Archived: Dr Eamon McQuillan Also known as Bloomsbury Medical Centre

Updated 24 August 2017

Dr Eamon McQuillan’s Surgery (also known as Bloomsbury Medical Centre) is part the NHS Birmingham Cross City Clinical Commissioning Group (CCG). CCGs are groups of general practices that work together to plan and design local health services in England. They do this by 'commissioning' or buying health and care services.

Services to patients are provided under a General Medical Services (GMS) contract with NHS England. A GMS contract ensures practices provide essential services for people who are sick as well as, for example, chronic disease management and end of life care and is a nationally agreed contract. The practice also provides some enhanced services such as childhood vaccinations.

The practice is located in a residential property that has been adapted for the purpose of providing primary medical services. Clinical services are provided on the ground floor of the premises. There is limited parking available at the practice however, parking is permitted on the street and well served by local transport.

The practice registered list size is approximately 1,800 patients. Based on data available from Public Health England, the practice is located within the 10% most deprived areas nationally. The practice population is slightly younger than the national average. The practice has a high proportion of patients whose first language is not English which they estimate at approximately 40%.

Practice staff consist of the principal GP (male), a practice nurse (female), a practice manager, and two reception staff.

The practice is open between 9.00am and 6.30pm Monday to Friday except for Thursday afternoon when the practice closes at 1.30pm. Appointments take place from 9.50am to 11.00am every morning and 4.10pm to 5.20pm daily (except on Thursdays). Extended hours surgeries are not offered at the practice. When the practice is closed during the out of hours period between 6.30pm and 8am on weekdays and all weekends and bank holidays the service is provided by another out of hours provider Birmingham and District General Practitioner Emergency Rooms (BADGER). Patients are directed to this service via the practice answerphone. BADGER also provides cover on a Thursday afternoon when the practice is closed.

Updated 24 August 2017

Letter from the Chief Inspector of General Practice

This inspection was undertaken to ensure improvements made leading to the good rating from the inspection in August 2016 had been sustained. It was an announced comprehensive inspection on 21 July 2017. Overall the practice continues to be rated as Good.

Our key findings 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. These included safeguarding, infection prevention and control and medicines management.
• 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.
• Feedback from patients through the National GP patient survey (published July 2017) showed patients found it easy to make an appointment and access the service. Urgent appointments were available the same day. There was continuity of care.
• 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.
• The practice sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour.

There were also areas of practice where the provider should make improvements.

The provider should:

• Review and continue to take action to improve the uptake of national screening programmes for breast and bowel cancer.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 August 2017

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

• Clinical staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority. The practice had a low rate of emergency and unplanned admissions compared to others in the locality.
• Nationally reported outcome data for patients with diabetes was comparable to the CCG and national average overall (93% compared with the CCG average of 92% and national average of 90%). The practice also had lower exception reporting for diabetes indicators at 8% compared to the CCG average of 11% and national average of 12%.
• Longer appointments and home visits were available for patients who needed them.
• The was a recall system in place for patients with long term conditions to attend regular reviews to check that their health and medicine needs were being met.
• Patients had access to the electronic prescription service, which enabled them to collect the medication from a pharmacy of choice without needing to attend the practice.

Updated 24 August 2017

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

• There were systems to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who attended accident and emergency (A&E) attendances or did not attend for their appointments.
• Immunisation rates were relatively high for all standard childhood immunisations. The practice provided information to promote the uptake of the MMR vaccine where concerns were raised.
• Appointments were available outside of school hours and the premises were suitable for children and babies. Baby changing facilities were available and practice staff said they would provide a room for breast-feeding if needed.
• The practice worked with midwives and health visitors to support this population group. For example, the midwife held an antenatal clinic at the practice on alternate weeks.

Updated 24 August 2017

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice had a low rate of emergency and unplanned admissions compared to others in the locality.
• The practice had carried out falls risk assessments on 79 out 81 patients over the age of 76 years. Those identified as high or medium risk had a care plan in place. High risk patients were offered a referral to the falls prevention clinic for further assistance , 15 out of 22 eligible patients took up this offer.
• Patients are able to receive continuity of care from the principal GP.
• Multi-disciplinary team meetings are regularly held to discuss and manage the care of older patients with complex and palliative care needs.
• The practice would accept prescription requests via the telephone for those who had difficulty attending the practice.
• The practice was accessible to patients with mobility difficulties. A hearing loop was also available for those with a hearing impairment.

Updated 24 August 2017

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

• The practice did not offer extended opening hours. However, telephone appointments were available with the GP where appropriate. The practice was proactive in offering online services for making appointments and repeat prescriptions.
• Text messaging was used to remind patients of appointments and ease of cancellation.
• A range of health promotion and screening that reflects the needs for this age group was available.
• Uptake of cervical screening was comparable to CCG and national averages. National data for 2015/16 showed the practice uptake was 76%, compared with the CCG average of 79% and the national average of 81%.
• However, there was low uptake of national screening programmes for breast and bowel cancer. The practice had tried to promote the uptake of bowel cancer screening through information on the practice website.
• Health checks were offered to patients aged 40 to 74 years.
• Health trainer attended the practice on a weekly basis to provide lifestyle advice and support.
• Other services provided for this age group include travel advice and vaccinations on the NHS, chlamydia self-testing.

Updated 24 August 2017

• Nationally available data for 2015/16 showed 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, compared to the CCG and national average of 84%. There was no exception reporting.
• National reported data for 2015/16 showed 71% of patients with poor mental health had a comprehensive, agreed care plan documented, in the preceding 12 months, which was below the CCG average 88% and national average 89%. Exception reporting at 7% was also below CCG averages at 10% and the national average of 13%. Unverified data for 2016/17 showed a small increase to 73%. We saw that the numbers involved in this indicator were relatively small 11 patients. Staff told us that they had difficulties getting these patients to attend.
• The practice met with the community mental health teams every six months to discuss those with severe poor mental health.
• Staff had undertaken Mental Capacity Act training.

Updated 24 August 2017

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

• The practice held register of patients living in vulnerable circumstances including those with a learning disability, with palliative care needs and carers.
• The practice had recently signed up to provide an enhanced service to provide annual reviews for patients with a learning disability.
• Learning disability passports were issued as part of a CCG initiative. These enabled patients to record and share important information including their likes and dislikes as they passed through different services.
• The practice offered longer appointments to patients who required them, such as patients with a learning disability.
• The practice supported patients to access the service. This included the provision of interpreter services and hearing loop.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• 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. Staff had also undertaken training in female genital mutilation awareness.
• The practice’s computer system alerted the GP if a patient was also a carer. There were 24 patients on the practices register for carers; this was 1.4% of the practice list. Patients on the carers register were offered additional support.