Alum Rock Medical Centre

Updated 31 August 2017

Alum Rock Medical Centre is located in a suburb of Birmingham. The practice holds a General Medical Services (GMS) contract, this is a nationally agreed contract commissioned by NHS England. The practice serves a population of 5,600 patients who are predominately of younger age groups and 93% are of Asian backgrounds. The practice lies within a low socioeconomic area.

The premises consist of two converted residential properties situated on a main road. There is a car park to the rear of the surgery for staff and patients, and on-street parking to the front of the surgery is available. The practice has wheelchair access to the front of the premises. Senior staff have requested from the local Council two disabled parking spaces at the front of the practice.

The practice is managed by two GP partners (one male and one female) who are assisted by a regular locum GP. There is one practice nurse who provides clinical support to GPs. They also provide cervical screening and contraceptive services. There are three healthcare assistants (HCAs) who carry out duties such as, phlebotomy (taking blood for testing), health checks and vaccinations. There is a practice manager who is supported by a part time business manager, two full time receptionists and an administrator.

The practice offers a range of clinics for chronic disease management, diabetes, heart disease, cervical screening, contraception advice and vaccinations.

Opening/appointment times are:

• 9am until 2pm every weekday morning

• 4pm until 6.30pm Wednesdays

• 4pm until 7.30pm Mondays, Tuesdays and Fridays

• Telephone consultations are available and communication via email.

• Patients who request a home visit may be contacted by telephone to enable GPs to prioritise which patients should be visited first.

Between 8am and 9am and 2pm until 4pm Mondays, Tuesdays, Wednesdays and Fridays patients who telephone are directed to the emergency service telephone number. The emergency service will contact the practice with any urgent requests made by patients and a receptionist receives the call and directs it to a GP who will see the patients.

The practice has opted out of providing GP services to patients out of hours. When the practice is closed, there is a recorded message providing details of the out of hours’ provider, Badger. The practice leaflet includes contact information and there are out of hours’ leaflets in the waiting area for patients to take away with them. Information was also on the practice website.

Updated 31 August 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Alum Rock Medical Centre on 11 July 2017.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded. Significant events were investigated, acted on when necessary and learning shared with staff.

• Risks to patients were assessed and well managed. There were safe systems for prescribing medicines.

• Staffing levels were monitored to ensure they reflected patients’ needs. Effective staff recruitment procedures ensured that only suitable staff were employed.

• The practice worked closely with other health and social care organisations and with the local community in planning how services were provided to ensure that they met patients’ needs. For example, in conjunction with a visiting health trainer and the practice nurse they were providing a 10 week course on dietary needs for safe fasting during Ramadan and the importance of exercising.

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

• We observed that patients were treated with compassion, dignity and respect.

• Previous data published showed that patient satisfaction in respect of care and access to the service were rated mostly in line with the local and national averages. An action plan had been developed to address results that were below average. Current data showed that improvements had been achieved but that further work was needed in a few areas.

• Information about how to make a complaint was readily available and easy to understand. Complaints were dealt with in a timely appropriate way.

• There was a clear leadership structure and staff told us they felt well supported by senior staff. Management sought feedback from patients and staff, which it acted on. The governance system monitored the quality of care and the overall performance across the practice.

We saw an area of outstanding practice:

• Patients 40 – 70 years of age were offered NHS health checks. Clinical staff also carried out health checks of patients aged between 16 and 39 years of age, 57% of patients within this age range had been screened for diabetes. Following the inspection, the practice advised that due to this intervention 65 patients in this age range had been identified as diabetic and 62 patients identified as pre-diabetic leading to early treatment and health promotion. 

However, there was an area of practice where the provider needs to make an improvement.

The provider should:

• Continue to make improvements for the national patient survey results that remained below local and national averages and carry out a review and develop an action plan regarding telephone access for patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 31 August 2017

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

• Patients with long-term conditions had structured annual reviews to check that their health and medicine needs were being met. Where necessary reviews were carried out more often. Staff identified effective ways for patients to manage their condition.

