Archived: Small Heath Medical Practice

Updated 7 July 2016

Small Heath Medical Practice is part of the NHS Birmingham Cross City Clinical Commissioning Group (CCG). CCGs are groups of general practices that work together to plan and design local health services in England. They do this by 'commissioning' or buying health and care services.

Small Heath Medical Practice is registered with the Care Quality Commission to provide primary medical services. The practice has a general medical service (GMS) contract with NHS England. Under the GMS contract the practice is required to provide essential services to patients who are ill and includes chronic disease management and end of life care.

The practice is located in purpose built accommodation. Based on data available from Public Health England, the area served is among the most deprived areas in the country (within the highest 10%). The practice has a registered list size of approximately 5500 patients.

The practice is open between 8am and 6.30pm Monday to Friday, with the exception of Wednesday when it closes from 1.30pm for the afternoon. Appointments are available:

Monday 7am to 12.30pm and 3pm to 5.30pm

Tuesday 9am to 12.30pm and 3pm to 5.30pm

Wednesday 7.15am to 8am and 10am to 12.30pm

Thursday 9am to 12.30am and 3pm to 5.30pm

Friday 9am to 12.30pm and 3pm to 5.30pm

When the practice is closed primary medical services are provided by an out-of-hours provider (BADGER).

The practice currently has four GP partners (1 male and 3 female) and one salaried GP (male). Other practice staff consist of a team of three practice nurses and two recently appointed nurse prescribers, a healthcare assistant and a team of administrative staff which includes a practice manager who supports the daily running of the practice.

The practice is a training practice for qualified doctors training to become a GP and also supports training for student nurses.

The practice has not previously been inspected by CQC.

Updated 7 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Small Heath Medical Practice on 13 May 2016. 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. Although national GP patient survey data showed scores below CCG and national average for patient involvement.
• 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 usually found it easy to make an appointment and changes had been made to the appointment system to improve access. Urgent appointments were 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.

The areas where the provider should make improvements are:

• Clarify within the repeat prescribing policy which medicines are to be referred back to GP for uncollected prescriptions.
• Undertake routine fire drills of the premises.
• Review clinical audit process to ensure improvements made are sustained.
• Review appraisal process for nursing staff to ensure they receive clinical input into this.
• Review processes to try and encourage greater uptake of national screening programmes for relevant patients.
• Review and implement ways in which the identification of carers might be improved.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 July 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 specific clinics including chronic pulmonary disease, diabetes and asthma were held. Patients at risk of hospital admission were identified as a priority.
• Practice performance for diabetes related indicators overall was 92% which was slightly higher than the CCG and national average 89%.
• The practice offered a range of services to support the diagnosis and management of patients with long term conditions for example insulin initiation, electrocardiographs (ECGs), ambulatory blood pressure monitoring and spirometry.
• Home visits were available for patients whose clinical needs made it difficult to attend the practice.
• Patients with long term condition had a named GP and received a structured annual review to check their health and medicines needs were being met.
• For those patients with the most complex needs, the practice worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 7 July 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 or failed to attend for immunisations.
• Immunisation rates for all standard childhood immunisations were comparable to the CCG average. The practice had approached local community leaders to encourage uptake among ethnic groups in the area.
• The practice’s uptake for the cervical screening programme was 72%, which was lower than the CCG average of 78% and the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice worked with midwives, health visitors and school nurses in providing care and treatment to vulnerable children.
• The practice had baby changing facilities and was accessible for pushchairs. The practice also offered a breast feeding friendly service.

Updated 7 July 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.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• Uptake of flu vaccines in the over 65years was similar to other practices in the local clinical network.
• The practice participated in the admissions avoidance scheme to review the care of those who had an unexpected admission to hospital.
• The practice held quarterly multidisciplinary team meetings with relevant health and care professionals to discuss and plan the care of those with end of life needs.

Updated 7 July 2016

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.
• Early morning appointments were available to accommodate the needs of those who worked during surgery opening hours.
• The practice offered telephone consultations.
• 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. NHS Health checks were available to patients aged 40 to 75 years, 5% of eligible patients had taken up this offer. Patients were also signposted to support services such as health trainers.

Updated 7 July 2016

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

• National reported data for 2014/15 showed 80% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the CCG average 82% and national average 84%. The practice told us the latest data (not yet published) was 100%.
• National reported data for mental health outcomes (2014/15) was 95% which was comparable to the CCG average 92% and national average 93%.
• Some of the reception staff at the practice had been trained as dementia friends to ensure a better understanding and support for patients with dementia.

Updated 7 July 2016

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 such as those with a learning disability. Alerts on patient records identified those who were vulnerable so that efforts could be made to deal with them promptly where possible.
• The practice offered longer appointments for patients with a learning disability and told us that 75% of patients with a learning disability had received a health check in the last 12 months.
• Patients with a learning disability received health passports to support them as they moved between services.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• 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.
• The practice hosted weekly sessions with the Citizens Advice Bureau who were able to provide financial and social advice.
• A carers pack was available to support patients with caring responsibilities. The practice had identified 63 carers registered with them.
• The practice registered patients with no fixed abode at the practice address so that they could receive health care.