Archived: The Dove Medical Practice

Updated 15 August 2016

• The Dove Medical practice is located in Erdington, a suburb of Birmingham.
• The practice provides primary medical services to approximately 9800 patients in the local community.
• The practice has a General Medical Services (GMS) contract. The GMS contract is a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract.
• The practice hasfour GP partners (two male and two female) , two salaried GP’s, two GP registrars, four practice nurses, a practice manager, an assistant practice manager, three healthcare assistants (HCA’s) as well as reception and secretarial staff.
• The practice also has a sexual health team comprising of a sexual health nurse, a sexual health advisor, two sexual health HCA’s (one of whom is also an administrator).
• The practice is open between 8am and 6pm Monday to Friday except for Thursday afternoons when the practice closes at 5pm. Appointments take place from 8.30am to 11.30am every morning and 3pm to 6pm (or 4pm on a Thursday) daily. Extended hours surgeries are not offered at the practice. In addition to pre-bookable appointments that can be booked up to two weeks in advance, urgent appointments are also available for people that need them.
• The practice does not provide an out-of-hours service but has alternative arrangements in place for patients to be seen when the practice is closed. For example, if patients call the practice when it is closed, an answerphone message gives the telephone number they should ring depending on the circumstances. The practice employs the use of the Birmingham and District General Practitioner Emergency Room group (Badger) to provide this out-of-hours service to patients.
• The practice is located in an area where there are higher levels of deprivation.

Updated 15 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced focused inspection at The Dove Medical Practice on 23 June 2016.

During our previous inspection of the practice on 10 December 2015 the practice was rated requires improvement for safe and effective domains leading to an overall rating of requires improvement. The practice was issued with a requirement notice for breach in regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Fit and proper persons employed. This inspection was to review the action taken by the provider to meet both the regulatory requirements where we had previously identified a breach and to report on the action taken for any other issues within the safe and effective domains. For this reason we have only rated the location for the safe and effective domains. The report should therefore be read in conjunction with the full inspection report published in March 2016.

At this inspection we found the practice had made changes since their previous inspection in December 2015 and was now meeting the requirements of the breach identified at the previous inspection. We also found that sufficient action had been taken regarding other issues identified at the previous inspection. This meant that the practice was now rated good for both safe and effective domains leading to an overall rating of good.

Specifically we found that since the last inspection, the practice had:

• A robust system in place for sharing, learning and analysing significant events.
• The practice had implemented a new recruitment policy that ensured all necessary employment checks for staff such as evidence of satisfactory conduct in previous employment were being carried out. We saw evidence to demonstrate that the new processes were being followed.
• Put in place a new telephone triage system to improve the processes for making non-urgent appointments. A patient survey had been carried out in conjunction with the patient participation group (PPG) to get patient feedback regarding the new system.
• Reviewed policies and procedures to ensure they were practice specific and to enable better monitoring of processes.
• Made targeted and focused efforts to improve patient outcomes in areas identified for improvement. The practice was previously identified as an outlier for QOF (or other national) clinical targets for diabetes, hypertension and emergency admissions. However, at this inspection we saw evidence to demonstrate significant improvements in these areas and in almost all cases the latest unpublished QOF data showed that the practice was now performing in line with local and national averages.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 August 2016

Although the population groups were not looked at during this focused inspection, the rating for this population group has now been updated from requires improvement to good. This is because the provider rating for both safe and effective has now changed to good leading to a new rating of good overall. These updated ratings apply to everyone using the practice, including this population group. At our previous inspection on 10 December 2015, we reported that:

• Patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was below the national average
• Longer appointments and home visits were available when needed
• Patients had a personalised care plan or structured annual review to check that their health and care needs were being met.
• For those patients with more complex needs, we identified that the GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 15 August 2016

Although the population groups were not looked at during this focused inspection, the rating for this population group has now been updated from requires improvement to good. This is because the provider rating for both safe and effective has now changed to good leading to a new rating of good overall. These updated ratings apply to everyone using the practice, including this population group. At our previous inspection on 10 December 2015, we reported that:

• Same day appointments were available for children and those with serious medical conditions.
• Immunisation rates for childhood vaccinations were slightly above CCG averages. For example, childhood immunisation rates for under two year olds ranged from 83% to 96% and five year olds from 94% to 98% for the practice which compared favourably with CCG rates of 80% to 95% and 86% to 96% respectively.
• Appointments were available outside of school hours.
• The premises were suitable for children and babies and b aby changing and breast feeding facilities were available at the practice.
• The practice’s uptake for the cervical screening programme was 85%, which was comparable to the national average of 82%.
• The practice had a dedicated sexual health clinic that offered a range of sexual health promotion services and treatments.

Updated 15 August 2016

Although the population groups were not looked at during this focused inspection, the rating for this population group has now been updated from requires improvement to good. This is because the provider rating for both safe and effective has now changed to good leading to a new rating of good overall. These updated ratings apply to everyone using the practice, including this population group. At our previous inspection on 10 December 2015, we reported that:

• The practice offered proactive, personalised care to meet the needs of the older people in its population. Patients with complex needs or recurrent admissions were discussed in monthly multi-disciplinary team meetings and offered extra support.
• Flu vaccination rates for the over 65s were 65% which was lower than the national average of 73%. The flu vaccination rates for those groups considered to be at risk were 45% which was also lower than the national average rate of 52%.
• There were longer appointments available for patients who required them.
• Patients were able to book appointments and order repeat prescriptions online.
• Home visits were available for older patients and patients who would benefit from these.
• Ramped access and disabled facilities were available at the practice.
• The practice had also installed a lift to improve access.

Updated 15 August 2016

Although the population groups were not looked at during this focused inspection, the rating for this population group has now been updated from requires improvement to good. This is because the provider rating for both safe and effective has now changed to good leading to a new rating of good overall. These updated ratings apply to everyone using the practice, including this population group. At our previous inspection on 10 December 2015, we reported that:

• The practice was open between 8am and 6pm Monday to Friday except for Thursday afternoons when the practice closed at 5pm.
• Although extended hours surgeries were not offered at the practice, patients could book appointments or order repeat prescriptions online.
• The practice was proactive in offering a full range of health promotion and screening that reflected the needs of this age group.

Updated 15 August 2016

Although the population groups were not looked at during this focused inspection, the rating for this population group has now been updated from requires improvement to good. This is because the provider rating for both safe and effective has now changed to good leading to a new rating of good overall. These updated ratings apply to everyone using the practice, including this population group. At our previous inspection on 10 December 2015, we reported that:

• Performance for mental health related indicators was above the national average (practice average of 93% compared to a national average of 89%).
• The practice carried out advance care planning for patients with dementia.
• The practice had informed patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• The GP we spoke with had good knowledge of the relevant consent and decision-making requirements of legislation and guidance, including the Mental Capacity Act 2005.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 15 August 2016

Although the population groups were not looked at during this focused inspection, the rating for this population group has now been updated from requires improvement to good. This is because the provider rating for both safe and effective has now changed to good leading to a new rating of good overall. These updated ratings apply to everyone using the practice, including this population group. At our previous inspection on 10 December 2015, we reported that:

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability and had carried out annual health checks for people with a learning disability.
• The practice offered longer appointments for patient requiring an interpreter or for those with a learning disability. There were translation services available.
• The practice had policies that were accessible to all staff which outlined who to contact for further guidance if they had concerns about a patient’s welfare.
• There was a lead member of staff for safeguarding and we saw evidence to show that staff had received the relevant safeguarding training.
• Staff members we spoke with were able to demonstrate that they understood their responsibilities with regards to safeguarding.