This practice is rated as Good overall. (Previous rating October 2014 – Good)

The key questions at this inspection are rated as:

Are services safe? – Requires Improvement

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 Union Brae and Norham Practice on 1 November 2018 as part of our inspection programme.

At this inspection we found:

• Staff demonstrated a very caring approach to their patients and it was clear they treated them with compassion, kindness, dignity and respect.
• Clinicians assessed patients’ needs and delivered person-focussed care and treatment.
• 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.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• The practice engaged well with their patients. There was an active patient participation group which provided support and challenge.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• Managers valued their staff and provided many opportunities for career progression.

We saw an area of outstanding practice:

• The practice was aware of the lack of some health care services provided in and around the town of Berwick. Ear, nose and throat (ENT) and audiology services were provided for patients across the area (not just those registered with the practice). An ophthalmology clinic was beginning on the day of the inspection and a dermatology service was due to start later in the month.

The area where the provider must make improvements is:

• Ensure care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

• Carry out a risk assessment to determine whether it is necessary to carry out Disclosure and Barring Service checks for non-clinical staff.
• Continue to review and implement effective infection control policies and procedures.
• Formalise the system for recording action taken following receipt of patient and medicines safety alerts.

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

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of Union Brae and Norham Practice on 14 October 2014. We inspected the main surgery at Union Brae and also inspected the branch surgery at Norham.

Our inspection team was led by a CQC Inspector and included a GP specialist advisor and a practice manager specialist advisor. We have rated the practice overall as good.

Comments we received from patients were overwhelmingly positive about the care and treatment they had received. Patients told us they are treated with dignity and respect and involved in making decisions about their treatment options.

Our key findings were as follows:

• The practice covered a large geographical and rural area, services had been designed to meet the needs of the local population.
• Staff reported feeling supported and were able to voice any concerns or make suggestions for improvement.
• There was a range of qualified staff to meet patients’ needs and keep them safe.
• The practice was clean and well maintained.  
• Data showed us patient outcomes were at or above average for the locality. People’s needs were assessed and care was planned and delivered in line with current legislation.
• The practice worked with other health and social care providers to achieve the best outcomes for patients

We saw an area of outstanding practice:

• The provision of services for young people. Significant time and effort had been taken to engage with young people. Services were specifically designed to meet local young people’s needs.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We reviewed the information available to us about Union Brae and Norham Practice on 25 May 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.