Background to this inspection
Updated
18 April 2019
The practice is located within a residential area of Maryport and adjacent to the community hospital. The practice provides care and treatment to approximately 14,000 patients from Maryport, is part of the North Cumbria Clinical Commissioning Group (CCG) and operates on a General Medical Services (GMS) contract.
The practice provides services from the following address, which we visited during this inspection:
Maryport Group Practice, Alneburgh House, Ewanrigg Road, Maryport, Cumbria, CA15 8EL
The practice is located in a two-storey building with all consultation rooms being on the ground floor and fully accessible. Counselling rooms were situated on the first floor. If patients with mobility problems need to access the upper floor of the building for any reason a stair lift is in operation. The practice has a car park and on-street parking is also readily available nearby. The practice is open between 8.00am to 6.30pm on a Monday to Friday with appointments running from 8.10am to 12.20pm and 2.00pm to 5.20pm. On weekdays extended access appointments are offered from the practice from 6.30pm to 8pm on Mondays and Thursdays and alternate Fridays. A neighbouring practice hosts extended access appointments on Tuesdays and Wednesdays and alternate Fridays. At weekends these appointments are hosted by another service and run on Saturdays from 1pm to 6pm, and on Sundays from 8am to 1pm.
The service for patients requiring urgent medical attention out-of-hours is provided by the NHS 111 service and Cumbria Health on Call (ChoC).
Maryport Group Practice offers a range of services and clinic appointments including chronic disease management clinics, antenatal clinics, baby clinics, family planning/sexual health/teenage sexual health, minor injuries service and minor operations and cervical screening. The practice team consists of:
- Six GP partners (four female, two male)
- Four salaried GPs (all female)
- A GP registrar
- Three Nurse practitioners
- Two community practitioners
- Two paediatric specialist nurses
- 11 practice nurses (including a nurse lead, long-term conditions nurses and treatment room nurses)
- Six healthcare assistants
- A practice manager and an assistant practice manager
- A medicines manager and medicines assistant
- A finance manager and finance assistant
- 20 administration and reception staff
- Five cleaners
The practice is a teaching and training practice and provides training to third year medical students and registrars.
The area in which the practice is located is in the third (out of ten) most deprived decile. In general people living in more deprived areas tend to have greater need for health services. The number of patients with a long-standing health condition is higher than local and national averages (61.6% compared to 55.5% and 51.2% respectively) and the number of patients in paid work or full-time education is slightly lower than local and national averages (57.7% to 58% and 61.9%). The ethnicity of the patient group is similar to the rest of Cumbria at 98.9% white.
Updated
18 April 2019
We carried out an announced comprehensive inspection at Maryport Group Practice on 12 February 2019 as part of our inspection programme.
At the last inspection in August 2015 we rated the practice as outstanding overall.
We based our judgement of the quality of care at this service is 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 outstanding overall.
We rated the practice as outstanding for providing caring services because:
- Feedback from people who used the service, those who were close to them, and stakeholders was continually positive about the was staff treated people.
- Staff recognised and respected the totality of people’s needs. They always took people’s personal, cultural, social and religious needs into account.
We rated the practice as outstanding for providing responsive services because:
- Services were tailored to meet the needs of individual patients. They were delivered in a flexible way that ensured choice and continuity of care.
- The practice had identified areas where there were gaps in provision locally and had taken steps to address them, particularly with regard to people whose circumstances may make them and people experiencing poor mental health.
We rated the practice as outstanding for providing well-led services because:
- The culture of the practice and the way it was led and managed drove the delivery and improvement of high-quality, person-centred care. The practice had faced significant challenges since the last inspection, but the innovative way in which they had faced these had not only meant that the practice had maintained good standards of care but had improved some services for patients.
We also rated the practice as good for providing safe and effective services because:
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- Patients received effective care and treatment that met their needs.
- Staff treated patients with kindness and respect and involved them in decisions about their care.
We saw several areas of outstanding practice including:
- The involvement of other organisations and the local community was integral to how services were planned. For example, the practice worked closely with a project run by the local secondary care trust and with a social enterprise group to support vulnerable patients and help reduce the number of repeat attenders at the practice. Data showed by working with the social enterprise group in particular, the practice had reduced the number of GP attendances from this repeat attenders from an average of 19 appointments per week to four, the approximate equivalent of one GP session.
- The leadership, governance and culture were used to drive and improve the delivery of high-quality, person-centred care. In response to a number of challenges since the last inspection, the practice had recruited new staff to a diverse range of clinical roles, such as a learning disabilities and dementia nurse and a care coordinator, and had made changes to their governance structure to retain and promote staff from within. These changes had a demonstrable positive impact on patients, such a 5% increase in the number of carers identified since the care coordinator joined the practice, and positive outcomes for patients with a learning disability.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice