Archived: Handsworth Medical Practice

Updated 4 February 2016

Handsworth medical practice provides primary medical services to approximately 4000 patients in the local community. The practice was a partnership between the GP (male) and the practice manager. The GP is supported by a practice nurse and one health care assistant. The non-clinical team consists of reception staff and the practice manager.

The practice has a General Medical Services contract (GMS) with NHS England. A GMS contract ensures practices provide essential services for people who are sick as well as, for example, chronic disease management and end of life care. The practice also provides some directed enhanced services such as minor surgery, childhood vaccination and immunisation schemes. Enhanced services require an enhanced level of service provision above what is normally required under the core GP contract.

The practice opening times are 9am to 12pm Monday to Fridays and 4pm to 6pm Mondays, Tuesdays and Fridays. The practice is closed in the afternoons on Wednesdays and on Thursdays the practice is open from 5.30pm to 8.30pm.

The practice has opted out of providing out-of-hours services to their own patients. This service is provided by an external out-of-hours service provider when closed.

The practice had joined a GP partnership consisting of 32 practices. However, this still allowed the practice to retain their individual identity.

We reviewed the most recent data available to us from Public Health England which showed that the practice is located in an area of high deprivation score compared to other practices nationally. Data showed that the practice has a higher than average practice population aged between 20 and 35 years in comparison to other practices nationally. The practice also has a lower than the national average number of patients aged 55 years and over.

The practice achieved 100% points for the Quality and Outcomes Framework (QOF) for the financial year 2014-2015. This was above the national average of 94%. The QOF is a voluntary annual reward and incentive programme which awards practices achievement points for managing some of the most common chronic diseases, for example asthma and diabetes.

Updated 4 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Handsworth Medical Practice on 17 December 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they found it easy to make an appointment and they were treated with compassion, 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.
• 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 areas where the provider should make improvement are:

• Ensure Control of Substances Hazardous to Health (COSHH) risk assessments are made available toall staff.

• Ensure audits have standards and where appropriate cycles are complete.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 4 February 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 the practice took part in the unplanned admissions enhanced service to identifying those with high needs and contacting them after hospital discharge to offer help and support. Longer appointments and home visits were available when needed. As there was one GP partner all patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 4 February 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. Appointments were available outside of school hours and children were given appointments as a priority. The premises were accessible for parents with small children and babies using pushchairs. Sexual health advice and screening was available and patients were informed of this. We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 4 February 2016

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. For example, the practices flu target for Over 65’s was being well met. 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 dementia; end of life care and for unplanned admissions. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. The text size on the practice website could be adjusted for those with difficulties with their vision.

Updated 4 February 2016

The practice is rated as good for the care of working age people (including those recently retired and students). The needs of this patient population had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. For example, late night appointments were available for working age patients until 6.30pm. The practice offered online services and telephone consultations as well as a full range of health promotion and screening that reflected the needs of this age group. They included NHS health checks for patients aged 40 to 74, cervical cytology for eligible women as well as tests to detect prostate cancer in men.

Updated 4 February 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). We saw that there were 37 patients on the mental health register and the practice had carried out annual physical health checks for most of those on the register with an agreed care plan. The practice regularly worked with multidisciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The practice carried out patient health questionnaires to monitor the severity of depression and response to treatment. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. Information was made available at the practice to sign post patients to various support groups and services as well making referrals to healthy minds and the Community Psychiatric Nurse (CPN). It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health.

Updated 4 February 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. We saw that there were 14 patients on the learning disability register and the practice had carried out annual health checks for most of those on the register. It offered longer appointments for people with a learning disability. The practice worked with multidisciplinary teams in the case management of vulnerable people. It had told 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.