Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Seaton Park Medical Group, on 21 October 2014. The overall rating for the practice was good. The practice was rated as good for all of the population groups and good in relation to the key questions of whether the service was safe, effective, caring and responsive. For the key question of whether the service was well-led, the practice was rated as outstanding.

The full comprehensive report on the October 2014 inspection can be found by selecting the ‘all reports’ link for Seaton Park Medical Group, on our website at www.cqc.org.uk.

We carried out this focussed inspection on 22 August 2017 because the findings of the most recent National GP Patient Survey for the practice, indicated there were lower levels of patient satisfaction with respect to access to appointments, when compared to the local clinical commissioning group and national averages.

Overall the practice is rated as good. Our key findings were as follows:

• Most of the patients we spoke to on the day of the inspection told us they had experienced difficulties getting through to the practice by telephone and obtaining suitable appointments. The practice had continued to receive complaints about access to appointments, although, over the last few months, these had significantly reduced.

• It was evident that, since the last inspection, the provider had made significant efforts to improve the appointments system and telephone access, and that they had a clear strategy to build on these improvements over the next 12 months.

• We found the practice had proactively managed access to care, taking into account patients’ needs, including those patients needing same-day access.

• The provider was collaborating closely with the local clinical commissioning group and healthcare trust, as part of the Northumberland ‘Vanguard’ initiative, to further improve access to appointments.

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

• Review the effectiveness of the measures taken to improve the practice’s telephone system and patient access to suitable appointments. This review should include an assessment of the impact of these measures on patient satisfaction levels.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out a planned comprehensive inspection of Seaton Park Medical Group on 21 October 2014 at their Norham Road branch in Ashington. This branch was their head office and all patients were registered at this branch. The group also had two other branches. One was located in Nursery Park Road in Ashington and the other in Buteland Terrace in Newbiggin by the Sea.

We rated the practice overall as: Good

Our key findings were as follows:

• The practice displayed strong leadership and a patient centred culture.
• The practice was supportive of their staff and drew on their skills, experience and comments to improve the services they provided.
• Staff reported feeling supported and able to voice any concerns or make suggestions for improvement.
• The practice was a training practice that offered training to medical students and trainee GPs in addition to providing comprehensive training to their own staff.
• Feedback from patients was positive. They told us staff treated them with respect and kindness.
• The patient participation group were complimentary about the practice and explained their relationship with it as constructive and collaborative.
• The practice was clean, tidy and well maintained.

We saw areas of outstanding practice:

• The practice had a clear vision to deliver high quality care and promote good outcomes for patients. The practice’s mission statement stated their aim was to be a top quality health care team, working with patients to enable good health, deliver excellent accessible care and continually develop to meet new challenges. All staff we spoke with were aware of this aim and their role to achieving it.

• The practice had effective governance arrangements in place that ensured all staff were aware of the nature and extent of their individual roles and responsibilities within the practice. There was clear evidence that there was a culture of openness, support and inclusiveness within the practice. The practice proactively and positively engaged with their staff.

• The practice had a comprehensive training programme for all staff that supported the needs of the practice, patients and staff.

• The practice had effective systems in place to capture and monitor incidents, complaints and concern. It displayed a positive approach to learn from them and made improvements for the benefit of patients. The practice had an ‘open door ‘policy where all staff were encouraged to raise any concerns or issues with their colleagues, managers and GP partners at any time. Staff we spoke with told us that support or guidance would be openly and freely given.

• The practice was proactive in finding and implementing ways of improving its services to patients. It regularly monitored its services and processes to ensure they were effective and made changes where necessary.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

This practice is rated as good overall. (Previous rated, comprehensive inspection – 21 October 2014 – rating – good).

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Seaton Park Medical Group on 19 June 2018 as part of our inspection programme.

At this inspection we found:

• The practice had systems to keep patients safe and safeguarded from abuse.
• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care they provided. They ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Some patients reported they were not able to access care and treatment from the practice within an acceptable timescale for their needs. The practice had implemented a range of innovative measures to help them improve patient access and were closely monitoring the effectiveness and impact of the changes they had introduced.
• The provider’s strategies and supporting action plans for improving the care and treatment they provided were challenging and innovative.
• There was a very strong focus on continuous learning and improvement at all levels of the organisation. The practice actively used performance information to drive improvement.

We saw the following area of outstanding practice:

• The leadership, governance and culture of the practice was used to drive and improve how care and treatment was provided. The practice had worked with other organisations to create a range of local, non-clinical services, to which clinical staff could refer, to help support vulnerable patients take greater control of their own health. Steps had been taken to expand and increase the skill-mix of the team, to create more time for GPs to focus their time on patients with the most complex needs. Leaders and clinicians were piloting a ‘group consultation’ approach for patients with some long-term conditions, to help them reduce appointment demand, whilst also delivering care and treatment in a supportive group setting, providing opportunities for patients to listen, learn and share experiences. Strategies had been developed to manage and reduce demand for appointments through, for example, the use of an awareness campaign to educate patients about the range of services provided by the practice.

The areas where the provider should make improvements are:

• Carry out periodic, comprehensive infection control audits, to make sure the practice is complying with the Health and Social Care Act (2008): Code of Practice.
• Improve uptake rates for cervical cancer screening so they are in line with the local clinical commissioning group average.
• Where the practice’s exception reporting rates are higher than the local clinical commissioning group and England averages, take action to reduce them.
• Carry out regular checks of the contents of the doctors’ bags and maintain suitable records of this.
• Continue to take steps to improve access to appointments and reduce patient complaints in this area.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice