Coseley Medical Centre

Updated 11 December 2019

Coseley Medical Centre is a long-established practice located in Coseley, West Midlands and services are provided from a single location. Coseley Medical Centre is a member of the Dudley Clinical Commissioning Group (CCG) and provides services to patients under the terms of a general medical services (GMS) contract. This is a contract between general practices and NHS England for delivering services to the local community. At the time of our inspection there were approximately 6,788 patients registered at the practice

The provider is registered with CQC to deliver the following Regulated Activities; diagnostic and screening procedures, maternity and midwifery services, treatment of disease, disorder or injury and surgical procedures.

The clinical team includes three male GP partners, two advanced nurse practitioners, three practice nurses and a health care assistant. The GP partners and the practice manager form the management team and they are supported by a team of administrative staff who cover reception, secretarial and administration roles.

There are higher than average number of patients between the ages of 15-44. The National General Practice Profile states that 90% of the practice population is from a white ethnic background with a further 10% of the population originating from black, Asian, mixed or other non-white ethnic groups. Information published by Public Health England, rates the level of deprivation within the practice population group as four, on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

The practice is open between 8am and 6.30pm Monday to Friday. Home visits are available for patients who are too ill to attend the practice for appointments. Patients can also access appointments on Saturdays between 9am and midday and on Sundays between 9am and 11am at this practice or at one of four other practices within the locality through the seven day opening service which operates on a rotational basis. Patients can access evening appointments at the practice between 6.30pm and 8pm for a one week period every four weeks. The practice has arrangements to ensure patients could access care during the out-of-hours period.

The practice does not provide out of hours services to their own patients. When the practice is closed patients are directed to contact Malling Health via NHS 111.

The practice website can be viewed at: www.coseleymedicalcentre.nhs.uk

Updated 11 December 2019

We carried out an announced comprehensive inspection at Coseley Medical Centre on 30 August 2017. The overall rating for the practice was good. The practice was found to be requires improvement in providing responsive services. The full comprehensive report on the August 2017 inspection can be found by selecting the ‘all reports’ link for Coseley Medical Centre on our website at www.cqc.org.uk.

A desktop inspection was carried out on 22 August 2018 to confirm that the practice had made improvements and the practice remained rated as requires improvement for providing responsive services.

This inspection was a desk-based review carried out on 12 November 2019 to confirm that the practice had made improvements that we identified in our previous inspection on 30 August 2017. This report covers our findings in relation to those requirements and additional improvements made since our last inspection.

Overall the practice remains rated as good overall.

Our key findings were as follows:

• The practice had installed a new telephone system in May 2018 and outcomes from the national patient survey results in 2019 have seen an increase in patient satisfaction relating to timely access of the service.
• The practice have introduced a telephone triage system and are supported by two advanced nurse practitioners to increase appointment availability for patients.
• The practice monitored the performance of telephone response times and had increased the number of call receivers.
• Patients satisfaction results for timely access to the service were in line with local and national averages.

Details of our findings and the evidence supporting our ratings are set out in the evidence table.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Updated 13 October 2017

• We saw evidence that multidisciplinary team meetings took place on a regular basis and that discussions took place to understand and meet the range and complexity of people’s needs and to assess and plan ongoing care and treatment.

• DQOF data for August 2017 highlighted that since April 2017, 65% of the practice’s patients on the diabetes register had a blood sugar reading which showed that their condition was being controlled appropriately. However the practice was aware of this and was continuing to work through their call and recall system. The practice was also in the process of planning to develop a Diabetes education programme in conjunction with a local residential home.
• The practice had systems in place to identify and assess patients who were at high risk of admission to hospital. Patients who were at high risk of admission to hospital had personalised care plans in place.

Updated 13 October 2017

• The practice operated an effective system for scheduling childhood immunisations and ensuring appropriate actions were taken if immunisation appointments were missed or risk factors identified. The practice regularly engaged with the health visitor.

