Archived: Lanchester Medical Centre

Updated 5 August 2022

Lanchester Medical Centre is located in County Durham and provides services from, Lynwood House, Durham Road, Lanchester, County Durham, DH7 0LS

The provider is Dr Ian Gordon Davidson a sole provider. They are registered with CQC to deliver the regulated activities, diagnostic and screening procedures; family planning; maternity and midwifery services; treatment of disease, disorder or injury; and, surgical procedures.

The practice is situated within the NHS County Durham Clinical Commissioning Group (CCG) and delivers a general medical services contract (GMS) to a patient population of about 4,225. This is part of a contract held with NHS England.

The practice is part of a wider network of GP practices, Derwentside Primary Care Network (PCN). They build on existing primary care services and enable greater provision of proactive, personalised, coordinated and more integrated health and social care for people close to home.

Information published by Public Health England shows that deprivation within the practice population group is in the eighth lowest decile (eight of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 98.5% White, 0.7% Asian, 0.6% Mixed and 0.2% other. The practice advised us that 1-2% of the practice population were made up of Irish travellers.

The age distribution of the practice population mirrors the local and national averages. However, there are more older people registered at the practice compared to local and national average 26.6% compared to CCG average of 20.7% and national average of 17.7%.

The Medical Centre was purpose built in 2014. There are dedicated parking and disabled parking bays. There are two floors with disabled access via the main doors. The practice has an operational lift for access to the second floor and all doors are wheelchair friendly.

There are three GPs working at the practice; two male and one female, who provide 17 sessions per week. There is a nurse practitioner, practice paramedic and a practice nurse who all work part time. There are two part time health care assistants, a practice manager and business management consultant and a team of administration and reception staff.

The practice is a training practice who have GP trainees allocated to the practice. They are allocated year five students, Foundation Year 2 Doctors and GP Registrars.

The practice is open Monday, Thursday and Friday between 8 am to 6 pm, Tuesday between 7am and 6pm and Wednesday between 8am and 4.30pm. The practice offers a range of appointment types including book on the day, telephone consultations and advance pre-bookable appointments. Most requests for appointments were triaged by a GP.

Extended access is provided locally under a separate contract, where late evening and weekend appointments are available. This service offers pre-bookable appointments for patients who require urgent attention at two hub sites across the local CCG area, the hours are:

• 6.30pm – 8:00pm: Monday to Friday

8.30am – 1.30pm: Saturday, Sunday and Bank Holidays

Updated 5 August 2022

We carried out an announced inspection at Lanchester Medical Centre on 8 and 10 June 2022. Overall, the practice is rated as Good.

The ratings for the key questions are:

Safe - Good

Effective - Good

Caring - Good

Responsive - Good

Well-led - Good

This is the first time we have inspected this practice under the current provider, Dr Ian Gordon Davidson.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Lanchester Medical Centre on our website at www.cqc.org.uk

Why we carried out this inspection

This inspection was a comprehensive inspection to check how the practice was meeting essential standards and to inspect and rate it following the new location registration with the Care Quality Commission. As this was an inspection of a new registration, we inspected all five key questions. These are: is the practice safe, effective, caring, responsive, and well led?

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting staff interviews using questionnaires, phone calls and video conferencing.
• Completing clinical searches on the practice’s patient records system and discussing findings with the provider.
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A short site visit.

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as Good overall

We found that:

• Patients were protected by a strong safety system, with a focus on openness and transparency.
• There were comprehensive systems in place to keep patients safe, which take into account current best practice.
• There was a proactive approach to anticipating and managing risks. Innovation was encouraged to achieve sustained improvements.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice recognised it had sometimes been a challenge for patients getting through by telephone to make an appointment. They continued to seek ways to improve and support good access for patients.
• The leadership governance and culture at the practice were improving the delivery of high-quality, community focused, person-centred care.
• There were high levels of staff satisfaction. Staff were proud of the organisation and there were high levels of staff engagement. Leaders endeavoured to motivate staff.
• There was a clear and proactive approach to seeking new ways to provide care and treatment.

We saw an example of outstanding practice:

• The practice had a weekly care home multi-disciplinary team meeting (MDT) which was attended by care home staff and other healthcare staff such as the community matron and district nurses. This helped to support the provision of high quality care and treatment for care home residents.

Whilst we found no breaches of regulations, the provider should:

• Improve the documentation of clinical patient records. For example, ensuring that clinical decisions to increase the frequency of high-risk drug monitoring are clearly documented.
• Improve the process for the on-going management of all historical safety alerts.
• Check that clinical coding on medication reviews is correct, for example, does it include checks for side effects, compliance and drug interactions.
• Take steps to improve the identification of patients with caring responsibilities, so that they have the opportunity to benefit from any additional support available to them.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services