Druids Heath Surgery

Updated 20 October 2016

Druids Heath Surgery is located in South Birmingham. The practice has a list size of 6,000 patients based across three sites. There is a high level of social deprivation. The practice has two branch surgeries. We had no specific information about the branch surgeries to lead us to inspect them and the inspection therefore focussed on the main site.

The practice has three GP partners and one salaried GP (two male and two female). The practice has a nurse practitioner, two practice nurses and a healthcare assistant (HCA).

Druids Heath Surgery is a training practice providing up to two GP training places. A GP trainee is a qualified doctor who is training to become a GP through a period of working and training in a practice. Only approved training practices can employ GP trainees and the practice must have at least one approved GP trainer.

The clinical team are supported by a practice manager, an assistant practice manager and a team of reception and administrative staff.

The practice has a Patient Participation Group (PPG), a group of patients registered with a practice who work with the practice team to improve services and the quality of care.

The practice holds a General Medical Services (GMS) contract with NHS England . This is a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract.

The practice is open at the following times:

Monday - 8.30am to 6.30pm

Tuesday - 8.30am to 7.30pm

Wednesday - 8.30am to 1.00pm

Thursday - 8.30am to 6.30pm

Friday - 8.30am to 6.30pm

The practice was part of the My Healthcare Hub which offered seven day access for patients when required. The practice was grouped with 23 local practices under the corporate name of My Healthcare. My Healthcare had three centres and this had been in place since September 2015.

The practice does not provide out of hours services beyond these hours. Information for NHS 111 and the nearest walk in centre is available on the practice website and on the practice leaflet. When the practice is closed on a Wednesday afternoon South Doc Services covers the calls for the practice. South Doc Services also covers the calls between 8am and 8.30am each day. The practice answerphone reflects this information and offers an alternative number to call for help. This is also highlighted in the practice leaflet and posters at the practice.

Updated 20 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Druids Heath Surgery on 17 August 2016. Overall the practice is rated as good.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. The GPs were leads in different areas and had monthly meetings to discuss concerns and share learning.

• There was a clear leadership structure and staff felt supported by the GPs and the practice manager. The practice proactively sought feedback from staff and patients which it acted on. There was a very proactive Patient Participation Group (PPG) of which we met with two members during the inspection.

• The practice was aware of and complied with the requirements of the duty of candour.

• Risks to patients were assessed and well managed, although the way some assessments were recorded and risk management measures were logged could be improved.

• Patients described staff as caring and helpful. Patients commented that they were treated with dignity and respect

• 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.

However, there were areas of practice where the provider should make improvements:

The provider should:

• Ensure that systems are in place so that risk assessments are fully documented and comprehensive.

• Ensure a comprehensive business continuity plan is in place.

• Take more proactive steps to encourage patients to engage in national screening programmes for breast and bowel cancer.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 October 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 monthly 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 78% which was the same as the CCG and national average.

• 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.

Updated 20 October 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 practice held quarterly multi-disciplinary team meetings with the health visitors to encourage effective communication.

• 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 78% which was just below the national average of 82%.

  There was a policy to offer telephone reminders for patients who did not attend for their cervical screening test.

• 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 20 October 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. Urgent home visits from the duty GP could be requested within two hours.

• The practice had quarterly multi-disciplinary team meetings with palliative care 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. Patients over the age of 75 were coded depending on risk factors and managed accordingly.

Updated 20 October 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 extended hours on Tuesday evenings until 7.30pm for the convenience of working people. The practice was part of the My Healthcare Hub which offered seven day access for patients when required. The practice was grouped with 23 local practices under the corporate name of My Healthcare. My Healthcare had three centres and this had been in place since September 2015.

• The practice offered sexual health and family planning services. One of the GPs was able to fit contraceptive implants. Patients requiring intrauterine contraceptive device (IUCD) fitting were referred to the local family planning clinic.

• The practice offered COPD spirometry screening to smokers age 40 and over

Updated 20 October 2016

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

• The percentage of patients diagnosed with dementia whose care had been reviewed in a face-to-face review in the preceding 12 months was 79% which was below the CCG average of 87% and 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 91 % which was the same as the CCG average and above the national average of 89%.

• 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 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 20 October 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 offered in-house counselling

• 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.