The Care Quality Commission
  • Doctor
  • Out of hours GP service

Birmingham And District General Practitioner Emergency Room Limited (Badger)

Overall: Outstanding read more about inspection ratings

Badger House, 121 Glover Street, Birmingham, West Midlands, B9 4EY (0121) 766 2101

Provided and run by:
Birmingham And District General Practitioner Emergency Room Limited

All Inspections

29 November 2023 to 11 December 2023

During a routine inspection

This practice is rated as Outstanding overall. (Previous inspection November 2017 – Good).

The key questions are rated as:

Are services safe? – Good

Are services effective? – Outstanding

Are services caring? – Outstanding

Are services responsive? – Outstanding

Are services well-led? – Outstanding

We carried out an announced comprehensive inspection at Birmingham And District General Practitioner Emergency Room Limited (Badger) between 29 November and 11 December 2023. We inspected this service due to the length of time since our previous inspection, in line with Care Quality Commission’s inspection priorities.

At this inspection we found:

  • The leadership, governance and culture within the service drove the delivery of high-quality person-centred care.
  • There was clear evidence of working in partnership with others to continue to improve the service by finding innovative solutions.
  • The service had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the service learned from them and improved their processes.
  • There were comprehensive and effective systems in place to safeguard children and vulnerable adults and to ensure there were no lost contacts.
  • The service consistently met or exceeded its key performance targets even during periods of extreme urgent care system pressure.
  • The provider ensured that care and treatment was delivered according to evidence-based guidelines.
  • The provider had an embedded program of audit that helped to drive further improvements. There was clear evidence of action to resolve concerns and improve quality.
  • Feedback from people who used the service, those who were close to them, and stakeholders, were consistently positive about the way staff treated people. People thought that staff went above and beyond their duties to provide great care. The provider monitored patient feedback and used this to further improve their service.
  • Patients were able to access out-of-hours care at a location of their choice and at a time that suited them. Where appropriate, patients where offered a home visit or a telephone call with a clinician.
  • From patient feedback, we saw that patients found the appointment system easy to use and reported that they were able to access care when they needed it.
  • Leaders strove to inspire and motivate staff to deliver high quality patient centred care. Staff feedback was positive about the changes in leadership and culture.
  • The provider had recognised that transformation in leadership and governance structures was needed to continue to deliver high quality patient centred services. We saw that changes that had been implemented had strengthened leadership, provided greater oversight over governance processes and provided stability for the future.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services

2 November 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Birmingham And District General Practitioner Emergency Room Limited (BADGER) – Glover Street on 7 and 8 June 2016. The overall rating for the practice was good. However, we identified areas of concern in relation to the provision of safe services and rated the provider as requires improvement in this area. The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for Glover Street on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 2 November 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection in June 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

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

  • Systems for responding to incidents and significant events had been reviewed to ensure they were responded to in a timely manner.
  • Effective systems were in place for managing and acting on safety alerts received.
  • Effective systems were in place for managing and monitoring infection control across all primary care centres.
  • Appropriate systems were in place for managing controlled drugs and prescription stationery to ensure a clear audit trail of use.
  • Effective systems were in place for monitoring the safety of vehicles used in the out of hours period.
  • There were clear leadership and governance arrangements in place for the management and monitoring of risks relating to health and safety.
  • Oxygen was now available in all vehicles as part of the home visit kit, however not all vehicles seen contained paediatric masks.
  • Staff were given the opportunity of an annual appraisal to discuss their learning and development needs.
  • There was evidence of service improvement activity through the annual clinical audit programme.

The areas where the provider should make improvement are:

  • Establish systems for reviewing themes and trends in incidents and complaints to identify areas for service improvements.
  • Establish systems for undertaking fire drills.
  • Ensure paediatric masks are available in all vehicles.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

7 June 2016 and 8 June 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Birmingham and District General Practitioner Emergency Room Limited (BADGER) on 7 and 8 June 2016. We visited all primary care centres used by the provider in the provision of out-of-hours services. Overall the service 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 an effective system in place for reporting and recording significant events. However, these were not always managed in a timely way.
  • Risks to patients were not consistently assessed and well managed. There were some weaknesses in the management of safety alerts, risks to health and safety, infection control, medicines and prescriptions. Recent loss and changes of staff had led to a lack of clear lines of responsibility in some areas.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. There was a strong emphasis on training and staff development to ensure staff had the skills, knowledge and experience to deliver effective care and treatment.
  • The service performed well against National Quality Requirements in the delivery of care and treatment.
  • Patients said they were treated with compassion, dignity and respect and they were satisfied with the care and treatment they received from the service.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • The service had good facilities and was well equipped to treat patients and meet their needs.
  • Staff felt supported by management. Systems and processes were well embedded within the primary care centres. However, lines of managerial accountability were not always clear.
  • The service proactively sought feedback from staff and patients, which were very positive.
  • The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

  • Ensure effective systems are in place for identifying and managing risks to patients, including risks relating to health and safety, fire, safety alerts, infection control, staffing hours, prescriptions and medicines.

The areas where the provider should make improvement are:

  • Review systems for acting on significant incidents to ensure that prompt action is taken for those assessed as high risk.
  • Ensure all staff have access to appraisals to discuss their development needs.
  • Review monitoring of audit systems to ensure improvements identified are implemented and sustained.
  • Establish routine reviews of complaints received to identify any themes or trends emerging to support further service improvement.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice

10/03/2014

During a routine inspection

Birmingham and District GP Emergency Room Limited (Badger) provides out-of-hours services across seven primary care centres including Glover Street which is the administrative base and call handling centre.

During our inspection we visited two of the provider’s primary care centres, Glover Street and a primary care centre at a local hospital. We spoke with 14 patients who were using the service and a range of clinical and administrative staff.

Most patients that we spoke with told us that they were happy with the treatment they received. Those that were not told us it was because they had felt rushed when they were seen. Most patients described a caring service and told us that they were involved in discussions about their health care and were treated with dignity and respect. We observed staff treating patients with sensitivity during telephone consultations.

We saw the service was provided in a clean and hygienic environment and there were systems in place to ensure the safety of patients such as safeguarding patients that may be at risk of harm and the safe use of medicines. Staff were aware of the systems in place for reporting incidents and untoward events and were involved in the investigations which enabled learning to take place.

We found the service was effective in meeting the wide range of needs of patients that presented to the service and dealing with the varying levels of demand that was placed on it. Staff had access to equipment and guidance needed to respond to patients. There were processes to ensure that those with urgent needs were seen as a priority.

The provider actively asked patients for their views and feedback and responded to information received to improve the service. Complaints were thoroughly investigated and responded to but not always in a timely way. Patients did not always have access to information needed to support them to raise a complaint.

We found the service was well-led and provided a supportive environment which empowered staff to flourish. Staff described an open culture and were supported through induction training, performance management and continuing professional development to provide a good service.