Spring Terrace Health Centre

Updated 8 September 2022

Spring Terrace Health Centre is located North Shields in North Tyneside at:

Spring Terrace,
North Shields,
Tyne and Wear
NE29 0HQ

We visited this site as a part of the inspection.

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury and surgical procedures.

The provider of this service is Northumbria Primary Care Limited. This is a not for profit, at scale provider offering services from seven practices in Northumberland and North Tyneside to approximately 60,000 patients. They are a separate limited company but are a wholly owned subsidiary of Northumbria Healthcare Foundation Trust. They provide additional support services to their own and other practices in the local area. You can find reports for other services from this provider by searching for ‘Northumbria Primary Care Limited’ on our website at www.cqc.org.uk and selecting services.

As part of the additional support services provided by Northumbria Primary Care Limited, they provided pharmacist support to GPs via a clinical support unit. This unit is spread across various locations, including co-locating at Spring Terrace Health Centre.

The practice is situated within the North East and North Cumbria Integrated Care Board (ICB) area and delivers General Medical Services (GMS) to a patient population of about 5,600. This is part of a contract held with NHS England.

The practice is part of a wider network of GP practices covering the North Shields area with four other practices (Collingwood Health Group, Priory Medical Group, Redburn Park Medical Centre and Nelson Health Group).

Information published by Public Health England shows that deprivation within the practice population group is in the second lowest decile (two 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 2% Asian, 96.4% White, 0.3% Black, 1.1% Mixed, and 0.3% Other.

There are more older people registered at the practice (at 24.6%) than the average locally (20.4%) and for England (17.7%), with less children and young people registered at the practice (14.4%), compared to the local (19.4%) and England average (20%).

There is a team of seven GPs (five female / two male) and an advanced nurse practitioner (female). The practice has a team of three nurses (two female / one male) who provide nurse led clinics for patients with long-term condition. The GPs are supported at the practice by a practice manager and a team of reception/administration staff.

The practice is open between 8am to 6.30pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations, online consultations and advance appointments.

Patients registered with the practice are also able to access pre-bookable routine appointments with a GP, nurse or healthcare assistant from 4pm to 8pm on a weekday, 9am to 2pm on a Saturday and 9am to 1pm on a Sunday at one of several hubs in the North Tyneside area for access by any patients who are registered with a practice in the North Tyneside area.

Out of hours services are provided by Vocare Limited accessed via the 111 service.

Updated 8 September 2022

We carried out a short notice announced inspection at Spring Terrace Health Centre on 1, 3 and 15 August 2022. Overall, the practice is rated as Good.

The key question ratings were:

Safe - Good

Effective - Good

Well-led - Good

Following our previous inspection on 13 July 2017, the practice was rated Good overall and for all key questions.

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

Why we carried out this inspection

This was a focused inspection to respond to risk and follow up on concerns that were raised with us. These concerns related to the ancillary service provided by Northumberland Primary Care Limited (the provider of Spring Terrace Health Centre) to a number of GP practices locally. The ancillary service was provided by pharmacy hub teams co-located within GP practices, including Spring Terrace Health Centre.

We inspected three key questions - Is the practice safe, effective and well led as part of our methodology to carry out more focused inspections for those practices rated as good overall. All other ratings were carried forward from the July 2017 inspection.

The focus of this inspection was to:

• Review and respond to the concerns highlighted to the Care Quality Commission.
• Review the quality and safety of care provided.
• Review the areas we said the GP practice should address, identified in the previous inspection of July 2017.

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 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 site visit
• Reviewing concerns that were highlighted to us.

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:

• 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.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

At the last CQC inspection in July 2017, we said the practice should take action to reduce exception reporting for those clinical indicators where their performance on Quality and Outcomes framework areas (QOF) was below the England average. Since the last CQC inspection, we have changed the way we regulate GP practices. We no longer routinely use QOF to check on the clinical performance of the practice. The practice showed us the governance processes in place to check on progress with clinical indicators and benchmark themselves with other practices locally.

We also said they should continue to take steps to improve patient telephone access and appointment availability. We spoke with the practice about the steps they have taken to improve access within the practice. They told us they had implemented a quality improvement plan in this area. This had included analysing data from the telephone system to target areas for improvement, such as peak times for inbound calls and deploying additional staff at these times to answer calls. Across the local primary care network (PCN) there was a plan to recruit a specialist in children’s mental health to improve support for these patients.

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

• Continue with the relaunch of the Year of Care approach for people with long term conditions and the risk stratified plan to identify and follow up on the small percentage of patients who have not had appropriate monitoring carried out.
• Improve the process for monitoring patients who are living with asthma to identify and address those who have high use of first step rescue medicines, which might indicate either misuse or an exacerbation of their asthma.
• Continue to identify and follow up female patients of childbearing age on teratogenic medicines who have not yet had discussions about the risks or do not have appropriate effective contraception arrangements in place.
• Continue to identify and implement improvements to support increased cervical screening uptake.
• Enhance the support for workers to speak up when they feel they are unable to do so by other routes, by appointing a Freedom to Speak Up Guardian.

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