We previously carried out an inspection at Bewick Crescent Surgery on October 2015, we rated the practice as good.

We carried out this announced comprehensive inspection on 21 March 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall and good for all population groups except working age patients (including those recently retired and students) which we rated as outstanding.

We rated this population group as outstanding because;

• Patients had good access to late opening, a walk-in service at the branch surgery and telephone appointments.
• The practice highlighted the importance of cervical screening to their patients, this included carrying out cervical screening at home for those who could not come to the surgery, promoting the importance of this at a local supermarket and sending out extra reminders for screening on pink paper.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

We saw an area of outstanding practice which was:

• The practice provided us with data that showed they had the lowest rate of patients attending the urgent care centre by 1,000 of the practice population, out of 26 practices. They had 19 per 1,000, year to date for 2018/2019 compared to the highest which was 130.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Letter from the Chief Inspector of General Practice

We carried out this comprehensive inspection on 10 September 2015.

Overall, we rated this practice as good. Specifically, we found the practice to be good for providing well-led, effective, caring, safe and responsive services.

Our key findings were as follows:

• The practice provided a good standard of care, led by current best practice guidelines.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
• The practice actively reviewed their performance in the management of long term conditions, and was proactive in offering review and screening services.
• The practice actively sought to make improvements following feedback from patients and patient groups.
• The building had sufficient facilities and equipment to provide safe effective services.
• There was a clear leadership structure and staff felt supported by management.
• Nursing staff were given additional protected learning time each week for professional development. Staff were highly supported within their roles to develop their interest in new specialist areas and obtain further qualifications.
• The practice had good retention rates for GPs, with seven out of the 10 GPs having previously been in training at the practice.
• The practice Healthcare Assistants (HCA) had received an award from the County Durham NHS stop smoking service for high quit rates achieved

We saw several areas of outstanding practice:

• Following a project initiated by the practice, community psychiatric nurses were employed and managed at the practice on behalf of the Federation as an additional suicide prevention service. Patients referred to the service would be given an hour-long appointment within two days at any one of three practices within the area.
• Learning disability patients were given a ‘health action plan’, which was an easy read summary of their health checks, which they could then take away with them and bring to the next appointment.
• People with a new diagnosis of diabetes were invited to monthly group education events, attended by among others GPs, nurses, and dieticians. The medical secretary responsible for referrals and arrangement of treatment also attended, so that patients could meet a named point of contact within the system.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

• Ensure that stock control and date check systems function correctly so that all single use clinical instruments stored and used are within their expiry dates. Dispose of in accordance with the appropriate guidance any unused instruments or equipment which have expired.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice