Archived: Hall Green Health

Updated 31 January 2017

Hall Green Health is registered to provide primary medical services. The main practice is located  in the Hall Green district of Birmingham, with a  branch surgery in Acocks Green.

The practice has a general medical service (GMS) contract with NHS England. Under the GMS contract the practice is required to provide essential services to patients.

Hall Green Health is part of the NHS Birmingham Cross City Clinical Commissioning Group (CCG). CCGs are groups of general practices that work together to plan and design local health services in England. They do this by commissioning or buying health and care services.

The practice has a registered list size of approximately 27,000 patients.  Data shows the  practice is in an area of higher deprivation compared to  the national average. 

The main practice is located in a purpose built health centre, which it shares with various services provided by Birmingham Community Health.

The practice is managed by a partnership of 15 GP partners. The clinical team also includes four salaried GPs, nine nurses (including an advanced nurse practitioner and a prescribing nurse), five healthcare assistants and three pharmacists. The practice team also includes two practice managers, receptionists, and administrative staff.

The practice is a training practice for doctors who are training to be qualified as GPs and a teaching practice for medical students.

The practice is open from 8.30 am to 6.30pm on Monday to Friday, with the exception of Wednesday when the practice closes at 1.00pm.

Appointments are available throughout the opening times. Extended opening hours are available on Saturday mornings from 8.30am to 11am, and from from 7.40am on Tuesdays and Thursdays.

The practice remains opted in for the provision of out-of-hours services for its patients, and retains overall responsibility for the standard of care received outside of normal practice opening hours, but currently subcontracts the delivery of the out of hours care to Birmingham and District General Practitioner Emergency Rooms (BADGER).

The provider's current certificate of registration issued by the Care Quality Commission includes 13 partners. Two new partners have submitted applications to be added to the provider's registration.

Updated 31 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Hall Green Health on 18 January 2016. During that inspection we found that although patients were able to obtain urgent same day appointments, they found it difficult to book routine appointments or to see or speak with their preferred GP. The practice had high levels of patients who did not attend their appointments. Whilst t he practice had put measures in place to try and improve access, this was not reflected in patient satisfaction.

In view of the above the practice was rated as requires improvement for providing responsive services.

We undertook this desk based review on 16 December 2016 to check that the provider had completed the required improvements. We did not visit the practice as part of this inspection.

This report only covers our findings in relation to the above area. You can read the report from our last comprehensive inspection, by selecting the 'all reports'link for Hall Green Health  on our website at www.cqc.org.uk.

Our finding across the area we inspected was as follows:

• The practice had responded to patients concerns and had made significant changes to improve access to appointments. For example, in response to the increase in online registration, the number and variety of available online appointments had significantly increased. The extended hours at the practice had also increased in response to feedback.
• The practice continued to review and adapt the appointment system to meet the demands on the service.
• The practice were adopting new ways of working to ensure the services are responsive to people's needs. The practice had employed three clinical pharmacists whose duties included carrying out patient medication reviews.
• To meet the demand for nurse-led services the practice had expanded the nursing team by 28%, which had increased access to various services.
• Members of the Patient Participation Group were completing an in-house satisfaction survey to obtain patients views as to the recent improvements made. 
• Information received from the provider showed a commitment to improving satisfaction results with continuous action plans, that are regularly reviewed.  Whilst the latest national patient satisfaction results relating to access to the service and appointments remained low in areas, there had not been enough time since the above improvements had been made to impact on the results. 

​ Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 April 2016

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

• The practice had experienced and trained staff to lead in the management of long term conditions, including COPD, asthma, diabetes and rheumatology.
• Reviews of long term conditions were undertaken using standardised templates. Those seen for chronic obstructive pulmonary disease and diabetes reviews exceeded the quality outcomes framework (QOF) requirements and included self-management plans.
• The practice offered in-house services to support long term condition management including spirometry, anti-coagulation clinics and diabetes insulin initiation for the convenience of patients.
• National reported data for 2014/15 showed performance for diabetes related indicators was at 98% which was significantly higher than both the CCG average and national average of 89%. The practice was also able to demonstrate some year on improvements in the management of patients with diabetes.
• A designated team of staff were responsible for the recall of patients with long term conditions. Timing of recalls was based on need (for example, test results and medicines prescribed).
• Daily discharge meetings helped monitor patients who had been admitted to hospital as an emergency and we saw evidence of attendance at a hospital case reviews to discuss the multi-disciplinary care needs of a patient who was regularly admitted to hospital.
• The practice was able to show how screening patients for atrial fibrillation and monitoring patients with the potential to develop diabetes had led to improved patient outcomes through early detection of these conditions.

Updated 28 April 2016

The practice is rated as good for the care of families, children and young people.

• There were robust 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.
• Childhood immunisation rates were above the CCG average for most standard childhood immunisations.
• The percentage of patients diagnosed with asthma, on the register, who had an asthma review in the last 12 months was 72% which was comparable with the CCG average of 74% and national average of 75%.
• The practice’s uptake for the cervical screening programme during 2014/15 was 95%, which was significantly higher than the CCG average of 79% and the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies. Baby health and post natal health checks were also provided at the practice.
• We received positive feedback from members of the health visiting and school nurse team about working relationship to meet patient needs.

Updated 28 April 2016

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. Patients over 75 had a named GP and nationally reported data showed good outcomes for many conditions commonly found in older people.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those that needed them. Systems were in place to review the care of those at risk of unplanned admissions.
• The percentage of people aged 65 or over who received a seasonal flu vaccination was comparable to national averages. Shingles vaccinations were also available to eligible patients.
• The Patient Participation Group (PPG) was working with the practice to provide support to patients in this age group from Age UK and in relation to dementia.
• We received positive feedback on the practice from the managers of two homes for older patients and the district nursing team on the practices support and care of end of life patients.

Updated 28 April 2016

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 and flexible.
• The practice was proactive in offering online and automated telephone services for booking appointments and prescription ordering.
• Extended opening hours were available on a Saturday morning including access to phlebotomy (blood taking) services for the convenience of patients who worked or who had other commitments during the day.
• A range of health promotion and screening was on offer to meet the needs of this patient group including NHS health checks, sexual health and family planning clinics.

Updated 28 April 2016

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

• Nationally reported data showed that 75% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was lower than the CCG average of 82% and national average of 84%.
• Nationally reported data showed performance for mental health related indicators was 89% which was also lower than the CCG average of 92% and the national average of 93%.
• The practice had signed up for enhanced services to facilitate the timely diagnosis and support for patients with dementia and were writing to patients to invite them to attend for dementia testing.
• Representatives from the Alzheimer’s Society had visited the practice to provide support and advice to patients and there were plans to repeat this during the next month.

Updated 28 April 2016

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 those with a learning disability, drug and alcohol addiction and carers.
• The practice offered annual health checks for patients with a learning disability. There were 233 patients on the learning disability register and since our previous inspection had increased the number reviewed from 20% to 45%.
• Learning disability passports were available for patients to report their likes and dislikes so that they could be taken into account should the patient be admitted to hospital or move to another service.
• A carers pack was available which enabled staff to signpost patients to various support services available. In conjunction with the PPG, carer coffee mornings were being established to give carers respite and access to advice and support.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• 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 responsible for investigating safeguarding concerns.