Heath Hayes Health Centre

Updated 16 June 2017

Dr Hirendra Choudhary is registered with the Care Quality Commission (CQC) as an individual provider operating a GP practice in Cannock. Staffordshire. The practice is part of the NHS Cannock Chase Clinical Commissioning Group. The practice holds a General Medical Services (GMS) contract with NHS England. A GMS contract is a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract. At the time of our inspection the practice had 10,214 patients.

The provider operates from two sites. The main site is Heath Hayes Health Centre, with a branch site in Cannock. The practice sites are located as follows:

• Heath Hayes Health Centre, Gorsemoor Road, Heath Hayes, Cannock, WS12 3T
• Chase Medical Practice, 65 Church Street, Cannock, WS11 1DS

The staffing across the two sites consists of:

• Five male GPs, of which four work as salaried GPs, and a part time female locum.
• A nurse practitioner, a practice nurse and a health care assistant (all female)
• A practice manager supported by secretarial staff, reception staff, and two apprentices.

Both Heath Hayes Health Centre and Chase Medical Practice are open between 8am and 6.30pm Monday to Friday and 9am to 12 noon on Saturdays. GP and nurse appointments are available Monday to Friday from 9am to 12.30pm and 2pm and 6pm at both practice sites. Extended hours appointments with the GPs and nurses are offered at Chase Medical Practice between 6.30pm and 8pm on Mondays, and on Saturdays between 9am to 12 noon.

The provider is also part of the Cannock Practice Network Surgery, based in the GP Suite at Cannock Hospital. Reception staff can offer patients appointments at the Network Surgery after 1.30pm when the practice’s own weekday appointments have been booked. Appointments are available at the Network between 3.30pm and 7.40pm. There are also pre-bookable appointments at the Network on Saturdays and Sundays between 9am and 1pm.

The practice has opted out of providing of providing out of hours services to their own patients. Patients requiring a GP outside of normal working hours are advised to contact NHS 111, who triage the calls for the out of hours service, which is Staffordshire Doctors Urgent Care.

Updated 16 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Heath Hayes Health Centre on 4 May 2017. 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 a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said they were usually able to get an appointment with a GP when they needed one. Urgent appointments were available the same day and patients had access to appointments through the Cannock Practice Network Surgery.
• 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

However, there were areas of practice where the provider should make improvements.

The provider should:

• Ensure that up to date blood results for high risk medicines are available to clinicians to assist with safe prescribing.
• Carry out a risk assessment to support the rationale for not stocking injectable medicines to treat nausea and vomiting or severe pain.
• Formalise and record clinical supervision which takes place between the nurse practitioner and GP.
• Introduce a system to record any audits of patient notes for consent to procedures.
• Review the issues around confidentiality in the waiting area at Heath Hayes Health Centre and consider ways to improve confidentiality.
• Ensure information regarding interpretation services is easily accessible to patients at both sites.
• Adopt a more proactive approach to identifying and meeting the needs of carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 June 2017

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

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was similar to the CCG and national averages. For example, the percentage of patients on the diabetes register, in whom a specific blood test to get an overall picture of what a patients average blood sugar levels had been over a period of time was recorded as 71% compared with the CCG and national average of 78%.
• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.
• There was a system to recall patients for a structured annual review to check their health and medicines needs were being met. The practice had a structured system for inviting patients for their review or identifying patients who did not attend.
• For those patients with the most complex needs, the GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 16 June 2017

The practice is rated as good for the care of families, children and young people.

• From the sample of documented examples we reviewed we found there were systems to identify and follow up children living in disadvantaged circumstances and who were at risk.
• Immunisation rates were relatively high for all standard childhood immunisations.
• Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice worked with midwives and health visitors to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.

Updated 16 June 2017

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

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice offered proactive, personalised care to meet the needs of the older patients in its population.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice provided a service to patients in six care homes and carried out regularly weekly visits at one home. The same GP visited to provide continuity of care. The GPs visited patients in all of the care homes on request.
• The nurse practitioner and practice nurse carried out reviews for house bound patients.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.

Updated 16 June 2017

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

• 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.
• Patients could book appointments up to five weeks in advance.
• The practice offered extended hours appointments with the GPs and nurses were offered at Chase Medical Practice between 6.30pm and 8pm on Mondays and on Saturdays between 9am to 12 noon.
• The practice offered all patients aged 40 to 75 years old a health check with the nursing team.

Updated 16 June 2017

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

• The practice carried out advance care planning for patients living with dementia.
• 80% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average.
• The practice specifically considered the physical health needs of patients with poor mental health and dementia. Patients were invited for an annual review of their physical health needs.
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.
• The percentage of patients experiencing specific mental health conditions with an agreed care plan documented in the preceding 12 months was 92% compared to the local CCG average of 90% and national average of 89%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• Patients at risk of dementia were identified and offered an assessment.
• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.
• The practice was involved in a pilot of a well being assessment worker programme. This pilot was funded by the local CCG and provided a counselling service for patients. Patients with low level mental health needs were seen within the practice.

Updated 16 June 2017

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 had identified 89 patients on the learning disability register, 12 of which had attended for an annual review this year.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.