Archived: Summerfield Primary Care Practice

Updated 15 March 2017

Summerfield Primary Care Practice is located in Winson Green, Birmingham and has approximately 1750 patients registered with the practice.

The current partners applied for new provider status in April 2016 and registered with CQC in July 2016. The previous provider was absent from the practice from June 2015 and there had been changes to the way the service was being delivered. For example, the service was delivered by another provider under a caretaker arrangement with the CCG until December 2015. There had been further changes to the way the service had been delivered until the current partners had taken over responsibility.

The practice is led by two GP partners (one male and one female). The partners also own another practice (Cavendish Medical Practice, Edgbaston, Birmingham). The clinical team also included two regular locum GPs (one male and one female) a locum female practice nurse. There is a practice manager and another experienced practice manager who is supporting the current manager as well as a small team of administration staff.

The practice has a General Medical Services (GMS) contract. A GMS contract is a contract between NHS England and general practices for delivering general medical services.

The practice is open between 9am and 6.30pm Monday to Friday except on Wednesdays when it closed at 1pm. Appointments were available during the above times. Extended hours appointments were offered on Tuesdays from 6.30pm to 7.30pm.

Pre-bookable appointments are available two and three months in advance as well as on the day booking. Urgent appointments are also available for people that need them. Children and the elderly are always seen on the day.

The practice has opted out of providing out-of-hours services to their own patients and this service is provided by Primecare. Patients are directed to this service on the practice answer phone message. Primecare cover is also provided between 8am and 9am.

The practice is in an area that is within the highest levels of social and economic deprivation.

Updated 15 March 2017

Letter from the Chief Inspector of General Practice

We had inspected the practice in March 2015 when the registered provider was Dr Salim. During the inspection we found the practice inadequate for providing a safe, effective and well-led service. It was also inadequate for providing services for the six population groups we reviewed. Improvements were also required for providing responsive and caring services. Overall the practice was rated as inadequate and placed into special measures. Following the inspection, due to the absence of the provider, a caretaking practice was put in place by the Clinical Commissioning Group (CCG). Subsequently Summerfield Primary Care Practice applied for registration in April 2016 and are now the registered provider.

We carried out an announced comprehensive inspection at Summerfield Primary Care Practice on 22 September 2016. Overall the practice is rated as requires improvement. However, the new leadership at Summerfield Care Practice had made significant changes since July 2016 under challenging circumstance. During the inspection there was evidence of a positive impact to the quality of care for patients and the process of continuous improvement was ongoing.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. Improvements identified were actioned to improve service.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff were supported and trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• 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 and easy to understand. Practice had carried out an analysis of the process and had identified areas for further improvements.
• Patients had experienced some changes within the practice in the last 12-15 months. They told us that as a consequence the continuity of care had suffered. However, patients felt there was now more stability in the practice, the partners had a vision and strategy to further improve continuity of care.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• It was clear that one of the GP partners was at the centre of the improvement strategy in the practice. They had contributed to the development of systems and processes to improve service and were developing staff members so that this improvement could be sustained.
• 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.

However, there were areas of practice where the provider should make improvements:

• The provider should continue with their efforts to recall patients for regular reviews and appropriate screening.

• The provider should continue with their efforts to identify and support patients who are carers.

• The provider should continue to review and act on the results of the 2016 national GP patient survey to improve patients’ experience of the service. This includes access to care and treatment, patients satisfaction on consultations with GPs and nurses and their involvement in planning and making decisions about their care and treatment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 March 2017

The provider was rated as requires improvement for providing effective, caring and responsive services. The areas for improvement which led to these ratings apply to everyone using the practice, including this population group .

• The partners had taken over the practice recently and so there was limited published data relevant to the provider available. However, current data we looked at (unpublished and unverified) demonstrated that patients with long term conditions were being managed effectively.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 15 March 2017

The provider was rated as requires improvement for providing effective, caring and responsive services. The areas for improvement which led to these ratings apply to everyone using the practice, including this population group.

• 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.

• The practice’s uptake for the cervical screening programme was 68% (unpublished and unverified data), which was below the CCG average of 79% and the national average of 82%. The practice had devised a search for recall of patients. This was in addition to the external recall system and the practice hoped to further improve going forward.

• Appointments were available outside of school hours and the premises were suitable for children and babies and baby changing facilities were available. The practice had a nurse working on a locum basis and had ensured appointments with the nurse were available outside of school hours.

• We saw positive examples of joint working with midwives and health visitors.

Updated 15 March 2017

The provider was rated as requires improvement for providing effective, caring and responsive services. The areas for improvement which led to these ratings apply to everyone using the practice, including this population group .

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

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

• There were longer appointments available for older patients.
• A facility for online repeat prescriptions and appointments bookings was available. We saw efforts were being made to increase uptake.
• The consultation rooms were all located on the ground floor. A hearing loop was also available at the practice.

Updated 15 March 2017

The provider was rated as requires improvement for providing effective, caring and responsive services. The areas for improvement which led to these ratings apply to everyone using the practice, including this population group.

• 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 extended appointments on Tuesdays from 6.30pm to 7.30pm to accommodate working patients who could not attend during normal opening hours.

• Patients could book appointments or order repeat prescriptions online and the practice was promoting this service to increase uptake.

• The practice offered a full range of health promotion and screening that reflected the needs for this age group.

Updated 15 March 2017

The provider was rated as requires improvement for providing effective, caring and responsive services. The areas for improvement which led to these ratings apply to everyone using the practice, including this population group.

• The partners had taken over the practice recently and therefore published and verified data that reflected current arrangement was not available. However, data provided by the practice showed that all patients diagnosed with dementia had their care reviewed in a face to face meeting.

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

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. A psychologist held clinics onsite weekly and patients were referred where appropriate. This service was commissioned by Healthy Minds.

• The practice maintained a mental health register on the clinical system.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• The GPs we spoke with demonstrated knowledge of the relevant consent and decision-making requirements of legislation and guidance, including the Mental Capacity Act 2005.

Updated 15 March 2017

The provider was rated as requires improvement for providing effective, caring and responsive services. The areas for improvement which led to these ratings apply to everyone using the practice, including this population group .

• The practice held a register of patients living in vulnerable circumstances and alerts were in place on the clinical patient record system.

• A patient we spoke with told us that they were a manager of a care home for patients with learning disabilities and told us of an example where the practice had responded to meet the needs of these patients.

• Translation services were available.
• There were longer appointments available for patients with complex needs such as those with dementia or a learning disability.

• There was a lead staff member for safeguarding and we saw evidence to show that staff had received the relevant training. The practice had used the RCGP safeguarding toolkit to identify and address gaps in their safeguarding process.

• The practice had policies that were accessible to all staff which outlined who to contact for further guidance if they had concerns about a patient’s welfare.

• Staff members we spoke with were able to demonstrate that they understood their responsibilities with regards to safeguarding.