Wenlock Road Surgery

Updated 9 October 2017

Wenlock Road Surgery is registered with the Care Quality Commission to provide primary care services. The practice is part of NHS South Tyneside clinical commissioning group (CCG) and operates on a General Medical Services (GMS) contract agreement for general practice.

The practice provides services to around 4,600 patients from two locations:

• 171 Wenlock Road, Simonside, South Shields, Tyne and Wear, NE34 9BP.

• Flagg Court Health Centre, Dale Street, South Shields, Tyne & Wear, NE33 2LS.

We visited the Wenlock Road premises during this inspection.

Wenlock Road Surgery is situated in converted two-story building. Patient services are all on the ground floor. Access to the building is via a ramp. All reception and consultation rooms are fully accessible for patients with mobility issues. There is very limited on-site car parking; however, parking is available close to the practice.

Flagg Court is situated in a purpose-built building, which also accommodates other GP practices and several community services. All reception and consultation rooms are fully accessible for patients with mobility issues. An onsite car park is available which includes dedicated disabled parking bays.

Wenlock Road Surgery is open at the following times:

• Monday, Tuesday and Friday from 9am to 1pm, then from 3:30pm to 6pm.
• Wednesday from 9am to 6pm.
• Thursday from 9am to 2pm.
• Friday from 9am to 1pm, then from 3:30pm to 6pm
• Alternate Saturdays from 10am to 12:30pm.

Flagg Court is open at the following times:

• Monday 9am to 6pm, then from 6:30pm to 7:30pm
• Tuesday, Thursday and Friday from 9am to 6pm.
• Wednesday from 9am to 2pm.

Appointments are available at Wenlock Road Surgery at the following times:

• Monday, Wednesday, Thursday and Friday 9am to 1:30pm and 3:30pm to 6pm.
• Tuesday 9:10am to 11:50am and 3:30pm to 6pm.
• Extended hours appointments are available 10am to 12:30pm on alternate Saturday mornings.

Appointments are available at Flagg Court at the following times:

• Monday 9am to 1pm and 1:30pm to 6pm or, 9:30am to 3pm and 3:30pm to 7.30pm alternate weeks.
• Tuesday and Wednesday 9:30am to 12:50pm and 3:30pm to 6pm.
• Thursday and Friday 9am to 1pm and 1:30pm to 6pm.
• Extended hours appointments are available at 6:30pm to 7:30pm on alternate Monday evenings.

The telephones are answered by the practice during their opening hours. This information is also available on the practice’s website and in the practice leaflet. 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.

The practice consists of:

• Three GP partners (all male) – at present only two are registered with CQC, although there is an application in progress to add the third partner to the registration.
• Two practice nurses (both female)
• Seven non-clinical staff including a practice manager and six staff who undertake reception and administrative duties.

The age profile of the practice population is broadly in line with the CCG averages. Information taken from Public Health England placed the area in which the practice is located in the second most deprived decile. In general, people living in more deprived areas tend to have greater need for health services.

Updated 9 October 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wenlock Road Surgery on 21 October 2016. The overall rating for the practice was good; but was requires improvement for providing well led services. The full comprehensive report on the October 2016 inspection can be found by selecting the ‘all reports’ link for Wenlock Road Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 6 September 2017 to review in detail the actions taken by the practice to improve the quality of care.

Overall the practice is still rated as good, but now also good for providing well led services.

Our key findings were as follows:

• Action had been taken to address all of the issues identified at the previous inspection.
• The arrangements for recording and learning from significant events and verbal complaints had been strengthened.
• A more structured approach to clinical audits had been developed, to ensure they were linked to improving outcomes for patients.
• The practice had begun the process for registering the third GP partner within the practice with CQC.

At our previous inspection on 21 October 2016 we said the provider should obtain evidence of all staff’s immunity status against vaccine-preventable diseases. During this inspection we found action had been taken to obtain this information from staff’s own GP practices.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 16 December 2016

The practice is rated as good for the care of people with long-term conditions.

• 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 below local and national averages but were improving. For example, the practice had achieved 73.8% of the QOF points available for providing the recommended care and treatment for patients with diabetes. This was 16.1% below the local CCG average and 15.4% below the national average. Shortly after we inspected the practice, the QOF data for 2015/16 was published. This showed that the practice had improved their performance and achieved 82.9%, an increase of 9.1%.
• 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 health and care professionals to deliver a multidisciplinary package of care.
• The practice held regular clinics for long terms conditions, for example for patients with diabetes.

Updated 16 December 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 28.3% to 100% (CCG average 24.8% to 98.9%) and for five year olds ranged from 98.2% to 100% (CCG average 96.2% to 99.1%).
• Urgent appointments for children were available on the same day. The practice’s appointment system set aside one same day appointment for under 16’s after school hours each day.
• Pregnant women were able to access an ante-natal clinic provided by healthcare staff attached to the practice.

• Nationally reported data showed that outcomes for patients with asthma were below average but were improving. The practice had achieved 63.4% of the QOF points available for providing the recommended care and treatment for patients with asthma. This was 34% below the local CCG and national average. Shortly after we inspected the practice, the QOF data for 2015/16 was published. This showed that the practice had improved their performance and achieved 96.7% of the QOF points available an increase of 33.3%.

• The practice provided contraceptive and sexual health advice.

Updated 16 December 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 was responsive to the needs of older people; they offered home visits and urgent appointments for those with enhanced needs. The practice’s appointment system set aside two same day appointments for older patients each day.
• Nationally reported data showed that outcomes for patients with conditions commonly found in older people were generally below the local and national averages but were improving. For example, the practice had achieved 92.8% of the Quality and Outcomes Framework (QOF) points available for providing the recommended care and treatment for patients with chronic obstructive pulmonary disease (COPD). This was 2% below the local clinical commissioning group (CCG) average and 3.1% below the national average. Shortly after we inspected the practice, the QOF data for 2015/16 was published. This showed that the practice had improved their performance and achieved 96.7%, an increase of 3.8%.
• The practice maintained a palliative care register and offered immunisations for shingles and pneumonia to older people.

Updated 16 December 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.

• Telephone appointments were available on request.
• 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 74.2%, 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 joint injections were available.
• The practice website provided a good range of health promotion advice and information.

Updated 16 December 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. Thirty-three patients were on this register, 74% of those has an annual review, 12% had an influenza vaccination (2015/2016 data, which is yet to be verified). The senior partner visited most patients with dementia at home each year for their annual review.

• Nationally reported data showed that outcomes for patients with mental health conditions were slightly below average but were improving. The practice had achieved 92.4% of the QOF points available for providing the recommended care and treatment for patients with mental health conditions. This was 0.8% below the local CCG average and 0.4% below the national average. Shortly after we inspected the practice, the QOF data for 2015/16 was published. This showed that the practice had improved their performance and achieved 97.4% of the QOF points available an increase of 5%.
• Nationally reported data showed that outcomes for patients with dementia were below average but were improving. The practice had achieved 91.2% of the QOF points available for providing the recommended care and treatment for patients with dementia. This was 4% below the local CCG average and 3.3% below the national average. Shortly after we inspected the practice, the QOF data for 2015/16 was published. This showed that the practice had improved their performance and achieved 97.5 % of the QOF points available an increase of 6.3%.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. They 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.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 16 December 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-five patients were on this register, 56% had an annual review and 40% had an influenza vaccination (2015/2016 data, which had not yet been verified).
• 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. Following a serious case review the practice had introduced a vulnerable patients’ policy, following which staff can now easily record any initial concerns and, any raised are regularly discussed at practice meetings.
• Good arrangements were in place to support patients who were carers.