Sacriston Medical Centre

Updated 10 May 2016

Sacriston Medical Centre is located in Sacriston, County Durham. It is part of the North Durham Clinical Commissioning Group. The total practice patient population is 9824. Housed in a purpose built ‘green’ eco-friendly building, the practice shares space with allied health professionals. During the design and build of the medical centre, staff and patients were consulted about the build and were able to contribute to design ideas to ensure their medical centre suited their needs.

The proportion of the practice population in the 65 years and over age group is slightly above the England average. The practice scored five on the deprivation measurement scale, the deprivation scale goes from one to ten, with one being the most deprived. The overall practice deprivation score is higher than the England average. People living in more deprived areas tend to have a greater need for health services.

The staff team comprises seven GP partners. Three of the partners are female GPs. There are three practice nurses, a healthcare assistant and a phlebotomist. The practice also employs a community nurse for the frail and elderly. The practice is managed and supported by a practice manager, two team leaders, two secretaries, a data entry clerk and eight receptionists. In total there are 23 staff, in addition to the GPs.

The practice is open Monday to Friday 8am until 6pm (excluding bank holidays). Extended opening hours are provided on Monday evenings until 8.30pm and four mornings per week from 7.30am (not Wednesdays). The practice offers pre-bookable appointments where these are booked in advance. Urgent appointments are available daily for patients that need them. The practice telephones switch to the out-of-hours provider at 6pm each evening and at weekends and bank holidays. This is an agreement between the practice and the CCG as normal core hours are until 6.30pm The practice is a training practice and often has GPs in training.

The practice has a General Medical Services contract with NHS England. They also provide some Directed Enhanced Services, for example they offer minor surgery and the childhood vaccination and immunisation scheme.

Updated 10 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Sacriston Medical Centre on 15 March 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• 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.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• 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.

We saw areas of outstanding practice:

The practice has employed a Community Nurse for the Frail and Elderly to care for housebound patients and those with multiple long term conditions. While the project is still in its infancy, the practice provided examples of the impact it has had on preventing hospital admissions and safeguarding older people and those whose circumstances make them vulnerable.

The practice employed an external agency, for a period of nine months, to improve the appointment system as a direct result of the feedback given by patients. This was funded 50% by the practice and 50% by an improvement scheme. Now these changes have been implemented, patients report high satisfaction with the appointments system, and this was corroborated by our interviews with staff and patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 May 2016

The practice is rated as good for the care of people with long-term conditions. Longer appointments and home visits were available when needed. Nurse led diabetes, asthma, COPD and CHD clinics ran weekly. The practice employed a pharmacist to review medication needs of patients and this was done through home visits when appropriate. Patients with long term conditions had a named GP and a structured annual review (in the month of their birthday) to check their health and medicines needs were being met. This was in addition to CCG pharmacy support. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 10 May 2016

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. Appointments were available outside of school hours, from 7.30am on Mondays, and the premises were suitable for children and babies. We saw positive examples of joint working with midwives, health visitors and school nurses. Practice nurses have all completed C Card training which is a system for safe distribution of contraception to young people.

Updated 10 May 2016

The practice is rated as outstanding for the care of older people. The practice offered proactive, personalised care to meet the needs of the older people in its population. The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. The practice recruited a Community Nurse for the Frail and Elderly after identifying that 1% (98) of its patients would benefit from this service. Patients who were housebound or took numerous repeat medications or had multiple long term conditions were eligible for this service. In addition, nurses and GPs could use their own discretion to refer patients in need of the service. Assessments, pathways of care, reviews and feedback tools had been designed to further develop the service. Staff were able to provide examples of where the service had safeguarded patients from abuse, through regular visiting and monitoring. End of life care was discussed frankly and openly with the patients and their wishes and feelings were documented and shared with next of kin, where a patient requested this. In the previous six months, the practice carried out 106 assessments and reassessments of patients in this group. They were able to identify deterioration in health and social care needs as a result of the assessments and continually monitor their older population.

The practice held a register of patients who were at risk of unplanned emergency admission to hospital and these patients were sent a letter to offer them an additional weekend service. By being identified as potentially needing extra weekend support, patients were given a dedicated mobile number to speak to a GP based at a local surgery who could give advice or do a home visit if required. This service appeared to be having a positive impact upon unplanned admissions to hospital, although quantitative data was not yet available. The practice was, overall, responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 10 May 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. We were told it was easy to obtain an appointment outside of standard working hours. 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. Despite a cease in funding, the practice had continued to open at 7.30am four mornings per week to increase accessibility for its patients.

Updated 10 May 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). 80% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is comparable to 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.  A register of patients with diagnosed dementia was held by the practice. 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.

Updated 10 May 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 those with a learning disability. The practice offered longer appointments for patients with a learning disability, and people who do require interpreter services. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. The practice informed vulnerable patients about how to access various support groups and voluntary organisations, and volunteers visited the practice on ‘open days’ to raise awareness of this. 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. Staff were all up-to-date with safeguarding training.