Archived: New Seaham Medical Group

Updated 17 March 2016

New Seaham Medical Group provides personal medical services (PMS) to approximately 5,100 patients in the catchment area of Seaham and surrounding villages. The main practice is located within a purpose built primary care centre. There is also a part-time branch surgery at Eastdene Rd within Seaham. This is the Durham Dales, Easington and Sedgefield Clinical Commissioning Group (CCG) area. The practice team consists of two GPs, one male and one female, one nurse practitioner, one practice nurse, and a healthcare assistant. These are supported by a practice manager, and a team of reception, and administrative staff.

The practice core hours are between 8am and 6pm on Mondays to Fridays. Additional extended hours are available for pre-booked appointments between 6.30pm and 7.30pm on Mondays, and 7.15am until 8am on Thursdays. The branch surgery is open from 8:30am until 12:30pm.

The practice has higher levels of deprivation compared to the England average. There are higher levels of people with daily health problems, long standing health conditions, and claiming disability living allowance. The practice has opted out of providing Out of Hours services, which patients access via the 111 service.

Updated 17 March 2016

Letter from the Chief Inspector of General Practice

We carried out this comprehensive inspection on 19 January 2016.

Overall, we rated this practice as good.

Our key findings were as follows:

• The practice provided a good standard of care, led by current best practice guidelines. A programme of clinical audit was used to identify where patient outcomes could be improved.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents, although there was some confusion around recording procedures at times. Information about safety was monitored, appropriately reviewed and addressed.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
• The practice was proactive in the promotion of good health and management of long term conditions. Staff communicated within multi-disciplinary teams to manage complex conditions.
• There was a clear leadership structure and staff felt supported by management. Staff felt confident in their roles and responsibilities.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

• Ensure that formal governance arrangements are sufficient to fully assess and monitor risks and the quality of the service provision. The practice had some risk assessments in place to monitor safety of the premises, but not all risks had been identified, monitored or reviewed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 March 2016

The practice is rated as good for the care of people with long term conditions. Clinics were designed to minimise patient need for attendance, for instance diabetic patients could see a dietician, GP, nurse and podiatrist as part of the same clinic review on the practice site. Staff ensured through joint working that housebound patients had the same access to reviews through home visits.

Staff skill mix had been reviewed and was mapped to patient need. People with long term conditions were monitored and discussed at multi-disciplinary clinical meetings so the practice was able to respond to their changing needs. Outcomes were monitored through clinical audits. Nurses and GPs worked collaboratively. Data showed the practice was proactive in managing long term conditions. Diabetes indicators were all above national averages. For instance QOF data from 2014-15 showed the percentage of diabetic patients having a record of a foot check in the previous 12 months was 93.19%, above the national average of 88.3%.

Updated 17 March 2016

The practice is rated as good for the care of families, children and young people. Systems were in place to identify children who may be at risk. The practice monitored levels of children’s vaccinations and attendances at A&E. Regular multidisciplinary meetings were held to review children on the safeguarding register. Immunisation rates were around average for all standard childhood immunisations. Antenatal clinics were held weekly, and patients accessed post-natal health review appointments combined with health visitor clinic and immunisation clinic at the same time. The under-five’s had protected appointment slots with same day access to a GP. Young people could access family planning and sexual health advice.

Updated 17 March 2016

The practice is rated as good for the care of older people. The practice held palliative care and multi-disciplinary meetings regularly to discuss those with chronic conditions or approaching end of life care. These patients were given priority access for appointments. Care plans had been produced for those patients deemed at most risk of an unplanned admission to hospital. Information was shared with other services, such as out of hours services and district nurses. Nationally reported data from the Quality and Outcomes Framework (QOF) showed the practice had good outcomes for conditions commonly found in older people. The over 75’s had a named GP, and were offered an annual review which included dementia screening and falls risk assessment.

Vulnerable patients living in residential units, the housebound or at high risk of admission were cared for by a GP in conjunction with Advanced Nurse Practitioners and district nurses. This was a CCG initiative to ensure the needs assessment of vulnerable patients remained up to date. 

Updated 17 March 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 population had been identified, and services adjusted and reviewed accordingly, for instance extended hours appointments were available later in one evening and earlier one morning each week. Patients could also access a Saturday morning surgery at a neighbouring practice. Patients could access a variety of services during these times, such as NHS health checks and contraceptive services. Routine appointments could be booked in advance, and could be made online. Repeat prescriptions could be ordered online. Telephone appointments were available. The practice carried out health checks for people of working age, and actively promoted screening programmes such as for cervical cancer. For instance, the practice’s uptake for the cervical screening programme was 81.1%, similar to local and national averages.

Updated 17 March 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice made referrals to other local mental health services as required, and worked with other services such as the substance misuse team, and the Crisis Team. Patients could be referred directly to a counsellor who attended the practice twice weekly. There was an alert on the records of patients with severe mental health issues so they could be offered extra support to access services and health checks.

The practice was proactive in dementia screening and review, which was offered opportunistically. The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the previous 12 months was above the national average of 86.04%, at 96%.

Updated 17 March 2016

The practice is rated as good for the care of people living in vulnerable circumstances. The practice had a register of those who may be vulnerable, including those with learning disabilities, who were offered annual health checks. Patients or their carers were able to request longer appointments if needed. The practice had a register for looked after or otherwise vulnerable children and also discussed regularly any cases where there was potential risk or where people may become vulnerable. The computerised patient plans were used to flag up issues where a patient may be vulnerable or require extra support, for instance if they were a carer. Carers could then be signposted to support organisations. Staff were aware of their responsibilities in reporting and documenting safeguarding concerns. New patients who may be vulnerable were identified through health checks and screening questionnaires.