The Swan Medical Centre

Updated 5 March 2018

The Swan Medical Centre provides primary care services to its registered list of approximately 8100 patients. The practice is situated at 4 Willard Road Yardley, Birmingham B25 8AA. The practice catchment area is classed as within the group of the second most deprived areas in England relative to other local authorities.

The practice has a General Medical Services (GMS) contract. A GMS contract is a contract between NHS England and general practices for delivering general medical services.

Practice staff comprises of four GP partners, an advanced nurse practitioner, a practice nurse, two health care assistants and a phlebotomist. The clinical team are supported by a practice manager, reception and administration staff. The Swan Medical Centre is also a teaching and training practice providing placements for GP registrars on a six month rotational basis. (GP registrars are qualified doctors training to specialise in General Practice). At the time of our inspection there was one GP registrar on placement.

The practice is located on two floors, the ground floor contains reception, waiting areas, consulting rooms and disabled toilet facilities and treatment rooms, whilst training rooms and administration offices are situated on the first floor. There is step free access into the building and access for those in wheelchairs or with pushchairs.

The practice is open between 8.30am and 6.30pm Monday to Friday, the exception being Wednesday when the practice is open between 8.30am and 1pm. GP appointments are available between 8.30am and 11.50am and 2.30pm and 5.50pm. The practice is closed at weekends. The practice does not provide an out-of-hours service but employs the use of Primecare to provide out-of-hours service to patients.

Updated 5 March 2018

We previously carried out an announced comprehensive inspection at The Swan Medical Centre on 14 November 2016. The overall rating for the practice was good, with good ratings in safe, effective, caring and well-led services and requires improvement rating in responsive services. The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for The Swan Medical Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 12 February 2018 to confirm that the practice had carried out improvements in relation to the areas of improvements we identified in our previous inspection on 14 November 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as good.

Our key findings were as follows:

• The practice had made significant improvements to ensure all staff were kept informed of significant events and any related learning.
• The practice had implemented an audit process for its stock of vaccines. Vaccine stock was stored and managed appropriately.
• Patient feedback remained mixed regarding telephone access. However, the practice had made significant improvements to its process of monitoring the effectiveness of actions taken regarding telephone access.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

• Continue to explore options to improve telephone access further and continue to monitor the effectiveness of actions taken regarding patient telephone access.
• Consider monitoring trends in incidents and complaints to further identify areas of improvement or areas where they are doing well.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 16 January 2017

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

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators were below the national average. For example: the percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months (01/04/2014 to 31/03/2015) was 65% compared to the national average of 88%, however more recent information for the period 2015/16 showed that the practice had achieved 84% in this area.

• Longer appointments and home visits were available when needed.

• All these patients had a named (usual) GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 16 January 2017

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, for example, children and young people who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• 73% of female patients aged 25-64 attended cervical screening within the target period compared with the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw examples of joint working with midwives, health visitors and school nurses.

Updated 16 January 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 kept up to date registers of patient’s health conditions and data reported nationally was that outcomes were comparable to that of other practices for conditions commonly found in older people.

• The practice provided clinics at a number of nearby nursing and residential care homes.

Updated 16 January 2017

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, however services had not been adjusted to ensure these were accessible, flexible and offered continuity of care.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 16 January 2017

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

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 16 January 2017

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 homeless people who were encouraged to register the practice as a home address and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.