Parkfield Medical Centre

Updated 22 September 2016

Parkfield Medical Centre is based in Castle Bromwich, an area of the West Midlands. The practice has a General Medical Services contract (GMS) with NHS England. A GMS contract is a nationally agreed contract to 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 enhanced services such as minor surgery, childhood vaccination and immunisation schemes. The practice runs an anti-coagulation clinic for the practice patients.

The practice provides primary medical services to approximately 3,000 patients in the local community. The practice is run by a family of three GP partners (two male and one female). The nursing team consists of two practice nurses and one health care assistant. The non-clinical team consists of administrative and reception staff and a practice manager.

The practice serves a higher than average population of people aged 65 and above years. The area served has higher deprivation compared to England as a whole and ranked at five out of ten, with ten being the least deprived.

The practice has been accredited by the Royal College of General Practitioners and the University of Birmingham as a research practice. They are involved in medical research and clinical studies.

The practice is open to patients between 8.15am and 6pm Mondays, Wednesdays and Fridays, 8.15am to 12.30pm Thursdays and 8.15am to 7pm on Tuesdays. Extended hours appointments are available from 6.30pm to 7pm on Tuesdays. Emergency appointments are available daily. Telephone consultations are also available and home visits for patients who are unable to attend the surgery. The out of hours service is provided by Badger and NHS 111 and information about this is available on the practice website.

The practice is part of NHS Solihull Clinical Commissioning Group (CCG) which has 38 member practices. The CCG serve communities across the borough, covering a population of approximately 238,000 people. (A CCG is an NHS Organisation that brings together local GPs and experienced health care professionals to take on commissioning responsibilities for local health services).

Updated 22 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Parkfield Medical Centre on 5 July 2016. Overall the practice is rated as Good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses and there was an effective system in place for reporting and recording significant events.
• Feedback from patients about their care was consistently positive. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met patients’ needs.
• 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.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
• 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.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Staff worked with multidisciplinary teams to understand and meet the range and complexity of patients’ needs. We saw evidence that multidisciplinary team meetings took place every two months.
• The provider was aware of and complied with the requirements of the Duty of Candour. The practice encouraged a culture of openness and honesty.

An area of outstanding was identified as follows:

• The practice had supported the patient participation group to set up an exercise group for older patients. This was held twice a week and was open to all patients who could only do gentle exercise or aged over 60 years. A total of 30 patients attended the exercise group. This encouraged patients to meet together and improve their well being. We saw displays in reception encouraging patients to attend.

The areas where the provider should make improvement are:

• Seek and act on feedback received from patients to demonstrate improvements to services.
• Ensure follow up of children who DNA their hospital appointments,

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 September 2016

• Longer appointments and home visits were available when needed and patients who were housebound received reviews and vaccinations at home. For example, blood tests for warfarin monitoring.
• Patients with long term conditions had a named GP and a structured annual review to check their health and medicines needs were being met.
• Two of the GPs and the practice nurse had completed the Warwick course for diabetes and the health care assistant had completed a nutrition and diet course to support diabetic patients.
• 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 22 September 2016

• 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.
• There were policies, procedures and contact numbers to support and guide staff should they have any safeguarding concerns about children.
• The practice held nurse-led baby immunisation clinics and vaccination targets were in line with the national averages.
• The practice’s uptake for the cervical screening programme was 81% which was slightly lower than the national average of 82%.
• 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. The midwife provided antenatal care once a week at the practice.

Updated 22 September 2016

• The practice offered proactive, personalised care to meet the needs of the older people in its population and offered one stop appointments for patients to receive reviews and tests in one visit.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice had systems in place to identify and assess patients who were at high risk of admission to hospital. We saw evidence that all patients had a care plan and were offered same day appointments. Patients who were discharged from hospital were reviewed to establish the reason for admission and care plans were updated.
• The practice supported the Patient Participation Group (PPG) exercise group for older people, which was held weekly. This was held twice a week and was open to all patients who could only do gentle exercise or aged over 60 years. This encouraged patients to meet together and improve their well being. A total of 30 patients attended the exercise group. We saw displays in reception encouraging patients to attend.
• The practice worked closely with multi-disciplinary teams so patient’s conditions could be safely managed in the community and also offered support and care to a local residential home.
• The practice support pharmacist carried out medicine reviews and held regular meetings with the GPs to discuss patient’s needs.

Updated 22 September 2016

• 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.
• Health trainers offered weekly sessions at the practice to educate patients on weight and healthy living.
• The practice provided a health check to all new patients and carried out routine NHS health checks for patients aged 40-74 years.
• The practice offered extended hours. Results from the national GP survey in January 2016 showed 80% of patients were satisfied with the surgery’s opening hours which was higher than the local average of 76% and the national average of 78%.

Updated 22 September 2016

• 95% 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 national average of 84%.
• 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.
• Counselling sessions were offered on a regular basis at the practice by Improving Access to Psychological Therapies service.
• 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. The practice had 20 patients on their mental health register and 80% had had their care plans reviewed in the last 12 months.

Updated 22 September 2016

• The practice held a register of patients living in vulnerable circumstances including homeless people and those with a learning disability.
• Patients on the learning disability register were screened for dementia and we saw evidence that 63% of the screening questionnaires had been completed.
• The practice offered longer appointments for patients with a learning disability and offered support and care to a local learning disability home.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations and held meetings with the district nurses and community teams every two months.
• 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.
• The practice offered longer appointments and annual health checks for people with a learning disability. There were 16 patients on the learning disability register and 81% of the patients had received their annual health checks.
• The practice had 7 patients on the palliative care register and all of the patients had a care plan in place and had regular face to face reviews. Meetings were held every two months with the MacMillan nurses to support patient care in the community.
• The practice’s computer system alerted GPs if a patient was also a carer. The practice had identified 41 patients as carers 1.36% of the practice list.