Guidepost Medical Group

Updated 15 April 2016

Guidepost Medical Group is registered with the Care Quality Commission to provide primary care services.

The practice provides services to around 8,500 patients from one location.

• North Parade, Choppington, Northumberland, NE62 5RA.

We visited this address as part of the inspection.

Guidepost Medical Group is based in purpose built premises in Choppington. All reception and consultation rooms are fully accessible. There is on-site parking and disabled parking. A disabled WC is available.

The practice has five partners and four salaried GPs (two male, seven female).The practice employs a practice manager, a receptionist manager, four practice nurses, three clinical support assistants (two of which also work as receptionists) and 14 staff who undertake administrative or reception duties. The practice provides services based on a Personal Medical Services (PMS) contract agreement for general practice.

The practice is an approved training practice where qualified doctors gain experience in general practice; on the day we inspected the practice, no trainee doctors were working at the practice.

Guidepost Medical Group is open at the following times:

• Monday to Friday 8am to 5:30pm

The telephones are answered by the practice during these times. When the practice is closed patients are directed to the NHS 111 service. This information is available on the practices’ telephone message, website and in the practice leaflet.

Appointments are available at Guidepost Medical Group at the following times:

• Monday to Friday 8am to 12:30pm then 1:30pm to 5:30pm

Extended hours surgeries are offered one Wednesday morning most weeks from 7am until 8am, one Thursday evening each month from 6:30pm until 8:45pm and two Saturday mornings each month from 8:30am until 10:45am. Same day ‘sit and wait’ appointments are available each day for urgent medical issues only.

The practice is active in clinical research and patients at the practice are encouraged to participate in appropriate clinical trials.

The practice had baby feeding facilities and a hearing loop was fitted.

The practice is part of NHS Northumberland clinical commission group (CCG). Information from Public Health England placed the area in which the practice is located in the fifth more deprived decile. In general, people living in more deprived areas tend to have greater need for health services. Average male life expectancy at the practice is 78 years compared to the national average of 79 years. Average female life expectancy at the practice is 81 years compared to the national average of 83 years.

The proportion of patients with a long-standing health condition is below average (57% compared to the national average of 59%). The proportion of patients who are in paid work or full-time employment or education is average (56% compared to the national average of 56%). The proportion of patients who are unemployed is below average (3% compared to the national average of 5%).

The service for patients requiring urgent medical care out of hours is provided by the NHS 111 service and Northern Doctors Urgent Care Limited.

Updated 15 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Guidepost Medical Group on 9 February 2016. Overall, the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Feedback from some patients reported that access to a named GP and continuity of care was not always available quickly, although urgent appointments were available the same day.
• Extended hours appointments were available one Wednesday morning most weeks, one Thursday evening each month and on two Saturday mornings each month.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw two areas of outstanding practice:

• The practice took steps to ensure that new patients were engaged with by the practice. Each new patient was offered a meeting with the reception manager or reception supervisor who ensured that patients were aware of the services offered by the practice. For example, the appointments system was explained, new patients were able to register for online services and initial clinical information such as smoking status was gathered.
• The practice had participated in a Health Champions scheme. Practice Health Champions were patients who worked with the staff in the practice to meet the health needs of patients and the wider community. The health champions at the practice focused on reducing social isolation. For example, a walking group had been set up and regular coffee mornings had been held.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 April 2016

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

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority for care and support by the practice.
• Nationally reported data showed the practice had achieved good outcomes in relation to the conditions commonly associated with this population group. For example, the practice had achieved 96.5% of the QOF points available for providing the recommended care and treatment for patients with diabetes. This was 1.5% above the local CCG average and 7.3% above the national average.
• A podiatrist was available to support patients with diabetes three days a week and a dietician was available one day each week.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and 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.

Updated 15 April 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 98% to 100% (CCG average 95% to 98%) and for five year olds ranged from 94% to 99% (CCG average 95% to 99%). A part-time breast feeding co-ordinator was available at the practice.
• Urgent appointments for children were available on the same day.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• Pregnant women were able to access an antenatal clinic provided by healthcare staff attached to the practice. The practice had an area where patients could secure prams.
• Nationally reported data showed that outcomes for patients with asthma were good. The practice had achieved 100% of the QOF points available for providing the recommended care and treatment for patients with asthma. This was 0.7% above the local CCG average and 2.6% above the national average.
• The practice’s uptake for cervical screening was 81%, which was comparable to the local CCG average of 83% and national average of 82%.
• The practice provided a full range of contraceptive services.

Updated 15 April 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 its population.
• All patients over the age of 75 had a named GP.
• Patients over the age of 75 and carers were offered an annual health check.
• Information was available in the practice waiting area for patients who were carers.
• The practice was responsive to the needs of older people; they offered home visits and urgent appointments for those with enhanced needs.
• Nationally reported data showed that outcomes for patients with conditions commonly found in older people were good. For example, the practice had achieved 100% of the Quality and Outcomes Framework (QOF) points available for providing the recommended care and treatment for patients with heart failure. This was 1.1% above the local clinical commissioning group (CCG) average and 2.1% above the national average.
• The practice maintained a palliative care register and reviewed the needs of these patients each month.
• The practice offered immunisations for pneumonia to older people.

Updated 15 April 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, students had been identified, and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
• Extended hours appointments were available one Wednesday morning most weeks, one Thursday evening each month and on two Saturday mornings each month.
• Patients could order repeat prescriptions and book appointments on-line.
• Text message appointment reminders were available.
• Telephone appointments and telephone advice were available.
• The practice offered a full range of health promotion and screening which reflected the needs for this age group.
• Additional services such as health checks for over 40’s, travel vaccinations, minor surgery and joint injections were provided.

Updated 15 April 2016

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

• The practice held a register for patients experiencing poor mental health.
• Nationally reported data showed that outcomes for patients with mental health conditions was good. The practice had achieved 96% of the QOF points available for providing the recommended care and treatment for patients with mental health conditions. This was 0.3% below the local CCG average and 3.4% above the national average.
• Nationally reported data showed that outcomes for patients with dementia were above average. The practice had achieved 100% of the QOF points available for providing the recommended care and treatment for patients with dementia. This was 0.9 % above the local CCG average and 5.5% above the national average. 94% of patients diagnosed with dementia had their care reviewed in a face-to-face meeting in the last 12 months, which is above the national average of 84%.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• The practice 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. Local mental health support services were available at the practice on a regular basis.
• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• The practice had an in-house counselling service for patients. The practice used the services of trainee counsellors to reduce the waiting time for appointments. Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 15 April 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 those with a learning disability.
• The practice offered longer appointments for patients with a learning disability if required.
• 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.
• The practice was a safe reporting centre as part of a local police initiative. Safe reporting centres provided a supportive environment for people to report disability hate crime to police.