Cornhill Surgery

Updated 5 April 2017

Cornhill Surgery is situated in Rubery in Birmingham. The practice has a list size of approximately 5,500 patients.

The practice has a car park for patients and staff to use.

The practice has three GP partners and one salaried GP (two male and two female offering patients their preferred choice). The practice has two practice nurses and a healthcare assistant (HCA) who is also a phlebotomist (takes blood).

The clinical team are supported by a practice manager and a team of reception and administrative staff.

The practice has a Patient Participation Group (PPG), a group of patients registered with a practice who work with the practice team to improve services and the quality of care.

Cornhill Surgery is a training practice providing up to two GP training places. A GP trainee is a qualified doctor who is training to become a GP through a period of working and training in a practice. Only approved training practices can employ GP trainees and the practice must have at least one approved GP trainer. The practice is also a teaching practice and provides placements for medical students who have not yet qualified as GPs.

The GPs undertake minor surgery such as joint injections, incision and drainage of cysts and abscesses.

The practice is open at the following times:

• Monday 8am to 1pm and 1.45pm to 6pm
• Tuesday 8am to 1pm and 1.45pm to 6pm
• Wednesday 6.45am to 1pm and 1.45pm to 5pm
• Thursday 6.45am to 1pm and 1.45pm to 6pm
• Friday 8am to 1pm and 1.45pm to 6pm

The practice does not provide out of hours services beyond these hours. Information for NHS 111 and the nearest walk in centre is available on the practice website and on the practice leaflet. There was a locally agreed contract in place with Care UK, the out of hours provider, to answer calls from patients when the practice is closed.

Updated 5 April 2017

Letter from the Chief Inspector of General Practice

We carried out a focused desk based inspection of Cornhill Surgery on 21 February 2017 to check that action had been taken since our previous inspection on 28 June 2016. At the inspection in June 2016, the practice was rated as good overall but rated as requires improvement for providing safe services.

We found that the practice required improvement in this area due to a breach of regulation relating to safe care and treatment. This was because:

• the practice had not undertaken a Legionella risk assessment, therefore the risk to patients and staff of infection by the Legionella bacteria had not been established.

On 21 February 2017 we reviewed the information the practice submitted to us to ensure that they had followed their action plan and to confirm that they now met legal requirements. This report covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection of Cornhill Surgery on our website at www.cqc.org.uk.

Our key findings for this inspection were as follows:

The provider had made improvements:

• They had commissioned the services of an external contractor to carry out Legionella testing, and had continued to receive ongoing regular assessments from them.

The provider had also addressed all areas which had been identified that actions should take place to improve practice which are detailed in the report.

The practice is now rated good for providing safe services.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 7 September 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff and GPs had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Patients with long term conditions were on a register and invited for annual reviews. The practice looked after patients with long-term conditions including diabetes, asthma and Chronic Obstructive Pulmonary Disease (COPD).

• The practice participated in the Quality and Outcomes Framework (QOF) and consistently scored highly due to the way they managed patients with long-term conditions. The practice had recently started running extended asthma clinics for more in depth reviews.

• A daily phlebotomy (blood-taking) service was provided.

Updated 7 September 2016

The practice is rated as good for the care of families, children and young people.

• There were systems in place to follow up on children the practice was concerned about, for example children who did not attend for appointments. Computerised alerts had been put in the notes of those patients where there were safeguarding concerns. The child safeguarding register was reviewed with information from the health visitors regularly.

• Appointments were available outside of school hours with GPs and nurses and the premises were suitable for children and babies. We saw positive examples of joint working with midwives, health visitors and school nurses. Same day appointments were always provided for children aged five and under.

• The practice’s uptake for the cervical screening in the last five years was 81% which was in line with the national average. There was a policy to offer telephone reminders for patients who did not attend for their cervical screening test.

• Antenatal and postnatal checks were carried out in the practice with the support of the midwives. The practice had baby changing facilities. The baby immunisations were tied in with the post-natal checks to reduce the number of visits needed.

• Childhood immunisation rates for the vaccinations given were comparable to the CCG averages. For example, for the vaccinations given to under two year olds ranged from 88% to 94% compared with the CCG average of 82% to 99% and five year olds from 88% to 94% compared with the CCG average of 94% to 97%.

• Patients were able to book appointments and order their repeat prescriptions online if they chose to.

• The practice offered an in-house provision of coils and contraceptive implant fitting which avoided the need to attend a family planning clinic.

Updated 7 September 2016

The practice is rated as good for the care of older patients.

• The practice offered personalised care to meet the needs of older patients in its population and had a range of enhanced services for example, unplanned admissions. The GPs met on a weekly basis and unplanned admissions were discussed.

• The practice co-ordinated care via monthly multi-disciplinary team meetings with district nurses and community matrons. The practice adopted the palliative care Gold Standards Framework (GSF). GSF is a systematic, evidence based approach to optimising care for all patients approaching their end of life. Advanced care plans were created to ensure that patients’ wishes were taken into consideration.

• Whenever possible, the practice conducted health reviews and tests on the same day for patients with multiple conditions to save them having to attend for repeated visits. The practice offered same day telephone consultations and appointments when required.

• One of the GP partners sponsored a weekly social group for older patients at community centre. On average 30 people attended per week. Patients were able to bring friends from different practices if they wished.This took place every Wednesday afternoon. The patients were given refreshments and played games such as bridge and chess. The GPs sometimes organised for external speakers to speak with the group.

Updated 7 September 2016

The practice is rated as good for the care of working-age people (including those recently retired and students) and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

• The practice sent out text messages to remind patients of their appointments and also when there were any health campaigns such as flu vaccinations.

• The practice offered extended hours on a Wednesday and Thursday morning. There was also a walk-in clinic on Monday mornings to extend patients on the day opportunities to see a GP.

• Telephone advice was available each day from a GP if required.

• Minor surgery and joint injections were done in-house to prevent the need for patients to go to secondary care.

• Family planning services were offered at the practice.

• There was a daily phlebotomy (blood taking) service.

Updated 7 September 2016

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

• The practice proactively screened patients for dementia. Patients with memory problems were routinely referred to the memory clinic.

• The percentage of patients diagnosed with dementia whose care has been reviewed in a face-to-face review in the preceding 12 months was 83% which was in line with the national average of 84%.

• Longer appointments were available for patients with poor mental health.

• There were alerts on patients’ records where it was known extra time would be needed for consultations. All staff at the practice had completed the dementia awareness training. Patients on the mental health register and those with dementia had comprehensive care plans and received annual health checks.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 7 September 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• All patients with a learning disability were offered an annual health check and longer appointments were allocated. The practice had 12 patients on the learning disability register and 10 of these had received their annual health check in the last year.

• Home visits were provided to elderly, disabled and housebound patients.

• Patients whose first language was not English were supported by involving interpreters. Longer appointments were provided as required.

• All of the practice team had received deaf awareness training and had ordered a hearing loop following this training. All patients with a hearing or visual impairment were highlighted on the system and alerts were put on so that patients were collected from the waiting area.

• The practice had monthly multi-disciplinary team meetings in order to identify and manage the on-going care of vulnerable patients, including adopting the gold standards framework for palliative care and management of safeguarding issues. The palliative care meetings took place on a quarterly basis. GPs regularly attended Child Protection Case Conferences.

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.