Archived: Modality LLP Osborn House

Updated 1 July 2022

Modality LLP is the registered provider of Modality LLP Osborn House. The provider is registered with CQC to provide the following regulated activities:

Diagnostic and screening procedures

Family planning

Surgical procedures

Treatment of disease, disorder or injury

The service is part of a wider organisation called Modality Partnership. This is a National GP Super-Partnership serving more than 430,000 patients.

The provider’s head office and the location that is registered with CQC is Osborn House, 55 Terrace Road, Birmingham, B19 1BP. Regulated activities are provided from this address as well as 15 satellite sites.

More information about the service can be found on their website https://modalitycommunityservices.com.

The service provides community-based NHS healthcare services to patients including:

Attention deficit hyperactivity disorder (ADHD), audiology, cardiology, contraception, dermatology, echocardiography, ear, nose and throat (ENT), flexible cystoscopy, gastroenterology, general surgery, gynaecology, neurology, ophthalmology, orthopaedics, paediatrics, respiratory, rheumatology, ultrasound, urology and x-ray services.

The service does not have a registered list. Patients are referred into the service by a GP or NHS trust they have a contract with. Services are provided from mostly GP practices or health centres. At the time of the inspection the provider had 16 service level agreements in place for the use of facilities from which services were delivered from. The provider ensures staff have remote access to patient care records and their quality assurance system, this allows staff to deliver services from different sites.

The provider has a management board, which is made up of the group CEO, group clinical chair, medical director, executive partner and managing director.

The provider employs a total of 125 clinical and 86 non-clinical staff. In addition to this, 76 clinical staff work under practising privileges (permission granted through legislation to work in an independent hospital clinic).

The service operates Monday to Sunday 8am to 6pm. Opening times vary for each service and site they are delivered from. The telephone lines are open for queries and booking appointments Monday to Sunday 8am to 6pm.

How we inspected this service

Before the inspection we reviewed information the provider sent us, any information we held on the service and any information that was available to the general public. We also contacted Clinical Commissioning Groups (CCGs) and NHS trusts that hold contracts with the service.

During the inspection we spoke with clinical staff, administration and call centre staff, members of the board and senior leadership team and we reviewed feedback from people using the service, made observations and reviewed documents and patient records.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 1 July 2022

This service is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Outstanding

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Modality LLP Osborn House (also known as Modality LLP) as part of our inspection programme and to provide a rating. The service has not been inspected before.

As part of this inspection we visited the provider’s registered location; Osborn House, 55 Terrace Road, Birmingham B19 1BP and three satellite sites from which services were delivered. The sites we inspected were:

Enki Medical Practice, Osborn House, 55 Terrace Road, Handsworth, Birmingham, B19 1BP.

Khattak Memorial Surgery, 309 Bolton Road, Small Heath, Birmingham, B10 0AU.

Nishkam Pharmacy 21 Soho Road, Handsworth, Birmingham, B21 9SN.

The executive partner is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Our key findings were:

• The provider had implemented processes and policies to provide care in a way that kept patients safe and protected them from avoidable harm.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The provider adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic.
• Data showed that patients could access care and treatment in a timely way.
• The provider took complaints and incidents seriously and demonstrated how they improved services.
• The way the service was led and managed promoted the delivery of high-quality, person-centred care.
• Clinicians told us they worked for the organisation because the provider listened to them and their ideas on how they could develop services further and that ideas were implemented quickly.
• The cardiology service had identified that additional specialist nurses were required to help improve services for patients further, and had used surplus funds to recruit these additional clinical staff.
• Where possible, services were designed so that all necessary tests were completed on the same day as the appointment with the clinician. Patients left their appointment with a treatment plan and reduced journeys to separate appointments on potentially different days.
• Services had been designed in conjunction with NHS trusts to ensure that patients received the right treatment in the right setting. Patients' needs were at the centre of each care pathway. Patients were discussed in multidisciplinary team (MDT) meetings which included clinicians from NHS trusts. Treatment plans could be discussed during the MDT, without needing to refer the patient on to another service and patients could be directly placed onto hospital waiting lists, expediating their care.
• The provider had invested in technology that allowed test and scan results to be available to hospital doctors in real time. This reduced waiting times and unnecessarily repeating tests.
• The provider had an extensive audit and quality improvement program. The provider was able to demonstrate that audits improved clinical quality.
• The provider had implemented a comprehensive system to monitor performance and quality to ensure they provided effective care and treatment. Data we viewed showed that all specialities had met their target for triaging patients and patients were being offered appointments in line with agreed targets most of the time.
• The provider demonstrated they took quick action to improve quality when concerns were identified with performance.
• The provider promoted innovation and improvement and was responsive to needs of patients and staff

We saw the following outstanding practice:

• All staff we spoke with felt extremely well supported by leaders and felt proud to work for an organisation that put patients at the centre, was forward thinking and reduced pressure on secondary care services.
• The provider encouraged clinicians to be innovative and take opportunities to improve patients’ overall health and reduce risk factors. For example, the cardiology service at the time of the inspection was involved in a project to help identify undiagnosed heart conditions. Initial data showed that out of 130 patients who had attended for relevant tests, six patients had been diagnosed with a condition that was previously undiagnosed. These six patients were referred onto relevant departments tor treatment and follow up.
• The provider had supported a local NHS trust to significantly reduce their waiting lists and prevented the trust from breaching 104 week waits. Feedback from the NHS trust was extremely positive and commented on the delivery of first-class outpatient care.

While we found no breaches in regulation, the areas where the provider should make improvements are:

• Improve incident reporting processes so that all incidents including near misses are reported to management to enable further service improvement.
• Improve complaint reporting processes to enable further service development.
• Improve governance systems to monitor and manage emergency equipment and Infection Prevention and Control (IPC).

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care