Archived: Mallard Medical Practice

Updated 4 February 2016

Mallard Medical Practice is registered with the Care Quality Commission to provide primary medical services.

The practice provides services to approximately 4,760 patients from one location at Killingworth Health Centre, Citadel East, Killingworth, Newcastle upon Tyne, NE12 6HS. This is the address we visited on the day of our inspection.

The practice is based in a purpose-built surgery with level-entry access and a car park for patients to use.

The practice has 14 members of staff, including two (one male, one female) GP partners, two (female) salaried GPs, two (female) practice nurses, one healthcare assistant, a practice manager, and six administrative and reception staff.

The practice is part of North Tyneside clinical commissioning group (CCG). Information taken from Public Health England placed the area in which the practice was located in the fifth most deprived decile. In general, people living in more deprived areas tend to have greater need for health services. The practice population broadly reflects the national average in terms of age distribution.

The surgery is open from 8.30am to 6pm, Monday to Friday, with evening opening times from 6.30pm to 8.30pm on Wednesdays. The phone lines operate from 9am until 5.30pm on weekdays. Outside of these hours a message on the surgery phone line directed patients to out of hours services, NHS 111, or 999 as appropriate. Appointments with a GP are available as follows:

• Monday – 8.40am to 11.20am and 3pm to 6pm
• Tuesday - 8.40am to 11.20am and 2.30pm to 6pm
• Wednesday – 9am to 1pm, 3pm to 5.20pm and 6.30pm to 8.30pm
• Thursday – 8.30am to 2.45pm and 3pm to 5.20pm
• Friday – 9am to 11am and 2.30pm to 5.20pm

The practice provides services to patients of all ages based on a General Medical Services (GMS) contract agreement for general practice. The practice population profile broadly reflects the national average, though there are slightly more patients aged between 30-34 and 60-69 than in other areas. The service for patients requiring urgent medical attention out of hours is provided by the NHS 111 service and Northern Doctors Urgent Care Limited.

Updated 4 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Mallard Medical Practice on 8 December 2015. Overall the practice is rated as good.

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

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• There was an open and transparent approach to safety and a 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.
• Information about services and how to complain was available and easy to understand.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff told us they felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

We saw an area of outstanding practice:

• A number of patients and staff gave us examples of high quality care at the practice. Examples included GPs seeking out treatment options for cancer patients which, while not available at the nearest hospital, would result in the best outcomes for patients both medically and emotionally. We were also told of GPs visiting palliative care patients in their homes late in the evening and at weekends when the surgery was closed. The doctors visited to ensure the patients had medication to make them comfortable and also to provide emotional support for the patient and their family members.

However there was an area of practice where the provider should make improvements:

• Ensure meetings to discuss significant events are minuted.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 4 February 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.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 4 February 2016

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 who were at risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.
• The practice’s uptake for the cervical screening programme was 79.5%, which was above the CCG average of 78% and the national average of 74.3%.
• Same-day appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 4 February 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.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• Clinicians worked closely with other services and community groups to provide support to people with dementia or who needed end of life care. GPs visited palliative care patients in their homes late in the evening and at weekends when the surgery was closed to ensure the patients had medication to make them comfortable and also to provide emotional support for the patient and their family members.

Updated 4 February 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 and students had been identified and the practice had adjusted the services they offered to ensure these were accessible, flexible and offered continuity of care.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 4 February 2016

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

• 95.8% of people diagnosed with dementia had had their care reviewed in a face-to-face meeting in the last 12 months (national average, 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 had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• There was a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff had a good understanding of how to support people with mental health needs and dementia.

Updated 4 February 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.
• They offered longer appointments for people with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• Staff had told 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.