Background to this inspection
Updated
29 September 2016
Drs Zaidi & Partner, East Wing Practice is registered with the Care Quality Commission to provide primary care services. The practice provides services to around 4,000 patients from one location: The Palmer Community Hospital, Wear Street, Jarrow, Tyne and Wear, NE32 3UX. We visited this this address as part of the inspection.
Drs Zaidi & Partner, East Wing Practice is situated in purpose-built premises, which also accommodates another GP practice and several community services. The practice is based on the first floor; access is via a lift or stairs. All reception and consultation rooms are fully accessible for patients with mobility issues. An onsite car park is available which included dedicated disabled parking bays.
The practice has three GP partners (all male). There were no arrangements in place for patients to be able to see a female GP if they wanted to. The practice employs a practice manager, an assistant practice manager, a nurse practitioner, a practice nurse, a health care assistant and six staff who undertake reception and administrative duties. The practice provides services based on a General Medical Services (GMS) contract agreement for general practice.
Drs Zaidi & Partner, East Wing Practice is open at the following times:
- Monday to Friday 8:30am to 1pm and 1:30pm to 6pm.
The telephones are answered by the practice between 8:30am and 6pm, and till 7:30pm on days when extended appointments are offered. When the practice is closed patients are directed to the NHS 111 service. This information is also available on the practices’ website and in the practice leaflet.
Appointments are available at Drs Zaidi & Partner, East Wing Practice at the following times:
- Monday 8:30am to 12:30pm and 1:30pm to 5:30pm
- Tuesday 8:30am to 12:30pm and 1:30pm to 5:30pm
- Wednesday 9am to 12:30pm and 1:30pm to 6pm
- Thursday 8:30am to 12:30pm and 1:30pm to 5:30pm
- Friday 8:30am to 12:30pm and 1:30pm to 6pm
Extended hours appointments are available from 6:30pm to 7:30pm, rotating between a Monday, Tuesday and Wednesday. Appointments are available with a GP and a nurse or healthcare assistant.
The practice is part of NHS South Tyneside clinical commission group (CCG). Information from Public Health England placed the area in which the practice is located in the third most deprived decile. In general, people living in more deprived areas tend to have greater need for health services. Average male life expectancy at the practice is 76 years compared to the national average of 79 years. Average female life expectancy at the practice is 80 years compared to the national average of 83 years.
The proportion of patients with a long-standing health condition is above average (64% compared to the national average of 54%). The proportion of patients who are in paid work or full-time employment or education is below average (56.4% compared to the national average of 61.5%). The proportion of patients who are unemployed is below average (2.7% compared to the national average of 5.4%).
The service for patients requiring urgent medical care out of hours is provided by the NHS 111 service and Vocare, which is locally known as Northern Doctors Urgent Care Limited.
Updated
29 September 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Drs Zaidi & Partner, East Wing Practice on 4 August 2016. The practice is registered with the CQC as Drs Zaidi & Partner, East Wing Practice. However, as there is more than two people on the partnership they are known as
Dr Zaidi & Partners, East Wing Practice.
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. Lessons were learned when incidents and near misses occurred.
- Risks to patients were assessed and well managed.
- Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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.
- Most 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.
- Extended hours appointments were available from 6:30pm to 7:30pm, rotating between a Monday, Tuesday and Wednesday with a GP and a nurse or healthcare assistant available.
- 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 regulation.
There was one area of practice where the provider needs to make improvements.
The provider should:
- Review the arrangements in place for those patients who wish to see a female GP.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice
People with long term conditions
Updated
29 September 2016
The practice is rated as good for the care of people with long-term conditions.
- One of the GPs and one of the practice nurses had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority and support by the practice, comprehensive care plans were in place and regularly reviewed.
- Nationally reported data showed that outcomes for patients with conditions commonly found in this population group were generally in line with local and national averages. For example, the practice had achieved 86.9% of the QOF points available for providing the recommended care and treatment for patients with diabetes. This was 3% below the local CCG average and 2.3% below the national average.
- Home visits were available when needed. Longer appointments were available if requested.
- All patients with a long-term condition had a named GP and were offered 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 healthcare professionals to deliver a multidisciplinary package of care. The practice held weekly meetings were the management of long-term conditions was discussed.
- The practice held regular clinics for long terms conditions, for example for patients with diabetes.