• 2015/16 childhood immunisation rates for the vaccinations were above CCG and national averages. In addition, more recent practice data indicated that childhood immunisation rates for the year so far were above CCG and national averages. For instance quarterly data for January and April 2017 highlighted that over 90% of children aged one had received the full course of recommended vaccines.

• The practice offered urgent access appointments for children, as well as those with serious medical conditions.
• Data from 2015/16 showed that the practice’s uptake for the cervical screening programme was 80%, compared to the CCG average of 77% and national average of 81%. More recent data provided by the practice on the day of our inspection indicated that the practice’s cervical screening uptake was at 75% and no patients had been exception reported.

Updated 13 October 2017

• The practice offered home visits and urgent appointments for those with enhanced needs.

• The practice cared for a number of patients in local residential homes. The practice regularly attended the homes to care for patients, carry out health checks and to provide immunisations where needed.

• Immunisations such as flu and shingles vaccines were also offered to patients at home, who could not attend the surgery.

• Patients received continuity of care with a named GP and a structured annual review to check that their health and medicines needs were being met.
• Patients had access to appropriate health assessments and checks. These included health checks for new patients and NHS health checks for people aged over 75. The practice also offered annual reviews to patients aged 65 and over.

Updated 13 October 2017

• Patients could book appointments over the telephone, face to face and online.

• The practice was offering a new seven day opening service; this was being offered in conjunction with four other general practices within the locality. The practice was also opening from 8am to 8pm for one week every four weeks.

• Patients who may be in need of extra support were identified and supported by the practice. This included patients requiring advice on their diet, smoking and alcohol cessation.
• Patients had access to appropriate health assessments and checks, including health checks for new patients and NHS health checks for people aged 40–74.

Updated 13 October 2017

• The practice regularly worked with other health and social care organisations in the case management of people experiencing poor mental health, including those with dementia. Patients with complex needs and patients experiencing poor mental health were regularly discussed during MDT meetings.

• DQOFH data for August 2017 indicated that 88% of the practice’s patients with a diagnosis of severe mental illness had received a cardiovascular disease risk assessment in the last 12 months. This placed the practice in the top 25% of local practices for this specific area of care.

• We noted that the practice’s dementia register had increased since our previous inspection as the practice was focussing on identifying patients at risk of developing dementia to ensure they were offered the care and treatment they needed. We saw that the practice had purchased a staff booklet from the Alzheimer’s Society to coach staff on how to apply good customer care when supporting patients with dementia. In addition, there were plans in place to host a dementia café in conjunction with the Alzheimer’s Society in October 2017.

• DQOFH data for August 2017 highlighted that 94% of patients diagnosed with dementia had been referred to a memory assessment service.

• The practice had purchased comprehensive dementia friendly care planning packs which were sourced through the Alzheimer’s Society. At the point of our inspection the practice was in the initial stages of the project and was planning to start a new programme of recalls to start the process.
• The practice was also in the process of recruiting an in-house counsellor to offer services such as Cognitive behavioural therapy (CBT). This was in addition to the current counselling services provided in the practice and support services such as Integrated Plus which were also used appropriately to support people experiencing poor mental health.

Updated 13 October 2017

• There were facilities in place for people with a disability and for people with mobility difficulties. There were hearing loop and translation services available.

• The practice offered annual reviews and flu vaccinations for vulnerable patients including carers and patients with a learning disability. Vulnerable patients were regularly reviewed and discussed as part of the multidisciplinary team (MDT) meetings to support the needs of patients and their families.

• The practice actively utilised the local Integrated Plus scheme. This scheme was facilitated by the Dudley Council for Voluntary Service (CVS) team to help to provide social support to people who were living in vulnerable or isolated circumstances.
• The practice also supported patients by referring them to a gateway worker who provided counselling services on a weekly basis. In addition to counselling services, patients were supported to make use of the local Dudley talking therapies.