Bournbrook Varsity Medical Centre

Updated 22 December 2017

Bournbrook Varsity Medical Centre is a long established practice located in the Selly Oak area of Birmingham in the West Midlands. The practice is an accredited training practice for GP Registrars to undertake extra training to qualify as a General Practitioner.

There are approximately 10,100 patients of various ages registered and cared for at the practice. The practices registered patient population is made up of mostly young adults, students and working age people; at the time of our inspection approximately half of the registered patient list was aged between 20-29. Staff explained that most of these patients are part of the university which was situated over the road from the practice

The senior management team consists of two GP partners (both female) and the practice manager. The clinical team also includes four female GPs, well as two female practice nurses and two female health care assistants. The management team are supported by two deputy managers as well as a team of 12 staff that hold reception, secretarial, administration and domestic roles.

The practice is open for appointments Monday to Friday between 8:30am to 6pm and on Saturdays from 8:30am to 11am. The practice is also part of a local GP federation called My Healthcare, this enables patients to access services across five local practices up to 12 hours a day including early mornings and evenings, Monday to Friday and at varied times on weekends. The federation allows patients to access appointments at the other practice sites in the event that there are no appointments available at their registered practice. In addition, patients can access additional services such as physio support and nursing at home services. Patients also have the choice of male and female GPs when accessing services through the My Healthcare Hub. There are also arrangements to ensure patients receive urgent medical assistance when the practice is closed during the out-of-hours period.

Updated 22 December 2017

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Bourbrook Varsity Medical Centre on 7 December 2017. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, as part of our inspection programme.

At this inspection we found:

• The facilities and premises were appropriate for the services delivered and we observed them to be visibly clean and tidy.
• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. Clinicians assessed needs and delivered care and treatment in line with current legislation, standards and guidance.
• The practice organised and delivered services to meet patients’ needs. For example, the practice actively offered in house counselling, depression screening and further support to students who were experiencing poor mental health.
• There was evidence of adequate systems in place to support good governance. There were positive relationships between staff and teams and the practice had a culture of high-quality sustainable care.
• There were high levels of patient satisfaction at the practice.
• Patients told us they were satisfied with the service and we noted that the Care Quality Commission comment cards we received were extremely positive about the service experienced, many of the cards highlighted that the staff frequently went above and beyond for their patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 September 2016

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

• Nursing staff and GPs had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. All clinicians attended fortnightly clinical meetings.

• The percentage of patients with diabetes on the register, in whom the last diabetic reading was at an appropriate level in the preceding 12 months was 87% which was above the national average of 78%. The practice had an at risk of diabetes register before the Local Improvement Scheme was introduced and managed this effectively with an effective recall system and educating patients.

• 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. 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.

• The practice performed well in the CCG Respiratory Quality Improvement Scheme and held in-house training sessions. All clinicians at the practice attended an inhaler technique workshop.

• The practice held an annual flu day to which eligible patients were invited. This involved both the clinical and the administration teams as well as outside agencies. For example at the last flu day health trainers and a local safety officer also attended. Patients had their flu vaccines together with their blood pressure, height and weight checked. The PPG were very involved with this flu day and all proceeds from raffles went to the local hospice.

Updated 13 September 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. Immunisation rates were relatively high for all standard childhood immunisations.

• The quarterly multi-disciplinary team (MDT) meeting has helped to ensure effective communication between the practice and health visitors.

• 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.

• The practice had a comprehensive screening programme. The practice’s uptake for the cervical screening programme was 82%, which was the same as the national average. The practice wrote to patients to remind them and had an alert on the clinical system to flag a patient as overdue. Staff offered smears opportunistically when the patient contacted them over the phone and/or during a consultation.

• 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, health visitors and school nurses.

Updated 13 September 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.

• The practice kept good records to ensure that home visits were completed in a timely manner and reminders were sent by a member of the administration team if required.

• The practice had quarterly multi-disciplinary team meetings with palliative care nurses, district nurses and health visitors.

• Patients over the age of 75 were seen within seven days of hospital discharge and had full medication reviews to ensure all changes were updated. Patients over the age of 75 had full annual reviews.

Updated 13 September 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.

• 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.

• The practice offered in house counselling and support to students who had mental health problems such as anxiety and stress.

• The practice offered extended hours on Saturday mornings for the convenience of working people.

• The practice offered sexual health services. Three of the GPs were able to fit implants and coils.

• The practice offered COPD spirometry screening offered to smokers age 40+

• As the practice was very busy in September and October with new student registrations from the university the practice used their conference rooms for a few weeks over this period to help overseas students with registrations. Members of staff were also there to educate students about the NHS and choosing appropriate services. This helped the practice to keep A&E attendance low. It also meant that the impact on the reception area could be minimised in spite of a large number of people registering.

Updated 13 September 2016

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

• 96% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was above the national average of 84%.

• The percentage of patients with mental health problems who had a comprehensive, agreed care plan documented in their record in the preceding 12 months was 90 % which was above the national average of 88%.

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

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. The practice referred patients with mental health needs to the Edgbaston Well Being Hub if considered appropriate.

• The practice had a system in place to follow up patients who had attended A&E 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. All staff had carried out mental capacity training.

Updated 13 September 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 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.

• 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. All staff at the practice had recently completed domestic violence awareness training.