Archived: Dr Lumley & Partners

Updated 21 April 2017

Dr. Lumley and partners are located in Greenridge Primary Care Centre, Yardley Wood Road, Billesley, Birmingham in the centre of a busy residential area. The large health centre is owned and managed by NHS Property Services. There is easy access to the building and facilities are provided for patients with a disability. There is onsite car parking serving patients with limited parking for people with disabilities closer to the practice entrance. There are approximately 7935 patients of various ages registered.

The practice team consists of 11 GPs. Five of the GPs are partners (two male and three female) and six salaried GPs, (all female). There is also a GP Registrar (female), who are qualified doctors training to be GPs. The team also includes one male advanced nurse practitioner and three practice nurses (one male, two female), a pharmacist and two health care assistants (HCA). There is a practice manager, and a team of administrative staff.

The practice holds a General Medical Services (GMS) contract with NHS England. The practice is part of Birmingham Crosscity Clinical Commissioning Group (CCG).

The practice is open between 8:00am and 6pm Mondays to Fridays. Appointments are available from 8.30am to 11.30am and 3pm to 6pm Monday Friday. There are extended hours services 7.30 to 8am Monday and Wednesday and on one Saturday morning each month. In addition there are pre-bookable appointments that could be booked up to four weeks in advance and urgent appointments are available for people that needed them.

Patients requiring a GP outside of normal working hours are covered by Prime Care an out of hour’s provider. The majority of patients are of white British ethnicity with a small number of Asian, Portuguese and Rumanian patients. Information published by Public Health England rates the level of deprivation within the practice population group as two on a scale of one to ten, with level one representing the highest level of deprivation.

This practice provides placements for medical students.

Updated 21 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Lumley and Partners on 17 January 2017. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.

• Risks to patients were assessed and generally well managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

• A thorough process was used to ensure all staff remained up to date with NICE guidelines action taken and any learning outcomes.

The areas where the provider should consider making improvements are:-

• Leaflets for patients should be printed in a size suitable for people with visual impairment .

• A risk assessment should be completed regarding the lack of appropriate medicines in the Doctors bags for use in an emergency situation on a home visit.

• Strengthen arrangements for quality improvement by evaluating the impact of clinical audits.

• The patient participation group (PPG) should be developed to represent the voice of patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 April 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. This included diabetes, asthma and chronic obstructive pulmonary disease (COPD). There were daily clinical meetings to discuss new referrals.

• Diabetes related indicators were both comparable and lower than the national average. For example, the percentage of patients on the diabetes register with a record of foot examination and risk classification within the period April 2015 to March 2016 was 67% as compared to the CCG average of 88% and national average of 88%, while 95% of patients with diabetes had the influenza immunisation in the preceding August 2015 to March 2016 compared with the CCG average of 93% and the national average of 95%.

• Practice nurses specialised in diabetes and respiratory conditions so could start patients on insulin, offer personalised management plans and dedicated follow up.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met.

• Patients with a diagnosis of epilepsy were seen in their own home and had management plans.

• Protocols were under review, for example the pharmacist had recently reviewed hypertension and asthma.

Updated 21 April 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 high for all standard childhood immunisations with the practice achieving up to 97% uptake in 2015/16 across all age groups.

• 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.

• 72% of women aged between 25-64years had received a cervical screening test. This was lower than the CCG average of 79% and a national average of 81%.

• Appointments were available outside of school hours and the premises were suitable for children and babies. We saw positive examples of joint working with midwives and health visitors such as antenatal sessions provided by the midwife for delivering prenatal care and advice and regular meetings with health visitors.

• The practice provided family planning under the Umbrella sexual health scheme including the insertion of coils and implants.

Updated 21 April 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 population included 2% of patients over the age of 85 years.They invited these patients for annual health checks and all had a named GP.

• The practice had systems in place to identify and assess patients who were at high risk of admission to hospital. Patients who were discharged from hospital were reviewed to establish the reason for admission and care plans were updated

• Community nurse assessments were carried out as part of ACE Plus (Achieving Clinical Excellence) looking at patients nutrition needs and falls risk in their own home.

• Multidisciplinary meetings were held weekly and included discussions about patients who were at high risk of safeguarding and review of recent deaths.

• GPs provided weekly rounds at local nursing homes which included end of life care planning involving the patient, their family and the care team.

Updated 21 April 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 had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

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

• Extended hours were provided between 7.30-8.00am Monday and Wednesday and one Saturday morning each month for patients who were working. Telephone consultations were available daily.

• Minor surgery was available on Saturdays.

Updated 21 April 2017

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

• 93% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record, in the preceding 12 months, which was higher than the national average of 88%.

• 74% of patients with schizophrenia, bipolar affective disorder and other psychoses had their alcohol consumption recorded in the preceding 12 months, which was lower than the national average of 89%..

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

• The practice served several nursing homes including a unit for the elderly mentally illpredominantly looking after patients living with dementia. One of the GPs was the designated GP for care homes and provided designated full ward rounds each week to see patients in their own home and support staff in their care.

• The practice staff regularly met with the Community Mental Health Team in the case management of patients experiencing poor mental health and patients were signposted to Mental Health Matters to which they could self-refer.

• There were daily emergency appointments available for people in distress.

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Updated 21 April 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, travellers 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.

• All practice staff had attended Identification and Referral to Improve Safety training and were approved via Birmingham Women’s Aid to help women at risk of abuse.

• 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. Discussions about vulnerable adults and children were a standing item agenda in the clinical meetings.