St Heliers Medical Practice

Updated 20 December 2019

St Heliers Medical Practice is situated in a purpose built health centre, known as Northfield Health Centre, in the Northfield area of Birmingham. The health centre is shared with other community health services including health visitors, school nurses and district nurses.

Public Health England data ranks the levels of deprivation in the area as two out of 10, with 10 being the least and one being the most deprived. Approximately 17,400 patients are registered with the practice.

Up until 1 April 2019, two GP practices worked within Northfield Health Centre: St Heliers Medical Practice (which was also known as Dr Ross and Partners) and Dr Ali and Partners. On the 1 April 2019, the two practices joined together in an official merger to create a single practice working from Northfield Health Centre. The newly formed practice is known as St Heliers Medical Practice.

The service is registered to provide the regulated activities of Diagnostic and screening procedures, Maternity and midwifery services, Surgical procedures, Family planning and the Treatment of disease, disorder or injury.

The practices clinical team consists of seven GP partners and 10 salaried GPs; the GP team contains a mix of male and female GPs, one of the GP partners is also the CQC Registered Manager. There are four female practice nurses, one of which is a lead nurse at the practice. There are also two healthcare assistants (both female) and a male phlebotomist.

In addition to the GP partners, the management team includes an executive manager and managers for service management, IT, building management, and compliance and training. Each manager has defined areas of responsibility which include managing the practices administration, reception and secretarial teams.

The practice is open for appointments between 8am and 6.30pm on Mondays and Fridays, on Tuesdays to Wednesdays the practice is open for appointments from the earlier time of 7am to the to 6.30pm when the practice offers extended hours of a morning. Appointments are also available during evenings and weekends through the practices extended access arrangements with the MyHealthcare Hub. In addition, telephone consultations are available at the practice between 6.30pm and 7.30pm on weekday evenings. There is a GP on duty each weekday from 8am to 6.30pm for urgent appointment needs. At all other times, patients are referred to the NHS 111 service or the local walk in centre.

Updated 20 December 2019

We carried out an announced inspection of St Heliers Medical Practice on 21 November 2019. We carried out an inspection of this service following our annual review of the information available to us including information provided by the practice. Our review indicated that there may have been a significant change to the quality of care provided since the last inspection.

This inspection focused on the following key questions: Safe, Effective, Caring, Responsive and Well-led. This included how the practice provided effective and responsive care across the six population groups. The six population groups are:

• Older people
• People with long-term conditions
• Families, children and young people
• Working age people (including those recently retired and students)
• People whose circumstances may make them vulnerable
• People experiencing poor mental health (including people with dementia)

Up until 1 April 2019, two GP practices worked within Northfield Health Centre: St Heliers Medical Practice (which was also known as Dr Ross and Partners) and Dr Ali and Partners. On the 1 April 2019, the two practices joined together in an official merger to create a single practice working from Northfield Health Centre. Following which, Dr Abad Ali joined St Heliers as a GP partner. The newly formed practice is known as St Heliers Medical Practice.

You can read the reports from our last inspections by selecting the ‘all reports’ link for Dr Ali & Partners and for St Heliers Medical Practice on our website at www.cqc.org.uk.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

Following this inspection we have rated the practice as good for providing Safe, Effective, Caring, Responsive and Well-led services. This includes how the practice provides effective and responsive care to the six population groups. Therefore, the practice is rated as good overall.

We found that:

• There were clear and effective processes for managing risks and the practice had clear systems, practices and processes to keep people safe and safeguarded from abuse.
• The practice had systems for the appropriate and safe use of medicines, including medicines optimisation.
• There was evidence of systems and processes for learning and continuous improvement. The practice worked together and with other organisations to deliver effective care and treatment.
• The practice had a clear vision and credible strategy, they involved the public, staff and external partners to sustain high quality and sustainable care.
• Feedback and survey responses were positive about meeting patient needs and about the way staff treated people. Staff described the practice as a positive, friendly and an open environment in which to work.
• To ease patient anxiety, the practice developed bespoke letters to inform patients and provide further guidance following blood tests, as well as for other areas such as appointments for medicines reviews. We noted that the letters were informative and where appropriate also gave additional advice for areas such as nutrition and lifestyle.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• Continue with efforts to improve uptake of cervical cancer screening.
• Record the cleaning of medical equipment in line with good record keeping for infection prevention and control.
• Continue to engage patients experiencing poor mental health (including dementia) in attending appointments for reviews and care planning.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Updated 10 September 2015

The practice is rated as good for the care of people with long-term conditions. Clinical staff (GPs and nurses) took lead roles in the management of chronic diseases management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients had a named GP and structured annual reviews were carried out to check that their health and medication needs were being met. For those people with the most complex needs, the GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 10 September 2015

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. There was close working with health visitors who operated from the same health centre as the practice and follow-up of children who did not attend for immunisations. Immunisation rates were relatively high for all standard childhood immunisations. Services were co-ordinated to make it easier for parents. For example weekly one stop children and mother service enabled patients to see the health visitor at the same time as GP development checks. Appointments were available outside of school hours and the premises were suitable for children and babies. Children under five years would be prioritised for same day appointments.

Updated 10 September 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people with complex care needs. Vaccination including flu, pneumonia and shingles were available and the practice was above the CCG average for uptake of flu vaccinations in patients over the age of 65 years. There were locally enhanced services for older patients including unplanned admission avoidance and dementia. There was a designated lead for end of life care and systems in place to support the needs of patients at end of life including monthly multidisciplinary meetings. Home visits and same day appointments were available to those who needed them.

Updated 10 September 2015

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 offered services that 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.

Updated 10 September 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice had a lead GP for the management of patients with poor mental health. Patients experiencing poor mental health were offered annual physical health check and 93% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan in 2013/14. Patients requiring additional support were signposted to various support services including in-house counselling. The practice had systems in place to support safer prescribing of patients on medicines for example shorter or non-repeat prescriptions for patients on antidepressants.

The practice worked with multi-disciplinary teams in the management of people experiencing poor mental health, including those with dementia. The practice provided locally enhanced services for patients with dementia to support earlier referrals to specialist care.

Updated 10 September 2015

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 and carers. Over the last year the practice had sought to identify and increase the number of patients on these registers. The practice confirmed that they had not yet carried out annual health checks for people with a learning disability but were currently working with the CCG priorities to identify and issue health passports to patients with a learning disability to identify needs and preferences should they be admitted to hospital. Carer support and signposting to other support services was also being offered to those identified as carers. Where a need was identified patients at the practice gave longer appointment. There was a general ethos at the practice not to turn people who way that needed support and reception staff were aware of this.

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.