The GP Suite

Updated 23 September 2016

The GP Suite provides primary medical services to the town of Jarrow which is the NE32 postcode. The practice provides services from one location, The Palmer Community Hospital, Wear Street, Jarrow, Tyne and Wear, NE32 3UX. We visited this address as part of the inspection.

The surgery is located in Palmer Community Hospital, there are other services in the building including another GP practice, an outpatients and phlebotomy clinic. The practice is located on the ground floor of the building. There is step free access at the front of the building with full disabled access. There is a pay and display car park to the front of the building and three disabled parking bays.

The practice has two GP partners, one male and one female. There is a nurse practitioner and two practice nurses, of which one is part time and a healthcare assistant. There is a practice manager and eight reception and administration staff.

The practice provides services to approximately 5000 patients of all ages. The practice is commissioned to provide services within a General Medical Services (GMS) contract with NHS England.

The practice is open weekdays from 8:30am until 6pm Tuesday to Friday. There are extended opening hours on a Monday evening when the practice is open until 7:15pm.

Consulting times with the GPs and nurses are from 8:30am – 11am and from 2pm every afternoon. Consulting time run to: Monday 7:10pm, Tuesday 5:40pm, Wednesday 4pm, Thursday 5:10pm (the nurse practitioner has appointments to 6pm) and Friday 4.30pm.

The service for patients requiring urgent medical attention out of hours is provided by the NHS 111 service and ‘Vocare’, which is also known locally as Northern Doctors Urgent Care’.

 Information taken from Public Health England placed the area in which the practice was located in the third most deprived decile. In general, people living in more deprived areas tend to have greater need for health services. The average male life expectancy is 76 years and the female is 80. Both of these are lower than the CCG and national averages. The average male life expectancy in the CCG area is 77 and nationally 79. The average female life expectancy in the CCG area is 81 and nationally 83. The practice has a higher percentage of patients over the age of 50+ and lower levels of patients aged 30-50, when compared to national averages. The percentage of patients reporting with a long-standing health condition is slightly higher than the national average (practice population is 56% compared to a national average of 54%). The proportion of patients who are in paid work or full-time employment or education is 61% compared to the CCG average of 55% and the national average of 62%.

Updated 23 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The GP Suite on 10 August 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and report incidents and near misses.
• Risks to patients were assessed and well managed.
• 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
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice had a system in place for handling complaints and concerns and responded quickly to any complaints.
• Patients said they were able to get an appointment with a GP when they needed one, 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 in place and staff felt supported by management. The practice sought feedback from staff and patients, which they acted on.
• Staff throughout the practice worked well together as a team and they received opportunities for development.
• The practice was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider should make improvements are:

• Review the system in place for the checking and reading of hospital discharge and letters from out of hours services.
• Review the signs in place in the practice regarding oxygen to reflect which cylinders are in use.
• Review the stock of emergency medicines and risk assess the medicines held in the doctor’s bags.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 September 2016

The practice is rated as good for the care of patients with long-term conditions. The practice had a register of patients with long term conditions which they monitored closely for recall appointment for health checks with the assistance of the reception team. Patients who did not attend reviews were monitored closely; the practice had introduced telephone reviews for chronic disease management to increase the numbers of those having an annual review. Patients with more than one long term condition were offered one review appointment to cover all of their conditions.

Nationally reported Quality and Outcomes Framework (QOF) data (2014/15) showed the practice had achieved good outcomes in relation to the conditions commonly associated with this population group. For example, performances for related indicators for patients with chronic obstructive pulmonary disease (COPD) were above the national average (100% compared to 96% nationally).

The nursing team had areas of specialism which included COPD and diabetes. They had received training for this and received support from the full practice team to manage long term conditions. There were protocols in place for conditions such as for example chronic kidney disease and diabetes.

Updated 23 September 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 accident and emergency attendances. Immunisation rates were comparable to CCG averages. For example, childhood immunisation rates for the vaccinations given to under two year olds ranged from 95% to 98%, compared to the CCG averages of 85% to 99% and for five year olds from 88% to 100%, compared to CCG averages of 92% to 100%.

The practice had a cervical screening programme. The practice’s uptake for the cervical screening programme was 73.8%, which was comparable to the national average of 74.3%. Appointments were available outside of school hours and the premises were suitable for children and babies.

Antenatal clinics were run by a midwife attached to the practice Child immunisations were carried out by the practice nurse.

The practice participated in a CCG initiative ‘change makers’ to see if they were ‘young person friendly’ in 2015. Young people completed a questionnaire which resulted in changes being made in the practice. For example, information was made available for young people in the waiting room and a young person’s information leaflet on the practice was sent to them on their 14th birthday. 

Updated 23 September 2016

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population. For example, the practice had two nominated residential care homes for elderly patients where they provided care; care plans were in place for the patients. The nurse practitioner visited the homes weekly. All care plans for the elderly included preferences with respect to end of life arrangements.

There were older person’s health checks available and prescriptions could be sent to any local pharmacy electronically. Housebound annual reviews were carried out by the district nurse. They offered immunisations for pneumonia and shingles to older people.

The practice had a palliative care register and used a traffic light system used to identify the most vulnerable and in need patients on the register in order to manage their treatment and support.

Updated 23 September 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 which included appointment booking and ordering repeat prescriptions. There were telephone appointments available. There was a full range of health promotion and screening including health checks for patients aged between 40 and 75. Flexible appointments were available as well as extended opening hours.

Updated 23 September 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health.

Performance for mental health related indicators was above the national average (100% compared to 92.8% nationally). For example, 88.4% of patients with schizophrenia, bipolar affective disorder and other psychosis had a comprehensive agreed care plan documented within the preceding 12 months. This compared to a national average of 88.5%.

Performance for dementia indicators was comparable to the national average. The practice carried out advanced care planning for patients with dementia. The percentage of patients diagnosed with dementia whose care was reviewed in a face-to-face review within the preceding 12 months was 84.5%; the national average was 84%.

Updated 23 September 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice carried out annual health checks for people with a learning disability. Communication needs for vulnerable patients were identified and recorded on their records.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. They had told vulnerable patients about how to access various support groups and voluntary organisations. The practice cared for substance misuse patients in conjunction with another local service. Patients were signposted to drug and alcohol services.

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.

The practice’s computer system alerted GPs if a patient was a carer. There were 203 patients recorded on the practice’s computer system as a carer which is 4% of the practice population. The practice said this was an area they wanted to co-ordinate better.