Kings Medical Centre

Updated 3 January 2018

Kings Medical Centre is situated in North Ormesby in Middlesbrough and provides services under a General Medical Services (GMS) contract with NHS England, Durham, Darlington and Tees Area Team to the practice population of 5488, covering patients of all ages. The proportion of the practice population in the 65 years and over age group is the same as the England average. The practice population in the under 18 age group is slightly higher than the England average. The practice scored one on the deprivation measurement scale, which is the lowest decile. People living in more deprived areas tend to have greater need for health services.

The practice has two GP partners, one male and one female. There is a practice manager, an advanced nurse practitioner, a practice nurses and a health care assistants The practice has a team of secretarial, administration and reception staff.

The practice is open between 8.am to 6.pm Monday to Friday. Appointments are from 8.30am to 5.30pm daily. Extended hours surgeries are offered on Tuesday and Wednesday evenings. From 6pm until 9.30pm, when the practice is closed The South Tees Access and Response (STAR) service is used. Patients ring 111 for an appointment. The practice, along with all other practices in the South Tees CCG area have a contractual agreement for ELM Alliance to provide OOHs services from 9.30pm. This has been agreed with the NHS England area team. The practice has opted out of providing out of hours services (OOHs) for their patients.

Updated 3 January 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 08/09/2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Kings Medical Centre on 15 November 2017 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

• The practice used care navigation to assist their patients to be seen by the most suitable health professional for their needs. .

• The areas where the provider should make improvements are:

• Continue to encourage patients to form a patient participation group.

• Complete an annual infection and prevention control audit and provide additional training, as organised for the two infection control leads.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 December 2015

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.

• Nationally reported data for 2014/2015 showed that outcomes for patients with long term conditions were good. For example, performance for diabetes related indicators was 93% which was 3.8% above the local CCG and national average.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 17 December 2015

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.

• Nationally reported data from 2014/2015 showed the practice’s uptake for the cervical screening programme was 79.2%, which was 3.7% above the local CCG and 2.5% above the national average.  

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

• There was an eight week post natal visit that was a joint appointment with the GP and nurse which allowed the baby to have their first immunisations and contraceptive advice to be discussed all at one visit.

• We saw good examples of joint working with midwives, health visitors and school nurses. The practice monitored any non-attendance of babies and children at vaccination clinics and worked with the health visiting service to follow up any concerns.

Updated 17 December 2015

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. Patients over the age of 75 had a named GP.

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

• Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people.

Updated 17 December 2015

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.

• Extended hours were provided on a Saturday morning.

Updated 17 December 2015

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

• Nationally reported data from 2014/2015 showed 77.8% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months. This was 2.4% above the local CCG average and 0.8% above the national average.

• Nationally reported data from 2014/2015 showed the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive care plan documented in their record, in the preceding 12 months was 79.4%. This was 4.2% above the local CCG average and 2.2% above the national average.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• It 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.

• It 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 people with mental health needs and dementia.

• A counselling service was available in the practice for people with addictions.

Updated 17 December 2015

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 homeless people, travellers and those with a learning disability.

• It offered longer appointments for people with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• It had told 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.