Archived: Dr Surjit Dhillon Also known as Limbrick Wood Surgery

Updated 19 October 2016

Dr Surjit Dhillon (also known locally as Limbrick Wood Surgery) is located in the Tile Hill area of Coventry and serves patients within the CV4 (south west Coventry) and CV5 (north west Coventry) areas. The practice is situated in a large purpose built health centre along with other GPs and healthcare providers and is located within the NHS Coventry and Rugby CCG.

The practice is well served by the local bus network and there is limited accessible parking. The practice and all facilities are fully accessible to wheelchair users.

The practice provides primary medical services to approximately 3030 patients in the local community. The practice population is mostly white British but there has been an increase in East European, Chinese and African patients over the last five years.

The clinical staff team consists of a single female GP partner and two practice nurses. There is currently a salaried GP vacancy and the practice is supported by a locum GP.

The clinical team is supported by a practice manager, a practice administrator and a team of four reception staff. The practice is involved in research in collaboration with Coventry Research Symposium working with Warwick Medical School, and a commercial research organisation.

The practice is open from 8.30am to 12.30pm and 2pm to 6.30pm on weekdays and telephone lines are also open at these times. The practice is not open on Saturdays or Sundays. Appointments are from 8.30am to 12.30pm and 2pm to 6.30pm on weekdays.

Cover is provided by the West Midlands Ambulance telephone service (who contact the GP if required) when the practice is not open during NHS core contract hours (which means the period beginning at 8am and ending at 6.30pm on any day from Monday to Friday except Good Friday, Christmas Day or bank holidays).

The practice has joined a GP alliance group with a number of practices across Coventry which offers an extended hours service nearby between 6.30pm and 9.30pm on weekdays, between 9am and 12pm on Saturdays, and between 10am and 1pm on Sundays.

Further out of hours services are provided by the NHS 111 non-emergency facility. Patients are directed to this by the practice answer machine when telephoning the practice and it is closed. Information about out of hours services is available in the reception area and on the practice website.

Updated 19 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Surjit  Dhillon (also known locally as Limbrick Wood Surgery) on 26/07/2016. 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 and easy to understand. 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 the 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.

We saw an area of outstanding practice:

The practice provided a high level of support to vulnerable people. For example:

• The practice had helped to set up a ‘tea and talk’ support group within the health centre, and continued to refer elderly, socially isolated and recently bereaved patients of the practice to this group. This group had been running for over 15 years and continued to meet weekly.

• The practice held a carers’ clinic twice a month. This clinic was attended regularly by patients of the practice and provided support and advice for them. The practice was the first in Coventry to offer this service in 2009, and following the success of this initiative other practices decided to set up similar sessions locally which has led to increased provision of services for carers in the area.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 October 2016

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

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes-related indicators was in line with or above CCG and national averages. For example 99% of patients with diabetes on the register received influenza immunisation in the last 12 months compared with CCG and national averages of 94% and 94% respectively. Performance for a hypertension related indicator was above CCG and national averages. The percentage of patients with hypertension in whom the last blood pressure reading measured under a certain level was 91% compared with CCG and national averages of 84% and 84% respectively.

• Performance for an asthma related indicator was above CCG and national averages. The percentage of patients with asthma on the register who have had an asthma review in the preceding 12 months was 92% compared with CCG and national averages of 77% and 75% respectively.

• Longer appointments and home visits were available when needed.

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

Updated 19 October 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, for example, children and young people who had a high number of A&E attendances. Immunisation rates were high for all standard childhood immunisations.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• Performance for cervical indicators was higher than CCG and national averages. For example the percentage of women aged 25-64 receiving a cervical screening test in the last five years was 89% compared with CCG and national averages of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice provided combined parent and baby clinics carrying out post-natal and early child development checks.

• We saw positive examples of engagement and joint working with midwives, health visitors and school nurses.

Updated 19 October 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.

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

• The practice carried out 70 health checks for people aged over 75 in the last 12 months.

• The practice directed older patients to appropriate support services including those that the practice had helped to set up locally.

Updated 19 October 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 was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

• Appointments were offered to accommodate those unable to attend during normal working hours.

Updated 19 October 2016

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

• Performance for mental health related indicators was higher than CCG and national averages. For example the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the last 12 months was 92% compared with CCG and national averages of 84% and 88% respectively.

• The practice regularly worked with multidisciplinary 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.

• 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.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 19 October 2016

The practice is rated as outstanding for the care of people who circumstances may make them vulnerable.

• The practice had helped to set up a ‘tea and talk’ support group within the health centre, and continued to refer elderly, socially isolated and recently bereaved patients of the practice to this group.

• The practice held a carers’ clinic twice a month. This clinic was attended regularly by patients of the practice and provided support and advice for them.

• There was evidence of the practice team engaging with and providing targeted support for individual patients resulting in positive outcomes for them.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other healthcare professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• 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 in normal working hours and out of hours.