Sheldon Medical Centre

Updated 4 May 2018

Sheldon Medical Centre is based in the Solihull Clinical Commissioning Group (CCG) area. This is the partner practice to Arran Medical Centre which is about three miles away. Sheldon Medical Centre serves a population of 2747 patients living in Sheldon and the surrounding area in Birmingham. The total population for both practices is 5649 patients. Patients can attend either practice but choose to be seen at one in particular. This inspection report covers the findings of our inspection of the Sheldon Medical Centre only, however data including GP patient survey results reported on were combined from both practices. It provides primary medical services under a General Medical Services (GMS) contract. (A GMS contract is a standard nationally agreed contract used for general medical services providers.) The contract is for both practices although the two locations have separate CQC registrations and therefore we inspect and report on these services separately under each registration.

The population covered is predominantly white British, over 85%. National data indicates that the area is one that experiences significantly the highest levels of deprivation. The practice population has a significantly higher than average number of patients aged 0 to 39 years and a lower than average number of patients from the 40 to 85 years and over age groups.

The two practices are led by a GP partnership consisting of a female GP partner based at Sheldon Medical Centre and a male GP partner primarily based at Arran Medical Centre. Sheldon Medical Centre is a training practice and is currently supporting a final year medical student in gaining experience of general practice. Additional staff include a female practice nurse a phlebotomist who is training to be a healthcare assistant and a practice manager with administrative team of six staff supporting the clinical team.

The practice operates from a two storey building which has parking facilities on site. There is a disabled access approach to the main reception via a ramp and a bell with a specific ring tone to identify patients who may need assistance. This had been installed following the previous inspection. A spacious waiting area allows easy access for patients with mobility aids to manoeuvre. Consulting rooms are all located on the ground floor and office accommodation and staff facilities are located on the first floor.

The practice offers a range of clinics and services including, asthma, chronic obstructive pulmonary disease (COPD), child health and development, long acting reversible contraception and minor surgery including joint injections.

The practice has opted out of providing out-of-hours services to their own patients. If patients require a GP out of normal surgery hours a service is provided by Badger, who are an external out of hours service provider contracted by the CCG and can be accessed by the NHS 111 telephone service.

The practice is open at the following times:

• Monday: 8am to 6.30pm
• Tuesday: 8am to 6.30pm
• Wednesday: 8am to 6.30pm
• Thursday: 8am to 6.30pm
• Friday: 8am to 6.30pm

Updated 4 May 2018

This practice is rated as Good overall. (Previous inspection 20 June 2017 Requires Improvement)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students) – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We undertook a comprehensive inspection of Sheldon Medical Centre on 20 June 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The practice was rated as Requires Improvement for providing safe, responsive and well led services. The practice was required to produce an action plan to detail how they would meet the legal requirements in relation to the breaches in regulations that we identified in the June inspection. The full comprehensive report on the 20 June 2017 inspection can be found by selecting the ‘all reports’ link for Sheldon Medical Centre on our website at www.cqc.org.uk.

We undertook a further announced comprehensive inspection on 28 February 2018 to check that the provider now complied with legal requirements. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. We saw that when incidents did happen, the practice discussed these at clinical meetings and learned from them and improved their processes as a result.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect and the National GP Patient Survey results reflected this.
• In addition comment cards we received reported high levels of satisfaction with the services at the practice and patients we spoke with also provided positive feedback.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it. However we did receive feedback that it was sometimes difficult to get through to the practice on the telephone and the National GP Patient Survey results reflected this.
• There was a strong focus on continuous learning and improvement at all levels of the organisation. This is a training practice who were currently supporting a final year medical student who reported they felt well supported.

The areas where the provider should make improvements are:

• Continue to monitor patient satisfaction rates in particular in relation to access to appointments.
• Continue to monitor and improve cancer screening rates.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 August 2017

The practice is rated as requires improvement for providing safe, responsive and well led services; this affects all six population groups including people with long-term conditions.

• We saw evidence that multidisciplinary team meetings took place on a regular basis with regular representation from other health and social care services.

• We saw that discussions took place to understand and meet the range and complexity of people’s needs and to assess and plan ongoing care and treatment.

• Performance for overall diabetes related indicators was 99%, compared to the CCG average of 93% and national average of 89%.

• The practice had systems in place to identify and assess patients who were at high risk of admission to hospital. 

Updated 10 August 2017

The practice is rated as requires improvement for providing safe, responsive and well led services; this affects all six population groups including for the care of families, children and young people.

• The practice offered urgent access appointments for children, as well as those with serious medical conditions.

• 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.

• Overall child immunisation rates for under two year olds were at 91%, compared to the national standard of 90%. Immunisation rates for five year olds were ranged from 89% to 94% compared to the CCG average of 87% to 93%.

• Data from 2015/16 showed that the practice’s uptake for the cervical screening programme was 79%, compared to the CCG and national average of 81%.

Updated 10 August 2017

The practice is rated as requires improvement for providing safe, responsive and well led services; this affects all six population groups including for the care of older people.

• The practice offered home visits and urgent appointments for those with enhanced needs.

• Patients received continuity of care with a named GP and a structured annual review to check that their health and medicines needs were being met.

• Immunisations such as flu and shingles vaccines were also offered to patients at home, who could not attend the surgery.

• Patients had access to appropriate health assessments and checks. These included health checks for new patients and NHS health checks for people aged 40–74 and for people aged over 75.

Updated 10 August 2017

The practice is rated as requires improvement for providing safe, responsive and well led services; this affects all six population groups including for the care of working age people.

• Appointments could be booked over the telephone, face to face and online. The practice offered extended hours on Monday and Tuesday evenings between 6:30pm and 7:30pm.

• Patients had access to appropriate health assessments and checks. Practice data highlighted that they identified and offered smoking cessation advice to 45% of their patients and 12% had successfully stopped smoking.

• Although some steps were being taken to improve cancer screening uptake, the practice had not assessed how effective this had been and were unable to demonstrate if this had been effective.

• For example, 2015/16 cancer data from Public Health England highlighted that breast cancer screening rates for were at 44% compared to the CCG average of 72% and national averages of 72% and bowel cancer screening rates were at 48% compared to the CCG average of 59% and national average of 57%. 

Updated 10 August 2017

The practice is rated as requires improvement for providing safe, responsive and well led services; this affects all six population groups including for the care of people experiencing poor mental health (including people with dementia).

• The practice regularly worked with other health and social care organisations in the case management of people experiencing poor mental health, including those with dementia.

• Data provided by the practice during our inspection highlighted that 85% of patients diagnosed with dementia had received a review and there were ongoing reviews scheduled.

• Sixty eight percent of the practices patients on the mental health registered had received a medication and care plan review, with further reviews scheduled.

• Patients with complex needs and patients experiencing poor mental health were regularly discussed during multidisciplinary team (MDT) meetings.

Updated 10 August 2017

The practice is rated as requires improvement for providing safe, responsive and well led services; this affects all six population groups including for the care of people whose circumstances may make them vulnerable.

• There were hearing loop and translation services available.

• There were some disabled facilities in place. A notice was displayed at the front entrance to the building advising patients to call for help if they required assistance to access the building. However, there was no doorbell or clear method on how patients could call for help if needed.

• Although the practice manager had completed an equality assessment, the assessment had not considered how risk was managed in the absence of an emergency cord in the patient toilet.

• The practice had a register of patients from vulnerable groups, this included patients with a drug or alcohol dependency. These patients were frequently reviewed in the practice and 52% of their eligible patients had received a medicines review and there were further reviews planned.