Dr Manjit Singh

Updated 12 December 2018

Dr Manjit Singh’s practice also known as Cambridge Street surgery is a practice located in West Bromwich an area of the West Midlands. The surgery has good transport links and there is a pharmacy located nearby.

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services, surgical procedures and treatment of disease, disorder or injury.

Dr Manjit Singh’s surgery is situated within the Sandwell & West Birmingham Clinical Commissioning Group (CCG) and provides services to 3,000 patients under the terms of a general medical services (GMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.

The provider is a single handed male GP who registered with the CQC in April 2013. The practice employs a number of regular male and female locum GPs, a part time nurse and a number of administration staff.

The National General Practice Profile states that 57% of the practice population is from a white background with a further 29% of the population originating from an Asian background. Information published by Public Health England, rates the level of deprivation within the practice population group as two, on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. Male life expectancy is 76 years compared to the national average of 79 years. Female life expectancy is 81 years compared to the national average of 83 years.

Dr Singh’s practice is open between 8am and 6.30pm Monday to Friday. Extended hours appointments are available to all patients at additional locations within the area as the practice is a member of a GP federation: Monday to Friday 6.30pm until 8.30pm and on Saturday and Sunday 10am until 1pm. Additional out of hours care is accessed by calling the NHS 111service.

Updated 12 December 2018

We carried out an announced focused inspection on 15 November 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations we identified in our previous inspection in March 2018 where breaches of the Health and Social Care Act 2008 were identified. You can read the report from our last comprehensive inspection on 18 October 2017; by selecting the ‘all reports’ link for Dr Manjit Singh on our website at www.cqc.org.uk. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Our judgement of the quality of care at this service is based on a combination of what we found when we inspected, information from our ongoing monitoring of data about services and information from the provider, patients, the public and other organisations.

I have rated this practice as good overall.

This means that:

• People were protected from avoidable harm and abuse and that legal requirements were met.
• The provider had implemented a system to ensure the safety of blank prescription pads on the premises.
• The provider had processes in place to gain assurances through relevant checks that staff were competent for their role prior to employment.
• Patients had good outcomes because they received effective care and treatment that met their needs.
• The provider had reviewed all non clinical staff immunisation status to mitigate risk to both patients and staff.
• Patients were supported, treated with dignity and respect and were involved as partners in their care.
• People’s needs were met by the way in which services were organised and delivered.
• The leadership, governance and culture of the practice promoted the delivery of high quality person-centred care.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Updated 21 September 2017

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

• Patients at risk of hospital admission were identified as a priority.
• Performance rates for all of the diabetes related indicators were lower than the local and national averages. For example, 50% of patients with diabetes had been referred to a structured education programme compared with the CCG average of 89% and national average of 92%. The practice demonstrated that improvements had been made in 2016/17.
• The percentage of patients with chronic obstructive pulmonary disease (COPD) who had had a review in the preceding 12 months was 100%; this was higher than the CCG and national averages, both 90%. The practice exception-reporting rate was 5.6%. This was lower than the CCG average of 12.6% and the national average of 11.5% meaning more patients had been included.
• Longer appointments and home visits were available when needed.
• All these patients had 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 21 September 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 A&E attendances.
• The practice’s uptake for the cervical screening programme was 81%, which was the same as the national average and higher than the CCG average of 79%. However, the practice had reported higher exceptions, 18.7%, when compared with the CCG average of 8.8% and national average, 6.5% meaning fewer patients had been included. The practice said that this was attributed to the ethnic mix of its patients (some refused the screening and others had the screening done in their country of origin).
• Appointments were available outside of school hours and the premises were suitable for children and babies. A walk-in service was offered to children throughout the day.
• The practice held a monthly clinical safeguarding meeting to which the health visitor and school nurses were invited to attend.
• The practice had an effective system in place to follow up children who failed to attend for their immunisations. Children who do not attend for appointments were followed-up as appropriate.

Updated 21 September 2017

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

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice provided a named accountable GP for patients aged over 75 years with urgent appointments available the same day.
• Patients had access to telephone appointments with the GP and home visits.
• Care plans were in place and agreed for those patients identified as being at high risk of admission / re-admission.
• The practice held regular meetings with the community healthcare team to coordinate the provision of care.

Updated 21 September 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, 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.
• The practice offered extended opening hours between 6.30pm and 7pm each week day except Wednesdays as well as telephone consultations, which included this group of patients.

Updated 21 September 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 showed for example, the percentage of patients with a diagnosed mental health condition who had a comprehensive, agreed care plan documented in their record, in the preceding 12 months was 100%. This was higher than the CCG average of 81% and national average 89%. The practice had not exception reported any patients. This was lower than the CCG average of 10.9% and the national average of 12.7% meaning more patients had been included.
• A total of 92% 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 CCG average and the national average, both 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.
• Staff had a good understanding of how to support patients with mental health needs and dementia.
• The practice held a GP led dedicated monthly mental health and dementia clinic. Patients who failed to attend were proactively followed up by a phone call from a GP.

Updated 21 September 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 carers and those with a learning disability. The practice provided carer support, signposting, information packs and completed a carer’s register.
• The practice offered longer appointments for patients with a learning disability.
• 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 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.