Archived: Wychall Lane Surgery Also known as Dr Leigh & Partners

Updated 31 October 2016

Wychall Lane Surgery is a GP practice which provides primary medical services under a General Medical Services (GMS) contract to a population of approximately 9,200 patients living in Kings Norton and surrounding areas of Birmingham. A GMS contract is a standard nationally agreed contract used for general medical services providers.

The practice operates from a spacious two storey building where consultations with patients only take place on the ground floor. There are disabled parking spaces and a ramp leading to the front door to allow access to the premises for patients with mobility difficulties and there is a bell to alert the reception for assistance.

The practice population has a higher than average number of patients aged 0 to 15 years, and slightly above average numbers for those aged 50 to 70 years. National data indicates that the area is one that experiences significant levels of deprivation. The practice population is made up of predominantly white British with pockets patients from ethnic minority groups.

There are seven GP partners, five female, and two male. The practice employ an honorary salaried female GP with a special interest in weight management, an advanced nurse practitioner, two practice nurses, a treatment room nurse, a health care assistant, a practice manager and reception manager, who are supported by a team of administrative and reception staff.

Wychall Lane Surgery is an approved training practice for trainee GPs and supports medical students from Birmingham University. A trainee GP is a qualified doctor who is training to become a GP through a period of working and training in a practice. They also support nursing students and participate in an apprentice scheme. At the time of inspection the practice had three GP trainees. A GP trainee is a qualified doctor undergoing a period of further training in order to become a GP

The practice is open on Monday until Friday between 8am and 6.30pm and there is always access to a GP during these times. The telephones are switched over between 1pm and 2pm to allow for staff handover and calls are received by the out of hours service during that time but the practice remains open. Extended hours appointments are provided from 6.30pm until 7.30pm on Mondays, Tuesdays and Wednesdays for pre-bookable appointments only. When the surgery is closed services are provided by Badger who can be contacted via NHS 111.

Updated 31 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wychall Lane Surgery on 2 September 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. Staff were aware of this and the practice as a whole demonstrated a commitment to learning from them.
• Risks to patients were assessed and well managed and there was evidence of thorough discussions regarding safety and risk issues. There was good use of information technology (IT) to facilitate management of risk in the practice. We noted that whilst there was evidence that safety alerts had been managed in the past, the ownership had not been transferred since the recent practice management changes. However, the practice addressed this immediately, initiated discussions with all the partners and introduced a system to deal with safety alerts promptly and appropriately and provided evidence of this.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance and we saw that discussions and education took place around this. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• The practice demonstrated commitment to health promotion and education of patients regarding their health and encouraged the uptake of health screening programmes.
• Patients’ satisfaction with the practice was high and patients reported they were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment. The National Patient Survey data published in July 2016 was also consistently high specifically regarding the caring aspects of the practice.
• The practice had nominated a carers champion and was actively seeking to provide information to support carers.
• Information about services and how to complain was available in the practice leaflet and on the website and was easy to understand although this was not advertised in the waiting areas. 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, although making an appointment with a preferred GP required a longer wait. Urgent appointments were available the same day and several patients we spoke with had been accommodated on the day. The practice was also part of a pilot scheme providing access to GP appointments at weekends at a local centre.
• 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 and had a policy providing guidance on this.

The areas where the provider should make improvement are:

• Continue to monitor the system re-established for managing safety alerts from the Medicines and Healthcare products Regulatory Agency (MHRA).
• Maintain an inventory of standard medicines kept in the practice.
• Continue to update policies and training in line with the practice plan.
• Ensure information about how to complain is displayed for patients to see.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 31 October 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 patients at risk of hospital admission were identified as a priority.
• The practice demonstrated positive achievements in monitoring patients with long term conditions. For example, the percentage of patients with diabetes, on the register, whose last measured total cholesterol was within the recommended acceptable level was 77% which was comparable to the CCG and national averages of 80% and 81% respectively.
• 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 31 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 high for all standard childhood immunisations.
• The practice had good use of system alerts which identified all members of the family who lived in a household where there were children at risk.
• 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.
• Cervical screening rates were above the CCG and national averages. The percentage of females aged 25-64, attending cervical screening within target period (3.5 or 5.5 year coverage, %) was 73% compared to the CCG and national averages of 67% and 74% respectively.
• Appointments were available outside of school hours and the premises were suitable for children and babies. Child health medicals and post-natal checks were offered for new mothers as well as midwife appointments.
• We saw positive examples of joint working with midwives and health visitors.

Updated 31 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.
• The practice offered screening for atrial fibrillation at flu clinics.

The practice participated in the ‘Admission Avoidance’ enhanced service and followed up patients at risk of admission to ensure their needs were being met. 

Updated 31 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 HIV testing and INR testing to reduce the need of patients to attend hospital.
• The practice used macros to remind staff to invite patients to attend for screening for national programmes such as bowel and breast screening and data showed uptake was higher than the CCG and national rates.

Updated 31 October 2016

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

• 97% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was higher than the CCG average of 87% and national average 84%.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 87% compared to the CCG and national averages of 91% and 88% respectively.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 31 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 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. There was access to councillors and alcohol misuse support.
• 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.