We carried out an announced comprehensive inspection at Alnwick Medical Group, on 10 December 2018, as part of our inspection programme.

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 and other organisations.

We have rated this practice as good overall and good for all population groups, apart from children, families and young people, which we have rated as outstanding.

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.
• Staff treated patients with kindness and respect and involved them in decisions about their care and treatment.
• Services were tailored to meet the needs of individual patients. They were delivered in a flexible way that ensured choice and continuity of care, particularly for children, families and young people.
• The practice organised and delivered services to meet patients’ needs. The practice had identified areas where there were gaps in provision locally and was taking steps to address them.
• 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. The practice had a clear vision which was supported by a credible strategy.

We identified the following as examples of outstanding practice:

• The sexual health lead GP for the practice had developed a website, to provide patients with information about where to access sexual health services in Alnwick and the surrounding areas. The website covered such matters as pregnancy, contraception as well as the various services and information provided by local groups, organisations and pharmacists. The website included an email facility which allowed patients to directly contact the practice’s sexual health lead, regarding any queries they had. Leaders had introduced an ‘app’ to help patients understand the contraceptive choices and sexual health services available to them. Preparation for the introduction of the new website and ‘app’ included visits by the lead GP to local schools.
• Leaders held a daily multi-disciplinary team (MDT) meeting, involving the clinical staff on duty, including locum staff. A SKYPE facility was available to enable to the GP based at the surgery in Seahouses to attend. A social services representative attended the MDT meeting twice a week, and a local elderly care clinician once a week. Clinicians used these meetings to discuss the needs of vulnerable patients such as those nearing the end of their life, recent deaths and those with complex needs. Emerging significant events were also reviewed as were any safeguarding concerns. Home visits were also allocated.

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

• Improve how patients who are also carers are identified, to enable this group of patients to access appropriate care and support.
• Review their arrangements for ensuring that staff have received the relevant vaccinations.
• Reduce exception reporting rates for the clinical indicators identified, in the accompanying evidence table, as being higher than the local clinical commissioning group and national averages.
• Complete a risk assessment to underpin the decision not to carry out DBS checks for existing non-clinical staff.

Details of our findings and the evidence supporting our ratings are set out in the evidence table.

Professor Steve Field CBE FRCP FFPH FRCGP

Letter from the Chief Inspector of General Practice

We carried out a planned comprehensive inspection of The Bondgate Practices on 6 October 2014. We inspected all four locations registered with the Care Quality Commission. These were the Alnwick main surgery and the Seahouses, Embleton and Longhoughton branches.

We rated the practice overall as good.

Our key findings were as follows:

• The practice covered a large geographical and rural area; services had been designed to meet the needs of the local population.
• Feedback from patients was positive; they told us staff treated them with respect and kindness.
• Staff reported feeling supported and able to voice any concerns or make suggestions for improvement.
• The practices were clean and further work was planned to improve the approach to infection control.

However, there was also an area of practice where the practice needs to make improvements. The practice should:

• Ensure that blank prescriptions are stored and recorded in accordance with national guidance to reduce the risk of theft or misuse. 

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice