Newholme Surgery

Updated 21 August 2017

Newholme Surgery is located in Lowe House Health Care Resource Centre, Crab Street, St Helens,. The practice was providing a service to approximately 3,500 patients at the time of our inspection.

The practice is part of St Helens Clinical Commissioning Group (CCG) and is situated in an area with higher than average levels of deprivation when compared to other practices nationally. The percentage of the patient population who have a long standing health condition is higher than the national average at 62% (national average 53%).

The practice is run by one GP (male). At the time of our visit the practice had a long term locum GP (female). There was one practice nurse, one health care assistant, a practice manager and a team of reception/administration staff.

The practice is open from 8am to 6.30pm Monday to Friday with extended hours from 6.30pm to 8pm on Tuesdays. When the surgery is closed patients are directed to the GP out of hours service provider St Helens Rota.

Patients can book appointments in person, via the telephone or online. The practice provides telephone consultations, pre-bookable consultations, urgent consultations and home visits. The practice treats patients of all ages and provides a range of primary medical services.

The practice has a General Medical Services (GMS) contract. The practice provides a range of enhanced services, for example: extended hours, childhood vaccination and immunisations and health checks for patients who have a learning disability.

Updated 21 August 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Newholme Surgery on 11 July 2017. Overall the practice is rated as good. Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Significant events had been investigated and action had been taken as a result of the learning from events.

• Systems were in place to deal with medical emergencies and all staff were trained in basic life support.

• There were systems in place to reduce risks to patient safety. For example, infection control practices were carried out appropriately and there were regular checks on the environment and on equipment used.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.

• Feedback from patients about the care and treatment they received from clinicians was positive.

• Data showed that outcomes for patients at this practice were similar to outcomes for patients locally and nationally.

• Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

• Patients told us they were treated with dignity and respect and they were involved in decisions about their care and treatment.

• Patients said they found it easy to make an appointment and there was good continuity of care.

• The appointments system was flexible to accommodate the needs of patients. Urgent appointments were available the same day and routine appointments could be booked in advance.

• The practice had good facilities, including disabled access. It was well equipped to treat patients and meet their needs.

• Information about services and how to complain was available. Complaints had been investigated and responded to in a timely manner.

• There was a clear leadership and staff structure and staff understood their roles and responsibilities.

• The practice provided a range of enhanced services to meet the needs of the local population.

Areas where the provider should make improvement:

• Ensure all required information is maintained for each member of staff.

• Continue to develop the Patient Participation Group.

• Ensure records of meetings are appropriately maintained.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 August 2017

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

• The practice held information about the prevalence of specific long term conditions within its patient population. This included conditions such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. The information was used to target service provision, for example to ensure patients who required immunisations received these.

• Clinical staff provided regular, structured health reviews for patients with long term conditions.

• Patients with several long term conditions were offered a single, longer appointment to avoid multiple visits to the surgery.

• Data from 2015 to 2016 showed that the practice was performing in comparison with other practices nationally for the care and treatment of people with chronic health conditions.

• Patients were provided with advice and guidance about prevention and management of their health and were signposted to support services.

• Patients were signposted or referred to relevant health and social care professionals for advice and treatment.

Updated 21 August 2017

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 those who were at risk, for example, children and young people who had a high number of A&E attendances.

• The GP was the designated lead for child protection.

• Staff we spoke with had appropriate knowledge about child protection and they had ready access to safeguarding policies and procedures.

• Child health surveillance clinics were provided for 6-8 week olds.

• The practice hosted a weekly mid wife led ante natal and post natal clinic.

• Immunisation rates were comparable to the national average for all standard childhood immunisations. The practice nurse monitored non-attendance of babies and children at vaccination clinics and they told us they would report any concerns they identified to relevant professionals.

• Babies and young children were offered an appointment as a priority and appointments were available outside of school hours.

• The premises were suitable for children and babies and baby changing facilities were available.

• Family planning services were provided.

• The percentage of women aged 25-64 who had undergone cervical screening in the previous five years was comparable to the national average.

Updated 21 August 2017

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care and treatment to meet the needs of the older people in its population.

• All patients over 75 years of age had a named GP and access to emergency appointments as needed.

• Patients with a care plan had access to a dedicated telephone number for quicker access to the practice.

• The practice kept up to date registers of patients with a range of health conditions (including conditions common in older people) and used this information to plan reviews of health care and to offer services such as vaccinations for flu.

• Nationally reported data showed that outcomes for patients with conditions commonly found in older people were similar to outcomes for patients locally and nationally.

• GPs carried out regular visits to a local care home to assess and review patients’ needs and to prevent unplanned hospital admissions.

• Home visits and urgent appointments were provided for patients with enhanced needs.

• The practice used the ‘Gold Standard Framework’ (this is a systematic evidence based approach to improving the support and palliative care of patients nearing the end of their life) to ensure patients received appropriate care.

Updated 21 August 2017

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.

• The practice provided extended hours appointments one day per week when the surgery was open from 8am to 8pm.

• Patients could pre-book routine appointments up to four weeks in advance.

• Telephone consultations were provided and patients therefore did not always have to attend the practice in person.

• The practice provided a full range of health promotion and screening that reflected the needs of this age group.

• The practice was proactive in offering online services including the booking of appointments and requests for repeat prescriptions. Electronic prescribing was also provided.

Updated 21 August 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• The practice held a register of patients experiencing poor mental health and these patients were offered an annual review of their physical and mental health.

• Patients with dementia care needs had a care plan to support their care and treatment. Their care also included an annual review including blood tests.

• Data about how people with mental health needs were supported showed that outcomes for patients using this practice were comparable to local and national averages.

• The practice referred patients to appropriate services such as psychiatry and counselling services.

• Systems were in place to prompt patients for medicines reviews at intervals suitable to the medication they were prescribed.

• Patients experiencing poor mental health were informed about how to access various support groups and voluntary organisations.

Updated 21 August 2017

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 in order to provide the services patients required. For example, a register of people who had a learning disability was maintained to ensure patients were provided with an annual health check and to ensure longer appointments were provided for patients who required these.

• The practice worked with other health and social care professionals in the case management of vulnerable people.

• The practice has registered asylum seekers and liaised with support services to ensure appropriate care and treatment.

• 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 provided examples of when they had recognised signs of potential abuse in vulnerable adults and how they had taken action to report their concerns.

• The practice provided appropriate access and facilities for people who were disabled.

• Information and advice was available about how patients could access a range of support groups and voluntary organisations.