced care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• 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.

• Patients on medicines requiring regular monitoring and where the practice shared their care with mental health services were monitored regularly in the practice.

• Certain patients who were considered ‘at risk’ were supported by the dispensary by having their medicines issued weekly or daily, this was followed by a two weekly review with the GP.

Updated 10 November 2016

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 and provided a supportive and non-judgemental approach. Examples of these patient groups were people with drug and alcohol problems and those living with a learning disability. There were same day appointments available for those in crisis.

• The practice offered longer appointments for patients with a learning disability. Annual reviews for this group were monitored by the practice.

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

• One of the GPs had recently completed a Palliative Care Diploma to improve the management of palliative care patients.