Dr Manoj Prasad Also known as Apollo Surgery

Updated 3 October 2016

• Dr Manoj Prasad’s practice (also known as Apollo Surgery) is located in Great Barr, Birmingham and has approximately 2300 registered patients.
• The practice is led by one full-time male GP, one part-time salaried female GP. There are also two female practice nurses, a practice manager, an assistant practice manager and three receptionists at the practice.
• Dr Manoj Prasad’s practice is also a teaching and training practice and takes on both medical students and GP registrars periodically. There were two GP registrars, one foundation year 2 (undertaking postgraduate medical training programme) and one medical student at the practice at the time of the inspection.
• 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 8.30am and 7.30pm on Mondays and Tuesdays, 8.30am 2pm on Wednesdays, 8.30am to 1pm on Thursdays and from 8.30am to 6.30pm on Fridays. In addition to pre-bookable appointments that can be booked up to four weeks in advance, urgent appointments are also available for people that need them.
• The practice has opted out of providing out-of-hours services to their own patients and this service is provided by Birmingham and District General Practitioner Emergency Rooms (BADGER) medical service. Patients are directed to this service on the practice answer phone message. BADGER cover was also provided between 8am and 8.30am.
• The practice is located in an area with average levels of social and economic deprivation.

Updated 3 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Manoj Prasad’s practice on 13 September 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 an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• 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:

• Implement planned actions to ensure care plans are in place for patients with poor mental health.
• Take action to improve the disabled facilities and premises access for patients with mobility difficulties.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 October 2016

• Performance for diabetes related indicators for the practice was 92% which was above both the CCG average of 83% and national average of 84%.The practice had set up a pre-diabetic register and identified patients at higher risk of developing diabetes in order to support and advise patients on changes to prevent diabetes developing.
• 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.
• Patients attending for annual reviews were allocated extended appointment times of 30 minutes to allow full discussion of their long term condition.

Updated 3 October 2016

• Same day appointments were available for all children under 16 years of age and those patients with medical problems that require same day consultation.
• Immunisation rates for childhood vaccinations were above CCG averages.
• A self-check appointment service screen was available for the convenience of patients and allowed reception staff more time to deal with other queries.
• Fortnightly antenatal and postnatal clinics were held by a midwife at the practice.
• The practice’s uptake for the cervical screening programme was 82%, which was slightly above the CCG average of 78% and the same as the national average.
• Appointments were available outside of school hours.
• The premises were suitable for children and babies and baby changing facilities were available.

Updated 3 October 2016

• 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.
• A facility for online repeat prescriptions and appointments bookings was available.
• Patients were able to book telephone consultations with the GP.
• There were longer appointments available for older patients.
• The practice had a level access and the consultation rooms were all located on the ground floor. A hearing loop was also available at the practice.
• An equality assessment had been carried out by the practice which had identified that improvements were required with disabled access of toilets and as well as access to the premises.
• There were marked parking bays for the disabled near the practice.

Updated 3 October 2016

• 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 hours on Mondays and Tuesdays from 6pm to 7.30pm to accommodate working patients who could not attend during normal opening hours.
• Patients could book appointments or order repeat prescriptions online. Patients were also able to book telephone consultations with the GP.
• A text service to both mobiles and landlines had been implemented by the practice to communicate with patients unavailable to answer calls such as those at work.
• Weekly phlebotomy clinics were held at the practice for the convenience of patients.
• The practice offered a full range of health promotion and screening that reflected the needs for this age group. The practice nurse provided support to those identified as requiring advice on their diet, smoking cessation and alcohol awareness. Patients were also signposted to more specialist services where appropriate.

Updated 3 October 2016

• There were longer appointments available for patients with complex needs such as those with dementia, a learning disability and patients experiencing poor mental health.
• The practice was an outlier for the percentage of patients on the mental health register who had a comprehensive, agreed care plan documented which was 63% for the practice compared to 89% CCG and 88% nationally. The practice told us that a plan was being developed to target this in order to ensure care plans was in place for all patients on the mental health register. All clinical staff we spoke with were aware that this was an area that they would be focusing on and we saw minutes of meetings where areas of underperformance had been discussed.
• The practice had informed patients experiencing poor mental health about how to access various support groups.
• Weekly sessions by the Healthy Minds Counselling service were offered at the practice.
• The GP we spoke with had good knowledge of the relevant consent and decision-making requirements of legislation and guidance, including the Mental Capacity Act 2005. We saw evidence that the GP had completed mental capacity training.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 3 October 2016

• The practice held a register of patients living in vulnerable circumstances and alerts were in place on the clinical patient record system.
• 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 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.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.