Archived: Yardley Wood Health Centre

Updated 13 February 2017

Yardley Wood Health Centre is a well-established GP practice that has operated in the area for many years. It serves approximately 9,500 registered patients and has a general medical services contract with NHS Birmingham Cross City CCG. It is located in an area of Birmingham considered to be within the third most deprived decile. According to information taken from Public Health England, the patient population has a higher than average number of patients aged 65 and over compared to the practice average across England and a higher than average number of patients with a long standing health condition.

The practice team consists of four GP partners, of which two are male and two female (one additional GP recently retired), four salaried GPs, a registrar, four practice nurses, one healthcare assistant, two phlebotomists and a pharmacist. The clinical team are supported by a practice manager, reception team, housekeepers and administrators. It is a training practice linked with the University of Birmingham involved with the training of GPs and teaching medical students.

The opening times for the practice are Monday to Fridays from 8am to 6pm except on Thursdays when it opens at 7am for pre-booked appointments. Appointments are not available between 12.45pm and 2pm when the practice closed to patients over lunchtime or on Thursday afternoons. When the practice is closed, a service is available to patients from the local out of hour’s service provider. Clear information was available to advise patients of this or where to find the nearest walk in centre or access emergency health care.

At the time of the inspection, the practice was amending their CQC registration to reflect the changes within the partnership in accordance with the CQC (Registration) Regulations 2009.

Updated 13 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Yardley Wood Health Centre on 10 October 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 and recording significant events.
• There was a clear leadership structure, a strong commitment to teamwork and staff told us they felt valued, informed and involved in improving the service.
• 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 said 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.
• Patients said they found it easy to use the new GP triage system that had been implemented in July 2016. Patients told us this had made access to an appointment much better and they could always get an urgent appointment the same day. Pre- bookable appointments with a named GP were usually accessible within three weeks.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• The practice should continue to make improvements to the appointment system and access to the practice by telephone in order to improve patient satisfaction rates.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 February 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.

• The practice provided active management and support to patients taking long term anticoagulation medicines. This extended to a number of patients registered at other practices in the local area.

• Performance for diabetes related indicators was similar to national average scoring 85%. This was 6% below CCG and 5% below national average scores.

• Longer appointments and home visits were available when needed.

• All 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 13 February 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. Immunisation rates were relatively 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, and we saw evidence to confirm this.

• The practice’s uptake for the cervical screening programme was 81% which was similar to the CCG average of 84% and the national average of 81%.

• Appointments were available outside of school hours and the premises were suitable for children and babies and included a baby room where parents could talk with health professionals or other parents while their children played.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 13 February 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 in partnership with other health and social care professionals.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• Twice weekly ward rounds were completed at a local nursing home that was supported by the practice. This enabled proactive management of patient’s needs.

• Two members of the management team led a local pilot project (ACE). The scheme was aimed at older people who had not had contact with their practice for 12 months or lived alone. A community team visited and completed a full health assessment. Results were shared with the GP for further action.

Updated 13 February 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 reflects the needs for this age group.

Updated 13 February 2017

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

• According to the quality and outcomes framework results for 2015/2016, 84% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months. This compared to 84% CCG and a national average of 84%.

• The overall performance for mental health related indicators was slightly better than average scoring 89%. This was 2% lower than CCG and 3% lower than national average scores.

• 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 13 February 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 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.

• The practice used a special coding system on the patient records system. This alerted staff that the appointment should not be cancelled. For example if the patient was a carer or required the appointment to receive test results.
• The practice had identified that 3% of their registered patients were also carers and provided then with appropriate support.