Families, children and young people
Updated
29 September 2016
The practice is rated as good for the care of families, children and young people.
- There were processes in place for the regular assessment of children’s development. This included the early identification of problems and the timely follow up of these. Systems were in place for identifying and following-up children who were considered to be at-risk of harm or neglect. For example, the needs of all at-risk children were regularly reviewed at practice multidisciplinary meetings involving child care professionals such as health visitors.
- Appointments were available outside of school hours and the premises were suitable for children and babies.
- There were arrangements for new babies to receive the immunisations they needed. Childhood immunisation rates for the vaccinations given to under two year olds ranged from 78.3% to 100% (CCG average 84.9% to 99.4%) and for five year olds ranged from 95.9% to 100% (CCG average 91.5% to 100%).
- Urgent appointments for children were available on the same day.
- Pregnant women were able to access an antenatal clinic provided by healthcare staff attached to the practice.
- Nationally reported data showed that outcomes for patients with asthma were above average. The practice had achieved 100% of the QOF points available for providing the recommended care and treatment for patients with asthma. This was 2.6% above the local CCG and national average.
- The practice provided contraceptive and sexual health advice.
Updated
29 September 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 their population. All patients over the age of 75 had a named GP and patients over the age of 75 were offered an annual health check. The practice worked to reduce the unplanned hospital admissions for patients over the age of 75.
- The practice was responsive to the needs of older people; they offered home visits and urgent appointments for those with enhanced needs.
- Nationally reported data showed that outcomes for patients with conditions commonly found in older people were generally in line with local and national averages. For example, the practice had achieved 100% of the Quality and Outcomes Framework (QOF) points available for providing the recommended care and treatment for patients with heart failure. This was 1.1% above the local clinical commissioning group (CCG) average and 2.1% above the national average.
- The practice maintained a palliative care register and offered immunisations for shingles and pneumonia to older people.
Working age people (including those recently retired and students)
Updated
29 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.
- Patients could order repeat prescriptions and routine healthcare appointments online. A 24-hour repeat prescription line was available so patients could order repeat prescription at a time that was convenient for them.
- Ad hoc telephone appointments were available.
- A text message reminder service was available.
- The practice offered a full range of health promotion and screening which reflected the needs for this age group.
- The practice’s uptake for cervical screening was 91.3%, compared to the CCG average of 81.9% and the national average of 81.8%.
- Additional services such as new patient health checks, travel vaccinations and minor surgery were provided.
- The practice website provided a good range of health promotion advice and information.
People experiencing poor mental health (including people with dementia)
Updated
29 September 2016
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).
- The practice had identified 1% of their population with enduring mental health conditions on a patient register to enable them to plan and deliver relevant services. Forty-one patients were on this register, 78% of those has an annual review, 34% had an influenza vaccination (2015/2016 data, which is yet to be verified or published).
- Nationally reported data showed that outcomes for patients with mental health conditions were above average. The practice had achieved 100% of the QOF points available for providing the recommended care and treatment for patients with mental health conditions. This was 6.8% above the local CCG average and 7.2% above the national average.
- Nationally reported data showed that outcomes for patients with dementia were above average. The practice had achieved 100% of the QOF points available for providing the recommended care and treatment for patients with dementia. This was 4.8% above the local CCG average and 5.5% above the national average. 87% of patients diagnosed with dementia had their care reviewed in a face-to-face meeting in the last 12 months, which was above the national average of 84%.
- The practice regularly worked with multi-disciplinary teams in the case management of people 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.
- Staff had a good understanding of how to support patients with mental health needs and dementia.
- The practice actively screens patients with long-term condition for dementia.
People whose circumstances may make them vulnerable
Updated
29 September 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 patients with a learning disability; patients with learning disabilities had been invited to the practice for an annual health check. Twenty patients were on this register, 35% had an annual review and 40% had an influenza vaccination (2015/2016 data, which had not yet been verified or published). The practice had a vulnerable adults policy that was regularly reviewed.
- Nationally reported data showed that outcomes for patients with a learning disability were good. The practice had achieved 100% of the QOF points available for providing the recommended care and treatment for patients with a learning disability. This was the same as the local CCG average and 0.2% above the national average.
- The practice offered longer appointments for patients with a learning disability if requested.
- The practice regularly worked with multi-disciplinary teams (MDT) in the case management of vulnerable people.
- 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.
- Good arrangements were in place to support patients who were carers.