Govind Health Centre

Updated 3 May 2018

Govind Health Centre is a GP practice which provides primary medical services under a General Medical Services (GMS) contract to a population of approximately 2,700 patients living in Earlsdon and the surrounding areas in Coventry. A GMS contract is a standard nationally agreed contract used for general medical services providers.

The practice operates from a two storey building and patients are seen on the ground floor and first floor. The practice has a ramp and electronically operated automatic doors to allow access for patients with mobility aids and there is a lift to allow patients easy access to the first floor for consultations. The practice population has a higher than average number of patients aged over 50 years and those over 85 years and a lower than average number of patients aged 0-25 years. National data indicates that the area is one that does not experience high levels of deprivation. The practice population is made up of predominantly white British patients. The practice is one of three practices which form a larger organisation and staff records and organisational policies and procedures are maintained centrally. The practice is a teaching practice providing support and tuition to medical students and qualified doctors who are training to be GPs.

The practice has allocated GPs and staff to each location. There are three GP partners, two male and one female and one of the GPs is the lead for this location. They currently employ two salaried GPs, two practice nurses, one of whom is a nurse prescriber, a health care assistant and a practice manager who are supported by a team of reception and administration staff.

The practice is open on Monday, Tuesday, and Friday from 8am until 6.30pm, Thursdays from 8am until 1pm and on Wednesdays from 8am until 8pm. Appointments are available between these times. The practice offers a GP triage service which allows patients to be assessed by a GP to determine if an urgent appointment is necessary. When the surgery is not open during core hours, calls are diverted to the Warwickshire Ambulance Service via the NHS 111 service who also provides the out of hours service. This is a locally agreed contract.

Updated 3 May 2018

We carried out an announced comprehensive inspection at Govind Health Centre on 12 July 2017. The overall rating for the practice was good but required improvement for providing safe services.

The full comprehensive report on the 12 July 2017 inspection can be found by selecting the ‘all reports’ link for Govind Health Centre on our website at www.cqc.org.uk.

This desk-based review was carried out on 7 February 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 12 July 2017. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as Good

Our key findings were as follows:

• Immediately following the previous inspection the practice ran searches and identified one patient that had been affected by an alert. This patient was contacted by letter and informed of the action to take.
• The practice had put in place systems and processes to ensure that all safety alerts were managed, reviewed, actioned and communicated to all relevant staff and patients, and had installed an additional computer system to support this.
• The practice had put in place the formal recording of meetings. Examples of this were the weekly clinical meetings where safety alerts were discussed.
• The patient participation group had a schedule of meetings in place and the practice continued to try to increase the membership.
• Minutes of all meetings were now produced in a standard template and action points were recorded.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 5 September 2017

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

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.
• The overall practice achievement of QOF points for diabetes during 2015/16 was 86% which was comparable with the CCG and national average of 90%.
• Housebound patients and those who were unable to attend the practice were visited at home and received an annual review of their condition there.
• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.
• All these patients had a named GP and there was a system to recall patients for 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 5 September 2017

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

• The practice had appropriate systems 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 accident and emergency (A&E) attendances and we saw evidence of this.
• Immunisation rates were high for all standard childhood immunisations.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice worked with midwives and health visitors to support this population group. For example, in the provision of ante-natal, post-natal and child health clinics.
• The practice had a GP triage system in place and could assess acutely ill children, young people and acute pregnancy complications.
• The practice offered and promoted chlamydia screening and meningitis vaccinations for teenage patients.

Updated 5 September 2017

The practice is rated as good for the care of older people.

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice offered proactive, personalised care to meet the needs of the older patients in its population.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• The practice used a risk stratification tool to identify patients who may have been at risk of hospital admission and had developed care plans and a contact card to facilitate a fast response if they experienced a deterioration in their condition.
• Where older patients had complex needs, the practice shared summary care records with local care services.
• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible; for example, the shingles vaccine.

Updated 5 September 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example, extended opening hours.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.
• The health care assistant offered smoking cessation support for patients wanting to stop smoking.
• The practice had introduced GP telephone triage to assist patients who needed a health consultation but had work commitments to determine if a visit to the practice was necessary.
• The practice advertised and encouraged the abdominal aortic aneurysm (AAA) screening for male patients who met the criteria for screening.
• NHS health checks were offered to patients who were not identified as having a long term condition to promote health and identify any potential health problems early.

Updated 5 September 2017

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

• The practice had engaged in a pilot scheme which involved identification, diagnosis and treatment of dementia in the community to prevent the need for hospital attendance. The practice carried out advance care planning for patients living with dementia.
• 57% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the 12 months, during 2015/16 which was below to the national average of 83%. However, unpublished data provided by the practice showed that this had improved to 95% during 2016/17.
• The practice specifically considered the physical health needs of patients with poor mental health and dementia. The practice monitored patients attendance for injectable anti-psychotic medicines and contacted the mental health support team when patients did not attend to ensure the patients medicine could be organised.
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.
• The overall achievement of mental health indicators in the QOF during 2015/16 was 61% which was lower than the national average of 90%. However, the unpublished data provided by the practice showed that this had improved to 87% for 2016/17.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.
• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 5 September 2017

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.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice worked with the fire service and encouraged patients to take up the offer of a free fire check in their home.
• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.