Archived: Firstcare Practice

Updated 17 September 2015

Firstcare Practice is centrally located, less than two miles from the centre of Birmingham. They provide primary medical services to patients registered with the practice, covering an area within three miles of the practice location. The practice has four GPs including two female GPs, nursing staff including a practice nurse, a health care assistant (HCA), a phlebotomist (a person who takes blood), administrative and reception staff. The practice is an accredited training practice although as yet does not have any trainee GPs. There were 5,758 patients registered with the practice at the time of the inspection.

The practice is open from 8am to 6.30pm Mondays to Thursdays, from 8am to 8pm on Fridays and from 8am to 1pm on Saturdays. Home visits are available for patients who are too ill to attend the practice for appointments. There is also an online service which allows patients to order repeat prescriptions, book and cancel appointments and view parts of their medical record.

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, arrangements are in place to ensure patients receive urgent medical assistance when the practice is closed. If patients call the practice when it is closed, an answerphone message gives the telephone number they should ring depending on the circumstances. Information on the out-of-hours service is provided to patients and is available on the practice’s website.

The practice treats patients of all ages and provides a range of medical services. The practice provides a number of clinics such as disease management clinics which includes asthma, diabetes and heart disease. Other clinics include minor surgery, maternity care and family planning clinics.

Firstcare Practice has an Alternative Provider Medical Services (GMS) contract. The APMS contract is the contract between general practices and NHS England for delivering primary care services to local communities. This contract allowed Firstcare Practice to take over a previously failing practice and make improvements to provide a service to meet patients’ needs.

Updated 17 September 2015

Letter from the Chief Inspector of General Practice

We inspected this service on 23 June 2015 as part of our new comprehensive inspection programme.

The overall rating for this service is good. We found the practice to be good in the safe, effective, caring, responsive and well-led domains. The practice was good at providing services for older people, people with long term conditions, families, children and young people, the working age population and those recently retired, people in vulnerable circumstances, and people experiencing poor mental health.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from incidents were maximised.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a result of feedback from patients, staff and from the patient participation group (PPG).

• There were systems in place to keep patients safe from the risk and spread of infection.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Information about how to complain was available and easy to understand.
• The practice held regular multidisciplinary clinical team meetings to discuss the needs of complex patients, for example those with end of life care needs or children who were considered to be at risk of harm.
• The practice had an open culture that was effective and encouraged staff to share their views through regular practice and clinical staff meetings.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 September 2015

The practice is rated as good for the care of people with long term conditions. The GPs and nursing staff worked together in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. Practice staff held a register of patients with long term conditions and carried out regular reviews. For patients with the most complex needs, GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 17 September 2015

The practice is rated as good for the care of families, children and young people. There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, such as children and young people who had a high number of accident and emergency (A&E) attendances. All consultation rooms were on the ground floor which made the practice accessible for pushchairs and appointments were available outside of school hours. There were policies, procedures and contact numbers to support and guide staff should they have any safeguarding concerns about children. The clinical team offered immunisations to children in line with the national immunisation programme. Immunisation rates were comparable to local and national average.

Updated 17 September 2015

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 and had a range of enhanced services, for example, in dementia and end of life care. Nationally reported data showed that the practice performed well against indicators relating to the care of older people. For example, the practice maintained a register of patients in need of palliative care. The practice held regular multidisciplinary integrated care meetings where all patients on the palliative care register were discussed.

The practice offered home visits and rapid access appointments for those patients with complex healthcare needs. Patients over 75 years of age were offered annual health reviews.

Updated 17 September 2015

The practice is rated as good for the care of working age people (including those recently retired and students). The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

The practice offered extended opening hours to assist this patient group in accessing the practice. NHS health checks were available for people aged between 40 - 74 years. The practice offered a range of health promotion and screening services which reflected the needs for this age group.

Updated 17 September 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Care was tailored to patients’ individual needs and circumstances including their physical health needs. The practice offered health checks to patients on their mental health register. Practice staff worked in conjunction with the local mental health team to ensure patients had the support they needed. GPs had attended training in the Mental Capacity Act 2005 to ensure all care provided was in patients’ best interests.

Updated 17 September 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances including patients with a learning disability. It had carried out annual health checks for patients with a learning disability and all of these patients had received a follow-up where issues were identified. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. GPs carried out home visits on request to patients who were unable to attend the practice.