Gravel Hill Surgery

Updated 12 June 2017

Gravel Hill Surgery is as semi-rural practice located in the village of Wombourne. The practice is situated in a purpose built building. The practice population has low deprivation and low unemployment when compared to national averages. The practice has a list size of 7,600 of which a higher percentage are elderly patients; 24.2% are 65 and over compared to the national average of 16.7%. Life expectancy is in line with the national average.

The practice has six GP partners whose combined number of clinics is equal to four whole time equivalents. The partners are assisted by a clinical team consisting of three nurses and one healthcare assistant. The administration team consists of a practice manager, assistant practice manager, and ten supporting staff.

The practice is open from 8am to 6.30pm on Mondays. Extended hours for pre-booked GP appointments are offered each week day between 7.15am and 8am or 6.30pm and 7.15pm. When the practice is closed the telephone lines are diverted to the NHS 111 service and there is an out-of-hours service provided by Malling Health. The nearest hospitals with A&E units are situated at Dudley and New Cross Hospital, Wolverhampton.

Updated 12 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Gravel Hill Surgery on 18 January 2016. Overall the practice is rated as Good.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the Care Quality Commission (CQC) at that time.

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.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients said they were treated with 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.
• Patients told us they could get an appointment when they needed one. 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 the management. The practice proactively sought feedback from staff, patients and third party organisations, which it acted on.

• The practice provided a high number of home visits to its patients. We saw that the GPs had completed 172 home visits in November 2015 and 186 in December 2015.

We saw one area where the practice must improve. The practice must:

• Have a robust system to complete annual health checks on patients with a learning disability.

We saw one area where the practice should improve. The practice should:

• Risk assess the policy for excepting patients from receiving treatment without clinical input.

Have a robust system to account for prescription pads and forms within the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 April 2016

The practice is rated as good for the care of people with long-term conditions. Patients were reviewed in nurse led chronic disease management clinics.  We found that the nursing staff had the knowledge, skills and competency to respond to the needs of patients with long term conditions such as diabetes and asthma. Longer appointments and home visits were available when needed and reviews were coordinated to minimise the required number of patient visits. All patients with a long term condition were offered a review to check that their health and medication needs were met. Written management plans had been developed for patients with long term conditions who were at risk of hospital admissions. For those people with the most complex needs, the GPs worked with relevant health and social care professionals to deliver a multidisciplinary package of care. 

Updated 11 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 who were at risk, for example, children and young people who had protection plans in place. Appointments were available outside of school hours and the premises were suitable for children and babies. Same day emergency appointments were available for children. There were screening and vaccination programmes in place and the child immunisation rates were in line with the local Clinical Commissioning Group averages. The practice worked closely with the health visiting team to encourage attendance. New mothers and babies were offered post-natal checks.

Updated 11 April 2016

The practice is rated as good for the care of older people. Every patient over the age of 75 years had a named GP and all hospital admissions were reviewed. This included patients that resided in nursing and care homes.  The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in case management. All over 75 year olds at risk of hospital admission had a completed care plan and the practice staff had regular communication with the care plan nurse co-ordinator. The practice was responsive to the needs of older people and offered home visits and longer appointments as required. The practice identified if patients were also carers. Male patients over 65 years of age were invited to attend an abdominal aortic aneurysm screening (AAA) done at the practice (AAA screening is a way of detecting a dangerous swelling of the aorta, the main blood vessel that runs from the heart to the rest of the body).

Updated 11 April 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. A range of on-line services were available, including medication requests, booking appointments and access to health medical records. The practice offered all patients aged 40 to 75 years old a health check with the nursing team. The practice offered a full range of health promotion and screening that reflected the needs for this age group.

Updated 11 April 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Patients who presented with an acute mental health crisis were offered same day appointments. People experiencing poor mental health were offered an annual physical health check. Dementia screening was offered to patients identified in the at risk groups. It carried out advance care planning for patients with dementia.

The practice regularly worked with multi-disciplinary teams in the case management of patients with mental health needs. This included support and services for patients with substance misuse and screening for alcohol misuse with onward referral to the local alcohol service if required. The practice also worked closely with the health visiting team to support mothers experiencing post-natal depression. It had told patients about how to access various support groups and voluntary organisations and signposted patients to the advocacy service where appropriate.

Updated 12 June 2017