Background to this inspection
Updated
23 April 2020
Dr B Sahota & Dr K Cassam (also known as Kingstanding Circle Surgery) is located at 26 Rough Road, Kingstanding, Birmingham, B44 0UY. The surgery has good transport links and there is a pharmacy located nearby.
Dr B Sahota & Dr K Cassam registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury.
Kingstanding Circle Surgery is situated within Birmingham and Solihull Clinical Commissioning Group (CCG) and provides services to 5,282 patients under the terms of a general medical services (GMS) contract. This is a contract between general practices and CCGs for delivering services to the local community.
The provider is a two GP partnership who registered with the CQC in February 2017. The practice has two male GP partners, a nurse practitioner, two practice nurses, a paramedic, two health care assistants and a pharmacist. The non-clinical team consists of a practice manager and a team of receptionists and secretaries.
The practice is open between 7.15am and 6.30pm Mondays, between 7.15am and 6.30pm Tuesdays and Wednesdays, between 7.30am and 6.30pm Thursdays and Fridays. When the practice is closed, out of hours cover for emergencies is provided by Birmingham and District General Practitioner Emergency Room group (Badger). The practice is part of a local federation network which enables patients to access a local Hub for extended access.
Kingstanding Circle Surgery is in one of the more deprived areas of Birmingham. The practice catchment area is classed as being within one of the least deprived areas in England. The practice scored one on the deprivation measurement scale; the deprivation scale goes from one to 10, with one being the most deprived. People living in more deprived areas tend to have greater need for health services. National General Practice Profile describes the practice ethnicity as being 85% white British, 6% Asian, 6% black, 4% mixed and 0.4% other non-white ethnicities. The practice demographics show the average percentage of people in the four to 85+ year
age group were comparable to local and national percentage. Average life expectancy is 77 years for men and 83 years for women compared to the national average of 79 and 83 years respectively. The general practice profile shows that 69% of patients registered at the practice have a long-standing health condition, compared to 50% locally and 52% nationally.
Updated
23 April 2020
We carried out an announced comprehensive inspection at Dr B Sahota & Dr K Cassam (also known as Kingstanding Circle Surgery) on 4 February 2020 as part of our inspection programme to confirm that the practice had carried out their plan to meet the legal requirements in relation to the requirement notices served on the providers following our February 2019 inspection.
We based our judgement of the quality of care at this service 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.
We have rated this practice as good overall; however, requires improvement in effective key question. We have rated long-term conditions, families, children and young people as well as working age people (including those recently retired and students) population as requires improvement in effective. All other population groups has been rated good.
We found that:
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- The practice took action to strengthen processes for ensuring appropriate monitoring of patients prescribed high-risk medicines. Clinicians demonstrated they had access to information to ensure medicines remained safe for patients to receive prior to authorising repeat prescriptions.
- Records demonstrated that clinical staff participated in care planning.
- The 2018/19 Quality Outcomes Framework showed performance was in line with local and national averages. Except for exception reporting which was not in line with local and national averages.
- The practice had a programme of quality improvement activities which was used to review the effectiveness and appropriateness of non-clinical processes. However, there was limited evidence of effective use of clinical audits to monitor clinical outcomes.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care. The 2019 national GP survey results showed patient satisfaction in a number of areas was above local and national averages. Completed CQC comment cards was also aligned with these views.
- The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
- The way the practice was led and managed promoted the delivery of high-quality, person-centre care. There was clear evidence which showed that practice had taken action to strengthen most areas of the governance arrangements which previously impacted on the delivery of safe and effective services.
- However, we found areas such as the use of clinical data and information which did not routinely support development of actions to improve areas where performance was not in line with local and national averages.
- The management team participated in a general practice improvement leads programme. This enabled leaders to review workflow as well as identify whether the practice was effectively using staff skill mix. This resulted in non-clinical staff being allocated lead roles in areas such as coordinating childhood immunisation, clinical correspondence, managing safeguarding registers and ensuring staff were competent in signposting patients to the correct clinician.
Whilst we found no breaches of regulations, the provider should:
- Continue taking action to improve the uptake of childhood immunisation and national screening programmes such as cervical screening.
- Take action to improve the system of clinical audits including monitoring QoF exception reporting rates and take appropriate action when performance was not in line with local and national averages.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care