Dr Mohamedtaki Walji

Updated 10 August 2016

Dr Walji and Colleagues is situated in Balsall Health in South Birmingham less than two miles from the city centre of Birmingham. The practice has a list size of 5,500 patients.

The practice has a car park for patients and staff to use.

The practice has two GP partners and two salaried GPs (three male and one female offering patients their preferred choice). The practice has two practice nurses and two healthcare assistants (HCA).

The clinical team are supported by a practice manager, a deputy practice manager and a team of reception and administrative staff.

The practice has a Patient Participation Group (PPG), a group of patients registered with a practice who work with the practice team to improve services and the quality of care.

Dr Walji and Colleagues is a training practice providing up to two GP training places. A GP trainee is a qualified doctor who is training to become a GP through a period of working and training in a practice. Only approved training practices can employ GP trainees and the practice must have at least one approved GP trainer.

The GPs did minor surgery such as joint injections, cauterisation of warts and verrucas, incision and drainage of cysts and abscesses.

The practice holds a Personal Medical Services (PMS) contract with NHS England. This is a locally agreed alternative to the standard GMS contract used when services are agreed locally with a practice which may include additional services beyond the standard contract.

The practice is open at the following times:

• Monday 9am to 6.30pm

• Tuesday 9am to 6.30pm

• Wednesday 9am to 1pm and 3pm to 8pm (the practice closes between 1pm and 3pm every Wednesday) Calls were covered by out of hours during this period.

• Thursday 9am to 6.30pm

• Friday 9am to 6.30pm

• Saturday 9am to 10.30am

The practice does not provide out of hours services beyond these hours. Information for NHS 111 and the nearest walk in centre is available on the practice website and on the practice leaflet. Primecare provided cover when the practice was closed.

Updated 10 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Walji and Colleagues on 1 June 2016. Overall the practice is rated as good.

Our key findings were as follows:

• 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. The practice carried out an annual significant event audit to ensure learning from significant events was embedded.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. The GPs were leads in different areas and had weekly meetings to discuss concerns and share learning.

• There was a clear leadership structure and staff felt supported by the GPs and the practice manager. The practice proactively sought feedback from staff and patients which it acted on. There was a very pro-active Patient Participation Group (PPG) of which we met with four members during the inspection.

• The practice was aware of and complied with the requirements of the Duty of Candour.

• Risks to patients were assessed and well managed.

• Patients described staff as caring and helpful. Patients commented that they were treated with dignity and respect

• 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.

• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.

• Staff had also attended education sessions in female genital mutilation (FGM) and Identification and Referral to Improve Safety (IRIS) which was domestic violence training.

We saw areas of outstanding practice:

• The practice had been involved in the Irish Project from 2000 onwards, which involved proactive outreach work in the local community to identify and target vulnerable patients for care and treatment. Initially this project was initiated by the Primary Care Trust (PCT) but the practice continued this as a voluntary project. As a result of this project 324 undiagnosed serious diseases were picked up by the practice such as COPD, depression, asthma, arthritis and cancer. The practice was then able to refer patients where this was needed and to start patients on the correct treatment such as having x-rays, blood tests, counselling and psychotherapy.

• Staff told us that there was a practice charity fund which was used to pay for help for patients where emergency support was needed, for example providing a bag of essential items for those requiring unexpected hospital admissions. Therefore when the practice became aware that patients might benefit from this the fund was used for this purpose.

• Staff told us about examples of when the GPs supported patients by paying for their taxis to get to hospital when an ambulance was not required.

However, there was an area of practice where the provider should make improvements:

The provider should:

• Consider documenting verbal complaints so that any trends can be identified and lessons learned.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 August 2016

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

• Nursing staff and GPs had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Patients with long term conditions were on a register and invited for annual reviews. There were trained clinical leads for each long term condition.

• The practice was signed up to the Cardiovascular Disease Local Improvement Scheme and had achieved very high points last year and are on target to repeat it this year.

• Quality and Outcomes Framework (QOF) performance in relation to long term conditions was consistently good.

• The practice had signed up to a number of local initiatives including the Pre-Diabetes Local Improvement Scheme (LIS) to educate patients and try and reduce the incidence and impact of diabetes. The practice referred patients to the Health Exchange to advise patients about lifestyle changes, weight loss and exercise.

• In house Electrocardiograms (ECG) screening to record electrical activity of the heart to detect abnormal rhythms and the cause of chest pain was available. The practice offered routine monitoring to identify patients at risk of heart attack and offered ambulatory blood pressure, 24 hour ECGs, spirometry and lung function tests so that patients did not need to be referred to hospital for diagnosis.

Updated 10 August 2016

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

• There were systems in place to follow up on children who were considered vulnerable including the use of alerts. The child safeguarding register was reviewed with the health visitors regularly.

• Appointments were available outside of school hours with GPs and nurses and the premises were suitable for children and babiesWe saw positive examples of joint working with midwives, health visitors and school nurses. Same day appointments were always provided for children aged five and under.

• Family planning services were offered at the practice and the practice provided comprehensive sexual health services which were run by GPs and practice nurses.

