Archived: Dipton Surgery

Updated 25 July 2016

Dipton Surgery is situated in Stanley, County Durham. The practice is part of a larger group (Oakfields Health Group) which has another practice at nearby Hamsterley Colliery (Oakfields Health Centre). The principal GP owns both practices. They have a Personal Medical Services (PMS) contract and also offer enhanced services for example; extended hours. The practice covers the area of Dipton, Stanley and surrounding areas. Dipton is an ex-mining and steelworks community. There are 2700 patients on the practice list and the majority of patients are of white British background. The practice catchment area is classed as 5 out of 10 in the Indices of Multiple Deprivation (The lower the Indices of Multiple Deprivation (IMD) decile the more deprived an area is).

Dipton Surgery is a modern purpose built practice (built in 2011) and has good transport links and car parking facilities.

There is a principal GP (male), two salaried GPs, one male and one female, a female nurse practitioner and prescriber, a female practice nurse, a female health care assistant and an administration team of a manager and six receptionists. Some of the staff also work at the other location in the group. The practice has been a teaching and training practice in the past but due to staff changes is not currently adopting this role.

The practice is open Monday to Friday 8.30am to 6pm. Appointments are from 8.30am daily. Extended hours appointments are offered on Wednesdays at Oakfields Health Centre between 6pm and 8.15pm with GPs and the health care assistant. Patients requiring a GP outside of normal working hours are advised to contact the GP out of hours service (111) provided by County Durham and Darlington Foundation Trust (Commissioned by North Durham Clinical Commissioning Group (CCG).

Updated 25 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dipton Surgery on 16 June 2016. Overall the practice is rated as good.

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.
• Risks to patients were assessed and well managed.
• 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 said they 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.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• 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. The GPs and management encouraged a culture of openness and honesty.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 July 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.

• Housebound patients with diabetes were offered a telephone review and this followed a pathway of care devised by the Nurse Practitioner which incorporated current evidence based guidance.

• The percentage of patients with diabetes, on the register, in whom the last HbA1c was 64 mmol/mol or less in the preceding 12 months (01/04/2014 to 31/03/2015) was 87% which was higher than the local average of 81% and the national average of 78%.

• 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 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 were in the process of setting up collaboration with health trainers who would come into the practice and provide early intervention and health promotion advice for patients at risk of developing diabetes. This was part of the improving outcomes scheme with the CCG. Lifestyle coaches employed by the local authority were also invited into the practice to provide advice on dementia awareness, diabetes and healthy lifestyles.

Updated 25 July 2016

The 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.

• The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding 5 years (01/04/2014 to 31/03/2015) was 92% which was higher than the local average of 83% and the national average of 82%.

• The percentage of women aged 25-64 who attended cervical screening within target period (3.5 or 5.5 year coverage) was 86% which was higher than the local average of 78% and the national average of 74%.

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

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

Updated 25 July 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.

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

• Patients living in care homes were visited weekly by a GP who worked in collaboration with other health professionals involved in care planning and provision of treatment.

• The practice participated in a local scheme which enabled patients who were at risk of unplanned admission to hospital access to a dedicated telephone number at weekends. This was staffed by GPs.

Updated 25 July 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 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.

Updated 25 July 2016

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

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months (01/04/2014 to 31/03/2015) was 100% which was higher than the local average of 90% and the national average of 88%.

• 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 advance 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.

Updated 25 July 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 including those with a learning disability.

• The practice offered longer appointments and home visits 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 in normal working hours and out of hours.