Harborne Medical Practice

Updated 18 January 2017

Harborne Medical Practice is a purpose-built premises situated in Harborne, Birmingham and serves patients within the residential suburban district in south-west Birmingham. The practice is part of the Birmingham South Central CCG. The practice is well served by the local bus network and there is accessible parking. The practice and facilities are suitable for those with a physical disability including wheelchair users.

The practice provides primary medical services to approximately 10,592 patients in the local community.

The practice address is 4 York Street, Birmingham, Birmingham, B17 0HG.

The clinical staff team consists of six partners (two female and four male) and one female salaried GP. The clinical team is supported by a practice manager, 13 administrators, one advanced nurse practitioner, three practice nurses, one Phlebotomist and one health care assistant.

Opening Hours for appointments (phone lines are 8am to 6:30pm and Reception hours are 8am to 6:30pm) are: Monday 8:30am to 6pm (closed 12 - 1pm), Tuesday 7:30am to 7:30pm, Wednesday 8:30am to 6pm, Thursday 7:30am to 6pm and Friday 8:30am to 6pm.

Out of hours services are provided by the Primecare Birmingham Cross City 111 service.

Updated 18 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Harborne Medical Practice on 14 December 2016. Overall the practice is rated as Good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting, recording and discussing significant events.
• Risks to patients were assessed and well managed.
• 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.
• Patients CQC feedback cards commented that 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. Improvements were made to the quality of care as a result of complaints and concerns.
• The practice had appropriate 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 had an active patient participation group which influenced practice development.
• There was a strong focus on continuous learning and improvement at all levels.
• The provider was aware of and complied with the requirements of the duty of candour.
• The practice hosted a pilot DWP (Department for Work & Pensions) outreach service. This demonstrated excellent partnership working enabling patients from the practice to transform their lives. Examples included 30 patients who were given work experience, accessed education, obtained volunteering experience and paid employment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 January 2017

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 patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was similar to the CCG and national averages. For example 94% of patients with diabetes on the register received influenza immunisation in the last 12 months compared with CCG and national averages of 94%. The practice’s exception reporting rate for this indicator was 13% compared with the CCG average of 17% and the national average of 18%.
• Longer appointments and home visits were available when needed.
• These patients had a named GP and a structured annual review to check their health and medicines needs were being met. 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 18 January 2017

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 accident and emergency attendances.
• Immunisation rates were high for all standard childhood immunisations.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• Breast feeding facilities are available with signage in reception.
• The practice provided combined parent and baby clinics carrying out post-natal and early child development checks.
• We saw positive examples of engagement and joint working with midwives and health visitors.
• The practice offered seven days a week appointments working with the Prime Ministers Challenge Fund. This meant that the patients had access to book ahead appointments from 8am to 8pm seven days a week with a GP who would have access to their records through a data sharing agreement.
• The practice offered an emergency contraception service to young people on a daily basis.

Updated 18 January 2017

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population.
• 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 69 registered patients that were house bound and made regular visits to these patients in their homes; for example to provide joint injections when necessary.
• The Advanced Nurse Practitioner visited the elderly in their own homes from 8am to 6:30pm four days per week. A GP carries out the home visits 8am to 6.30pm on the other day of the week.
• The practice directed older people to appropriate support services.
• All patients aged 75 and over were offered an annual health check.
• The practice had regular contact with six nursing homes in the area with clinical sessions on a weekly basis. Two nursing homes with complex patients receive weekly ward rounds by the Advanced Nurse Practitioner or a GP.

Updated 18 January 2017

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 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 reflected the needs for this age group. At present 29% of their patients were registered for online services.
• Appointments were offered to accommodate those unable to attend during normal working hours.
• Performance for cervical indicators was comparable to CCG and national averages. For example the percentage of women aged 25-64 receiving a cervical screening test in the last five years was 82% compared with CCG and national averages of 80% and 82% respectively.

• The practice provided support for the young students at Queen Alexandra College which provides education for 16 to 25 year olds with disabilities as well as a supported living programme.

Updated 18 January 2017

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

• Performance for mental health related indicators was higher than CCG and national averages. For example, the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the last 12 months was 92% compared with CCG and national averages of 91% and 88% respectively.
• 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.
• The practice had a system in place to follow up patients who had attended accident and emergency 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.

Updated 18 January 2017

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 homeless people, travellers and those with a learning disability.
• The practice had 41 patients registered as having a learning disability and had completed health checks for 33 (80%) of these patients in the last 12 months.
• The practice offered longer appointments for patients with a learning disability (up to 30 minutes).
• 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.
• Staff told us they 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’s computer system alerted GPs if a patient was also a carer. The practice had identified 173 patients as carers (2% of the practice list).
• The practice had participated in a pilot programme and had worked with an in-house DWP advisor who sought referrals from GPs who had identified patients who struggled to obtain work; whether it was related or unrelated to a medical condition. This showed the practice had a wide and holistic view of health as work (paid or voluntary) has been generally considered to be beneficial to an individual’s overall wellbeing.