Archived: Bartley Green Medical Practice

Updated 3 March 2016

Bartley Green Medical Practice 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.

Bartley Green Medical Practice is registered with the Care Quality Commission to provide primary medical services. 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 who are ill and includes chronic disease management and end of life care.

The practice is located in purpose built accommodation. Based on data available from Public Health England, deprivation in the area served is higher than the national average. The practice has a registered list size of approximately 6000 patients.

The practice is open between 8.15am and 6.15pm daily with the exception of Wednesday when it closes at 1.15pm. Appointment times are 8.30am to 11.30pm daily, 2.00 to 6pm Monday and Thursday, 2.30pm to 6.00pm Tuesday and 3.30pm to 6pm on Friday. The practice offers extended opening hours on a Tuesday evening until 7.30pm. When the practice is closed patients receive p rimary medical services through other providers.

The practice currently has three GP partners (two female and one male) and a salaried GP (female). The practice also employs an Advanced Nurse Practitioner, three practice nurses one of which is an independent prescriber and a healthcare assistant. There is a team of administrative staff which includes a practice and office manager who support the daily running of the practice.

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 has not previously been inspected by CQC.

Updated 3 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bartley Green Surgery on 6 January 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 systems in place for reporting and recording significant events.
• Risks to patients were assessed and managed but not always in a systematic way.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment. Professional development was encouraged.
• 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 but had not been well advertised and contained information that was no longer current.
• Patients gave a mixed account about how easy they found it to access services. The practice was aware and was taking steps to try and improve this.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider should make improvement are:

• Strengthen recruitment processes to ensure the receipt of checks undertaken have been followed.

• Ensure robust systems are in place for monitoring and ensuring staff training has been completed and is up to date.

• Formally review access to emergency equipment to ensure that all risks associated with providing care and treatment in a medical emergency have been appropriately managed.

• Ensure patients are made aware of the practice complaints system and that information supplied about the process is accurate.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 March 2016

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

• Clinical staff including nurses had lead roles in chronic disease management and took responsibility for ensuring patients’ needs were managed and that they received regular health reviews. Staff were appropriately trained to undertake these roles.

• Systems were in place for managing the care of those at risk of unplanned hospital admissions.

• Longer appointments and home visits were available for those who were unable to attend the surgery due to their health needs.

• The practice maintained a prediabetes register for those who had been identified as at risk of developing diabetes. This enabled these patients to be reviewed annually and managed early should the development of diabetes be confirmed .

• Nationally reported patient outcomes for many long term conditions were above the CCG and national averages.

• In-house services such as phlebotomy (blood taking), 24 hour blood pressure monitoring, ECGs and spirometry helped support the identification and management of long term conditions and reduced the need for patients to travel for these services.

Updated 3 March 2016

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. Health visitors were located on site and there was good evidence of joint working arrangements.

• Immunisation rates were comparable to other practices nationally for all standard childhood immunisations.

• National data reported that 67% of patients diagnosed with asthma, had received an asthma review in the last 12 months. This was lower than the CCG average of 74% and the national average 75%.

• The practice offered child friendly services with baby changing facilities and premises accessible for those with pushchairs. A GP was available during the health visitor clinics and relocated their consulting room so that it was on the same floor for the ease of patients. GPs were aware of local services available to support young mums.

• The midwife held weekly clinics on site which enabled discussions to take place with practice staff as needed.

• The practice’s uptake for the cervical screening programme was 72%, which was comparable to the CCG average of 69% and the national average of 74%.

• Appointments were available outside of school hours and staff told us that acutely ill children would always be seen.

Updated 3 March 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 years had a named GP.

• Home visits and urgent appointments were available for those who were unable to attend the surgery for an appointment due to their health. Same day appointments were available for those with urgent needs.

• Patients who experienced an unplanned hospital admissions were reviewed and care plans amended to help support their needs.

• Multi-disciplinary team meetings took place with other health and care professionals for those with palliative and complex care needs to help plan coordinated care.

Updated 3 March 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, flexible and offered continuity of care.

• The practice offered online services for appointments and repeat prescriptions.

• The practice offered a range of health promotion and screening services including health checks, sexual health services and family planning.

• Travel vaccinations were available at the practice.

• Extended opening hours were available on a Tuesday evening for the convenience of those who worked or with other commitments during the day.

Updated 3 March 2016

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

• The practice was signed up to provide enhanced services for facilitating the timely diagnosis and support for patients with Dementia. 85% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was above the CCG average of 82% and the national average of 84%.

• Nationally reported data showed performance for mental health related indicators was 89% which was slightly lower than the CCG average of 92% and the national average of 93%.

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

• There was expertise among the GPs in mental health with one GP having previously worked in this area.

• Staff had access to Mental Capacity Act 2005 training on line. All GPs had completed this training.

• The practice was aware of support services that they could refer or signpost patients to for example, counselling services.

• The practice worked alongside health visitors to support and manage mothers with post natal depression.

Updated 3 March 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 such as for people with a learning disability and carers.

• The practice offered health checks for patients with a learning disability which were carried out by the Advanced Nurse Practitioner.

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

• If patients had any special requirements for example, hearing or visual impairments, these were noted so that the practice could accommodate them.

• 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.

• Annual cervical screening was offered to patients diagnosed with HIV.