• There was a higher than average number of patients who had diabetes. Staff had systems for identifying and monitoring patients who were at risk of developing diabetes and advising them on healthy living styles. Patients requiring insulin or other diabetic injectable medicines were given lessons on how to administer this by the GPs in the surgery.

• Data for 2015-2016 showed the overall review rate and updates of their agreed care plans for patients who experienced poor mental health was 92%, compared with the CCG average of 88% and the national average of 89%.

• Clinical staff worked with health care professionals to deliver a multidisciplinary package of care for patients.

• Where necessary patients in this population group had a personalised care plan in place which were regularly reviewed.

• Longer appointments and home visits were available when needed.

Updated 31 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 who were at risk.

• Alerts were put onto the electronic record when safeguarding concerns were raised.

• There was regular liaison and regular meetings with the health visitor to review those children who were considered to be at risk of harm.

• All children were given a same day telephone or face to face consultation.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.

• Pre-bookable appointments were available after school hours until 7.30pm every Monday, Tuesday and Friday.

• Childhood vaccinations for two year olds were 97%, which was above the anticipated 90% requirement.

Updated 31 August 2017

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

• Patients who required on-going care were assessed and clinical staff developed personalised care plans to meet the needs of older patients. Care plans were regularly reviewed to ensure they met patients’ needs.

• Staff kept up to date registers of patients’ health conditions and information was held to alert staff if a patient had complex needs.

• Home visits were provided for those who were unable to access the practice.

• Patients with enhanced needs were given prompt access to appointments.

• Practice staff worked with other agencies and health providers to provide patient support. For example, all older patients had been reviewed for the risk of falling and those who were identified at risk were referred to the falls clinic.

• Older patients were offered health checks at least annually and where necessary, care, treatment and support arrangements were implemented.

Updated 31 August 2017

The practice is rated good for the care of working-age people (including those recently retired and students).

• Telephone consultations were available for those patients who found it difficult to attend the practice or if they were unsure whether they needed a face to face appointment.

• Online services were available for booking appointments and ordering repeat prescriptions.

• Health promotion advice was available and there was a full range of health promotion material available in the practice. The practice website gave advice to patients about how to treat minor ailments without the need to be seen by a GP.

• Staff actively encouraged patients to attend for health screening, such as, breast and bowel cancer. Data for 2015-2016 informed us that the cervical screening rate was 84% compared with the CCG average of 80% and the national average of 78%.

Updated 31 August 2017

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

• Patients who experienced poor mental health were offered an annual physical health check.

• GPs carried out assessments of patients who experienced memory loss in order to capture early diagnosis of dementia. This enabled staff to put a care package in place and where necessary refer patients to the memory clinic.

• Practice staff regularly worked with multi-disciplinary teams in the case management of patients who experienced poor mental health, including those with dementia.

• Staff had a good understanding of how to support patients with mental health needs and dementia and provided signposting, for example, Birmingham Healthy Minds and the Well-being Hub.

• Referrals to other health care professionals were made when necessary such as the community psychiatric nurse team. Staff held quarterly meeting with the community psychiatrist to discuss how to best manage patients’ needs.

Updated 31 August 2017

The practice is rated 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 who had a learning disability.

• Annual health checks were offered to who had a learning disability. There were a total of 59 patients on the register and at the time of the inspection 41 of these patients had received their annual health check.

• Practice staff regularly worked with multi-disciplinary teams in the case management of vulnerable patients.

• There was a process in place to signpost vulnerable patients to additional support services.

• Staff knew how to recognise signs of abuse, the actions they should take and their responsibilities regarding information sharing.

• There was a clinical lead for dealing with vulnerable adults and children. A charitable organisation provided advice and support for patients who had suffered domestic abuse.

• The practice kept a register of the 2% of patients who were carers. Clinical staff offered them guidance, signposted them to support groups and offered them a flu vaccination each year.