Archived: Coventry Road Medical Centre

Updated 22 September 2016

• Coventry Road Medical Centre provides primary medical services to approximately 5200 patients in the local community and is the largest of four registered practices under the provider known as Heathford Group.
• The site works closely with its three other locations two of which are located less than a mile away and patients are able to attend one of the other practice locations if necessary..
• The practice has a General Medical Services (GMS) contract. The GMS contract is a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract.
• The practice has four male GP partners, three female salaried GP’s, two practice nurses, a practice manager and an administration and reception team. Most reception staff are also trained as healthcare assistants (HCA).
• Coventry Road Medical Centre is an approved training practice for trainee GPs. The practice has three qualified GP trainers who provide training to newly qualified doctors at the practice. The practice also provides medical education for Foundation Year Two (FY2) doctors. FY2 doctors undertake a two-year, general postgraduate medical training programme which forms the bridge between medical school and specialist and general practice training. The practice also provides training opportunities for student nurses wanting to gain experience of general practice.
• The practice is open between 8.45am and 6pm Monday to Friday except for Thursday afternoons when the practice closes at 12.30pm. Appointments take place from 9am to 12.30am every morning and 3pm to 6pm (or 12.30pm on a Thursday) daily.. Extended hours are not offered at this practice although patients are able to visit one of the other locations which does offer extended hours once a week from 6.30pm to 9.30pm. In addition to pre-bookable appointments that can be booked up to one week in advance, urgent appointments are also available for people that need them.
• The practice does not provide an out-of-hours service but has alternative arrangements in place for patients to be seen when the practice is closed. For example, if patients call the practice when it is closed, an answerphone message gives the telephone number they should ring depending on the circumstances.
• The practice’s patient profile is much younger than the national average with higher numbers of the patients aged 18 years or under and less numbers of patients aged 65 years or older.
• Data from Public Health England shows that the practice is located in an area where income deprivation is at the highest level.

Updated 22 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced focused inspection at Coventry Road Medical Practice on 19 August 2016. Overall the practice is rated as good.

During our previous inspection of the practice on 15 October 2015 the practice was rated requires improvement for the safe domain. The practice was issued with a two requirement notices for breaches in regulation 12 (Safe care and treatment) and regulation 19 (Fit and proper persons employed) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

This inspection was to review the action taken by the provider to meet the regulatory requirements where we had identified breaches and to report on the action taken. For this reason we have only rated the location for the safe domain. The report should therefore be read in conjunction with the full inspection report published in March 2016.

At this inspection we found the practice had made changes since their previous inspection in October 2015. We found that sufficient action had been taken regarding the issues identified and that the practice was now meeting the requirements of the breaches identified. This meant that the practice was now rated as good in safe domain. All other domains were previously rated as good.

Specifically we found that since the last inspection, the practice had:

• The practice had ensured the recruitment policy was being properly implemented to make certain that all necessary employment checks for staff such as evidence of satisfactory conduct in previous employment were being carried out. We saw evidence to demonstrate that these processes were being followed.
• The practice had fully assessed the decision to not keep some nationally recommended emergency medicines at the practice. Alternative arrangements with a local pharmacy were in place.
• The practice had carried out a risk assessment related to the decision not to carry emergency medicines when undertaking home visits. Alternative formal arrangements with a local pharmacy were in place.
• Risks to patients were assessed and well managed. A legionella risk assessment had recently been completed and the practice were in the process of implementing the recommendations.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 March 2016

• The GPs and nursing staff worked together in chronic disease management and patients at risk of hospital admission were identified as a priority. Care plans were in place for people with long-term conditions.

• Performance for diabetes related indicators was slightly above the CCG and national average (overall practice average of 87% compared to a national average of 84%).

• Longer appointments and home visits were available when needed.

• Patients were offered a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, their named GP worked with relevant health and care professionals to deliver a multi-disciplinary package of care.

Updated 3 March 2016

• 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 low for a number of the standard childhood immunisations. For example, childhood immunisation rates for vaccinations given to under two year olds ranged from 11% to 43% and five year olds from 52% to 90% for the practice which was much lower than the CCG rates of 80% to 95% and 87% to 96% respectively. The practice informed us that they were in discussions with the CCG regarding these figures as they believed this was being caused by a computer system error which was being investigated. 82%, which was the same as the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

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

Updated 3 March 2016

• The practice offered proactive, personalised care to meet the needs of the older people in its population. Patients with complex needs or recurrent admissions were discussed in monthly multi-disciplinary team meetings and offered extra support.

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

• Patients over 75 years of age were offered annual health reviews.

• Flu vaccination rates for the over 65s were 68% which was lower than the national average of 73%.

Updated 3 March 2016

• 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.

• Patients were able to access appointments at times suitable to them at any of the four practices within the Heathford Group. One of the four practice locations also provided extended hours.

• Requests for repeat medicines could be ordered online

Updated 3 March 2016

• Performance for mental health related indicators was similar to the national average (practice average of 90% compared to a national average of 89%).

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• Staff had a good understanding of how to support people with mental health needs and dementia. The GPs had completed Mental Capacity Act 2005 training and understood the relevant consent and decision-making requirements of legislation and guidance.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

Updated 3 March 2016

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

• Alerts were placed on patients care records so that staff were aware these patients may require a priority appointment or longer appointment times.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• The practice had informed vulnerable patients about how to access various support groups and voluntary organisations.

• Staff were able to demonstrate that they were aware of their responsibilities regarding safeguarding and had the appropriate knowledge to do this effectively. All staff had received training relevant to their role, for example GPs were trained to Safeguarding level 3.