Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Heaton Road Surgery on 10 February 2015. Overall the practice is rated as outstanding for providing caring and responsive services and for being well-led. They are rated good for providing safe and effective services. An innovative, caring, effective, responsive and well-led service is provided that meets the needs of the population served.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised, external agencies were informed of the outcome if they were involved. There were strong comprehensive safety systems in place.

• The practice had scored very well on clinical indicators within the quality outcomes framework (QOF). They achieved 98.4% for the year 2013/14, which was above the average in England of 96.47%. The QOF is part of the General Medical Services (GMS) contract for general practices. Practices are rewarded for the provision of quality care.

• Patients said they were treated with compassion, dignity and respect. The proportion of patients who described their overall experience of the GP surgery as good or very good in the GP National Survey was 97%, compared to the national average of 85%. Several patients we spoke with commented on the helpfulness of the staff and caring manner of the GPs and said it was the best practice they had ever been registered at.

• The practice had good facilities and was well equipped to treat patients and meet their needs. Patients commented how helpful the staff were in trying really hard to get them a convenient appointment. This was reflected in the data from the national GP survey. 91.5% of patients reported a good overall experience of making an appointment (national average 78%).

We saw several areas of outstanding practice including:

• The practice held a “watch list”; this was a detailed list which was maintained of high risk patients such as those who required palliative care. One of the GP partners had responsibility for the list. The dedicated practice nurse undertook reviews of these patients and made regular telephone calls to them to identify any potential issues, this was in addition to the consultations they received from the GPs. There was a dedicated practice nurse who reviewed all housebound and care home patients. These were in addition to the 2% of the practice population with complex needs.

• The practice held a dementia register and staff had received training in dementia. The dementia diagnosis rate was the highest in the CCG area at 82% (of the expected diagnosis rate) compared to the CCG average of 62%.

• The practice was awarded a “Healthwatch Newcastle Star Award” in September 2014. Healthwatch is the independent champion for members of the public and users of health and social care services. They were nominated by a patient who used their service who wanted to thank them for going the extra mile to make their experience great.

• The practice recognised that they needed to contact patients with serious or life limiting illnesses, to offer support. This was usually after a diagnosis from hospital. We saw an example of a letter which was sent to patients offering support from the practice and asking the patient to contact them if there was anything they could do to help.
• The practice arranged to be inspected by North East Health Checkers who use experts by experience with learning disabilities to carry out a quality check of the practice to assess its responsiveness to patients with learning disabilities. The practice carried out an audit of cervical screening uptake in learning disability patients in order to identify any learning on how they can enable this group of patients to undertake this type of health screening.

• The practice recognised that staff satisfaction was poor, two years earlier. The practice took action to improve the situation. They carried out leadership training for their staff and introduced 360 degree feedback for GPs. They implemented plans to improve staff satisfaction. All staff were encouraged to influence the practice’s approach to policies and procedures. A receptionist recognised a need for a protocol to be developed for transgender patients, which was written by the receptionist and formed part of the practice policies and procedures. This had positive results, staff felt supported and said the practice was a different place to work; they were now able to use their skills and initiative when this had previously not happened.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We reviewed the information available to us about Heaton Road Surgery on 1 June 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.