Background to this inspection
Updated
21 January 2019
Dr. Arul Savio Gaspar, Dr. Akila John and Dr. Adnan Masood are the registered providers of St Clements Surgery, which is located in a multipurpose building in Nechells, Birmingham, providing NHS services to the local community. Further information about St Clements Surgery can be found by accessing the practice website at www.stclementssurgery.myhealthcare.co.uk
Based on the most recent published data available from Public Health England, the levels of deprivation in the area served by St Clements Surgery shows the practice is located in a more deprived area than national averages, ranked at one out of 10, with 10 being the least deprived.
(Deprivation covers a broad range of issues and refers to unmet needs caused by a lack of resources of all kinds, not just financial).
The practice serves a slightly higher than average patient population aged between birth to 18. The number of patients aged 65 and over is below local and national averages. Based on data available from Public Health England and 2011 Census, the Ethnicity estimate is 35% White, 7% Mixed race, 35% Asian and 21% Black.
The patient list is 5,750 of various ages registered and cared for at the practice. Services to patients are provided under a General Medical Services (GMS) contract with Birmingham and Solihull Clinical Commissioning Group (CCG). GMS is a contract between general practices and the CCG for delivering primary care services to local communities.
The surgery has expanded its contracted obligations to provide enhanced services to patients. An enhanced service is above the contractual requirement of the practice and is commissioned in order to improve the range of services available to patients.
On street parking is available with some designated parking for patients who display a disabled blue badge. The surgery has automatic entrance doors and is accessible to patients using a wheelchair and push chairs.
Practice staffing comprises of three GP partners (two male and one female) and one salaried GP (male). The clinical team also includes one practice nurse and two health care assistants. The non-clinical team consists of a practice manager and a team of administrators and receptionists.
St Clements Surgery is also a teaching and training practice providing placements for GP registrars on a six-month rotational basis. (GP registrars are qualified Doctor training to specialise in General Practice). At the time of our inspection there were two GP registrars on placement.
The practice is open between 8.30am and 6.30pm on Mondays to Fridays. With the exception of Thursdays where opening times are between 8am and 1pm.
GP consulting hours are available between 8.30am and 6.30pm Mondays to Fridays, except Thursdays where GP consulting hours are between 9am and 1pm.
The practice is part of Myhealthcare Partnership (a federation of GPs) this enabled patients to access evening appointments from five local Hubs Monday to Friday between 6pm and 8pm, as well as Saturdays and Sundays between 8am and 8pm.
The practice has opted out of providing cover to patients in their out of hours period as well as Thursday afternoons when the practice closes from 1pm. During this time, services are provided by Birmingham and District General Practitioner Emergency Rooms (BADGER) medical services. Phone lines are closed between 1pm and 3pm Monday to Fridays, during this time calls are diverted to BADGER.
Dr. Arul Savio Gaspar, Dr. Akila John and Dr. Adnan Masood have been registered to provide Diagnostic and screening procedures, Family planning services, Maternity and midwifery services, Surgical procedures, and Treatment of disease, disorder or injury at St Clements Surgery since April 2013.
The surgery was previously inspected over two days in February and March 2018 and rated overall as requires improvement.
Updated
21 January 2019
This practice is rated as good overall. (Previous rating February 2018 – 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
We carried out an announced comprehensive inspection at St Clements Surgery over two days in February 2018 and March 2018 as part of our inspection programme where the surgery was rated as requires improvement overall. As a result, we issued requirement notices as legal requirements were not being met and asked the provider to send us a report that says what actions they were going to take to meet legal requirements. The full comprehensive report of all previous inspections can be found by selecting the ‘all reports’ link for St Clements Surgery on our website at
This inspection was an announced comprehensive inspection carried out on 26 November 2018 to check whether the providers had taken action to meet the legal requirement’s’ as set out in the requirement notices. The report covers our findings in relation to all five key questions and six population groups.
At this inspection we found:
- The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
- A sample of care records showed that patients prescribed high-risk medicines as well as other medicines which required closer monitoring were being managed in line with the practice protocol, which reflected national guidance for safer prescribing.
- 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.
- The practice had a comprehensive programme of quality improvement activity which demonstrated quality improvements. Clinical leads routinely reviewed the effectiveness and appropriateness of the care provided and implemented action plans to improve any identified areas.
- The practice was aware of their 2017/18 Quality Outcome Framework (QOF) performance and taking action to improve clinical areas where performance was below local and national averages. Discussions with staff and examples provided during as well as following our inspection, confirmed this.
- Results from the 2018 annual national GP patient survey showed patients felt staff involved and treated them with compassion, kindness, dignity and respect. Completed Care Quality Commission (CQC) comment cards were in line with these views.
- The 2018 national GP patient survey showed patients did not always find the appointment system easy to use and were not always able to access care when they needed it. Completed CQC comment cards were in line with these views. The practice was aware of patients views and taking a number of actions to improve access as well as reducing waiting times. Unverified data provided by the practice following our inspection, showed improvements in patient satisfaction.
- There was a strong focus on continuous learning and improvement at all levels of the organisation. For example, the practice demonstrated shared learning and actions taken as a result of complaints and incidents.
- At this inspection, we found that the practice had reviewed and implemented systems which demonstrated a more effective systematic approach to maintaining and improving the quality of service delivery. For example, the governance framework had been strengthened which in turn supported the delivery of the strategy and oversight of processes.
The areas where the provider should make improvements are:
- Continue taking action to improve the uptake of national screening programmes and childhood immunisations.
- Establish a process to increase the number of medicine reviews carried out for patients with a learning disability and patients receiving support for substance misuse.
- Continue following actions to reduce the practice exception reporting rates.
- Continue taking action in response to patient satisfaction survey results.
Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice