Lower Gornal Medical Practice

Updated 18 January 2017

Lower Gornal Medical Practice is a long established practice located in the Lower Gornal area of Dudley. There are approximately 8845 patients of various ages registered and cared for at the practice. Services to patients are provided under a General Medical Services (GMS) contract with NHS England. The practice has expanded its contracted obligations to provide enhanced services to patients. An enhanced service is above the contractual requirement of the practice and is commissioned to improve the range of services available to patients.

The clinical team includes five GP partners, a salaried GP, a nurse practitioner, three practice nurses and three health care assistants. The GP partners and the practice manager form the practice management team and they are supported by a team of 12 staff members who cover reception, IT, secretarial and administration roles.

The practice is open for appointments between 8am and 6:30pm during weekdays, the practice offers extended hours on Mondays and Wednesdays between 6:30pm and 7:30pm. There are also arrangements to ensure patients receive medical assistance during the out-of-hours period.

Updated 18 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lower Gornal Medical Practice on 1 March 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance

• Staff were aware of their responsibilities to raise and report concerns, incidents and near misses. Information about safety was recorded, monitored, reviewed and addressed.

• The practice had clearly defined and embedded systems, processes and practices in place to keep people safe and safeguarded from abuse.

• Clinical audits were carried out to demonstrate quality improvement and to improve patient care and treatment

• Staff we spoke with said they felt valued, supported and that they felt involved in the practices plans.

• Staff worked with multidisciplinary teams to understand and meet the range and complexity of patients’ needs.

• We observed the premises to be visibly clean and tidy. Information for patients about the services available was easy to understand, accessible and available on a variety of formats.

• The practice offered proactive care to meet the needs of its population.

• The practice proactively sought feedback from staff and patients, which it acted on. The practice had an active patient participation group which influenced practice development.

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

The areas where the provider must make improvements are:

• Ensure fridge temperatures are recorded correctly, in line with national guidance, to ensure robust maintenance of the cold chain.

• Ensure risk is assessed and mitigated in the absence of specific emergency medicine associated with minor surgery and the procedure of fitting specific birth control devices.

• Ensure risk is mitigated in the in the absence of emergency medical equipment such as the defibrillator.

The areas where the provider should make improvement are:

• Ensure systems are in place to inform patients that a private area is available for private discussions.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 6 April 2016

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 overall diabetes related indicators was 96% compared to the CCG average of 88% the national average of 89%.
• The practice focused on patients with Chronic Obstructive Pulmonary Disease (COPD) and offered a telemedicine service for patients with COPD to self-monitor and answer questions on a daily basis using telemedicine equipment sourced by the practice.

Updated 6 April 2016

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.
• Childhood immunisation rates for the vaccinations given were comparable to CCG and national averages. For example, childhood immunisation rates for under two year olds ranged from 82% to 97% compared to the CCG averages which ranged from 40% to 100%. Immunisation rates for five year olds ranged from 90% to 96% compared to the CCG average of 93% to 98%.
• The practice offered a wide range of resources and information leaflets to patients. The practice also displayed a comprehensive information board for young people. This contained information of a variety of support services and sexual health information.

Updated 6 April 2016

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.

• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• Clinical staff carried out home visits for older patients and patients who would benefit from these. Immunisations such as flu vaccines were also offered to vulnerable patients at home, who could not attend the surgery.
• 90% of the practices patients above the age of 75 had received a health check

Updated 6 April 2016

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

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

• The practice’s uptake for the cervical screening programme was 80%, compared to the national average of 81%.
• The practice offered extended hours on Mondays, Wednesdays and on Saturday mornings. The practice nurses also offered nurse services between 8am to 7:30pm on Mondays and Wednesdays for those who could not attend the practice during core hours.

Updated 6 April 2016

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

• There were longer appointments available at flexible times for people experiencing poor mental health. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• Data showed that diagnosis rates for patients identified with dementia was 80% compared to the CCG average of 94% and national average of 93%. Staff explained that they were working through systems and proactively identifying cases of dementia.

• There were 66 patients on the practices register for dementia and 55 patients on the mental health register. Most of these patients had care plans in place, these patients were regularly reviewed and further reviews were planned.

• Performance for mental health related indicators was 96% compared to the CCG average of 94% and national average of 93%.

Updated 6 April 2016

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

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

• There were 39 patients on the practices learning disability register. The practice shared a report which highlighted that 48% of the practices patients with a learning disability had a care plan in place, these patients were also regularly reviewed.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations. Information was available in a variety of formats including practice leaflets in large print and brail for people with a visual impairment.