• Staff had attended education sessions in female genital mutilation (FGM) and Identification and Referral to Improve Safety (IRIS) which was domestic violence training

• Childhood immunisation rates for the vaccinations given were comparable to the CCG averages. For example, for the vaccinations given to under two year olds ranged from 69% to 92% compared with the CCG average of 79% to 96% and five year olds from 82% to 100% compared with the CCG average of 84% to 95%. In order to increase up take the practice were running drop in clinics on a Wednesday evening up to 8pm with the practice nurses.

Updated 10 August 2016

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

• The practice offered personalised care to meet the needs of older patients in its population and had a range of enhanced services for example, unplanned admissions. The GPs met weekly and unplanned admissions were discussed. The practice co-ordinated care via weekly multi-disciplinary team meetings with district nurses and community matrons.

• The practice worked closely with a non-clinical case manager whereby older people with complex needs could be assigned a visit to look at social needs. The practice adopted the palliative care Gold Standards Framework (GSF).

• Patients over the age of 75 were allocated a named GP but had the choice of seeing whichever GP they preferred. There were no set clinics so patients were able to attend at a time convenient for them.

• Frail elderly patients were always seen on the same day even if no appointments were available. Patients who required an urgent visit were referred to a duty doctor if a GP was not available straight away. Home visits were offered to those patients who were not able to attend the practice.

• Older patients were able to order prescriptions by telephone as sometimes patients did not want to order online or found it harder to attend the practice. Whenever possible, the practice tried to get tests done while patients were in the practice to save them having to attend for repeated visits.

• We received very positive feedback about the GPs from the manager of sheltered accommodation who told us the GPs were flexible and responsive to their patients.

• The practice referred older patients to Gateway. This was a new scheme designed for those who may need additional support with social isolation.

Updated 10 August 2016

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

• The practice had adjusted the services it offered to ensure they were appropriate to the needs of working age patients. For example practice sent out text messages to remind patients of their appointments and also when there were any health campaigns such as flu vaccinations.

• Extended hours were available on a Wednesday evening until 8pm. Telephone advice was available each day from a pharmacist or GP if required.

• Minor surgery and joint injections were available at the practice.

• The practice’s uptake for the cervical screening in the last five years was 81% which was just below the national average of 82%. There was a policy to offer telephone reminders for patients who did not attend for their cervical screening test.

• There was a daily phlebotomy (blood taking service) with appointments available from 8am for working people. The drop in clinic with nurses until 8pm on a Wednesday had helped the practice with the uptake of cervical screening.

Updated 10 August 2016

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

• 91% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is above the national average of 84%.

• The practice was signed up to the Mental Health Local Improvement Scheme. Longer appointments were available for patients with poor mental health. All staff at the practice had completed the dementia awareness training. Patients on the mental health register and those with dementia had comprehensive care plans and received annual health checks.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. Patients were encouraged to see a regular clinician to ensure continuity of care.

• The practice signposted patients to local support such as a relationship and bereavement counselling service, available from Amman Walk in service and Birmingham Healthy Minds which offered advice and information for patients who were experiencing mental health issues.

• Home visits were done as required for patients who did not engage with the practice.

Updated 10 August 2016

The practice is rated as outstanding for the care of people whose circumstances may make them vulnerable.

• Staff told us that there was a practice charity fund which was used to pay for help for patients where emergency support was needed, for example providing a bag of essential items for those requiring unexpected hospital admissions. Therefore when the practice became aware that patients might benefit from this the fund was used for this purpose.

• The practice had been involved in the Irish Project from 2000 onwards, which involved proactive outreach work in the local community to identify and target vulnerable patients on the practice list for care and treatment. Initially this project was initiated by the Primary Care Trust (PCT) but the practice continued this as a voluntary project. As a result of this project 324 undiagnosed serious diseases were picked up by the practice such as COPD, depression, asthma, arthritis and cancer. The practice was then able to refer patients where this was needed and to start patients on the correct treatment such as having x-rays, blood tests, counselling and psychotherapy.

• All patients with a learning disability were offered an annual health check and longer appointments were allocated. The practice had 105 patients on the learning disability register and 79 of these had received their annual health check in the last year.

• Carers were offered an annual health check. 2% of the practice patient list were registered as carers.

• Patients whose first language was not English were supported by interpreters. Staff at the practice were able to speak a number of different languages which reflected the needs of the local population.

• The practice had weekly multi-disciplinary team meetings to identify and manage the on-going care of vulnerable patients,. Palliative care meetings were held quarterly.

• Staff had attended education sessions in female genital mutilation (FGM) and Identification and Referral to Improve Safety (IRIS) for domestic violence. The practice had information leaflets and posters about these and dealt with these subjects sensitively to protect patients who asked for help or who they believed might be at risk.

• The practice had patients living at a local bail hostel. The feedback from this service was positive indicating the GP partner was very flexible, approachable and always contactable.

• The practice hosted services to help patients with finances and benefits. The Citizens Advice Bureau attended the practice every Tuesday and the financial enabler attended every Thursday.