Dr Raquia Bano

Updated 10 January 2017

Dr Raquia Bano (known locally as Hillfields Health Centre) is located in the centre of Coventry within the modern City of Coventry Healthcare Centre. This facility is used by other healthcare services, including other GP practices and the walk-in centre. The area is urban and 70% of patients are from ethnic minority groups, particularly south Asian. Within the practice area, there are some significant areas of deprivation.

The practice is run as a partnership and at the time of our inspection had 2,818 patients registered. It has a General Medical Services (GMS) contract with NHS England. The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities. The practice is part of a local GP federation – the GP Alliance - a group of practices who work together to share best practice and maximize opportunities to improve patient outcomes.

The practice has two partner GPs (male and female). One has semi-retired as a full time GP and now provides locum sessions every week whilst retaining partnership. There are also two practice nurses (one of whom also works at another practice within the same building). The clinical staff are supported by a practice manager and administrative and reception staff.

The practice is open from 8.00am to 6.30pm from Monday to Friday, with the exception of Thursdays when it closes at 1.30pm and a duty GP is available. Appointments are available throughout these times. Extended hours appointments are available in conjunction with other local practices within the GP Alliance from 6.30pm until 9.45pm on weekdays and from 10am to 4pm on Saturdays and Sundays. This offers appointments with GPs and a practice nurse.

When the practice is closed, patients can access out of hours care provided by Coventry and Warwickshire NHS Partnership Trust in a neighbouring building through NHS 111. The practice has a recorded message on its telephone system to advise patients. This information is also available on the practice’s website.

Home visits are available for patients who are unable to attend the practice for appointments. There is also an online service which allows patients to order repeat prescriptions and book new appointments without having to telephone the practice. Telephone appointments are available for patients who are unable to reach the practice during normal working hours.

The practice treats patients of all ages and provides a range of medical services. This includes minor surgery and disease management such as asthma, diabetes and heart disease. Other appointments are available for blood tests, family planning and smoking cessation.

Updated 10 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Raquia Bano (known locally as Hillfields Health Centre) on 18 October 2016. Overall the practice is rated as good.

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

• There were clearly defined processes and procedures to ensure patients were safe and an effective system in place for reporting and recording significant events. They were fully reviewed at every staff meeting.
• Patients’ needs were assessed and care delivered in line with current guidelines. Staff had the appropriate skills, knowledge and experience to deliver effective care and treatment.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Additional NHS services were available within the same building.
• Patients said GPs gave them enough time and treated them with dignity and respect.
• Patients said they were treated with dignity, respect and compassion. Patients were involved with decisions about their care and treatment.
• Urgent same day patient appointments were available when needed. All patients we spoke with and those who completed comment cards before our inspection said they were always able to obtain same day appointments.
• Information about how to complain was available and easy to understand. The practice received very few complaints from patients and reviewed complaints to ensure lessons were learned.
• Risks to patients were assessed and well managed.

The area where the provider should make improvement is:

• Explore ways of increasing the identification of carers.

• Continue to try and improve the number of patients attending breast and bowel screening.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 10 January 2017

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

• The practice had a register of patients with long term conditions to enable their health to be effectively monitored and managed.

• Patients had a named GP and a review at least every 12 months to monitor their condition and ensure they received correct medicines. The frequency of the review depended on the severity of the patient’s condition. The practice had just started to change to a system of reviewing patients during their birthday month to make this easier to manage for the practice and easier to remember for patients.

• The practice achieved a 97% flu vaccination record for diabetes patients during 2015-2016. This was above the Clinical Commissioning Group (CCG) average of 93% and the national average of 94%.

• Longer appointments and home visits were available when needed.

Updated 10 January 2017

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

• There were appointments outside of school hours and the practice building was suitable for children and babies.

• Outcomes for areas such as child vaccinations were in line with or above average for the CCG and considerably higher than the national average.

• We saw positive examples of joint working with midwives and the local health visitor. Weekly midwife appointments were available at the practice.

• A monthly multi-disciplinary team meeting was held with the midwife and health visitor. This reviewed the child protection register and non-attendance for immunisations and checks.

• A full range of family planning and sexual health services were available within the practice building.

Updated 10 January 2017

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

• Older patients were given personalised care which reflected their needs.

• Care plans were in place with the most vulnerable older patients (81 patients). Of these, 95% had a care plan in place and this was used with multi-disciplinary teams to reduce unplanned hospital admissions. These patients had an alert placed on their patient records to ensure clinical staff were aware.

• The practice worked with the Integrated Neighbourhood Team to manage care for patients with complex and unstable conditions. (This included the community matron, social workers and community psychiatric nurse.)

• Over the last 12 months all patients aged 75 and over had been invited for a health check. This included blood tests, fracture assessment, frailty assessment, and checks for depression and dementia. From those checks, the practice identified patients who needed further investigation and referred them appropriately.
• The practice provided frailty checks.

• Home visits were offered to patients who could not reach the practice.

• Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people.

Updated 10 January 2017

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

• The practice ensured it provided services to meet the needs of the working age population, For example, extended hours appointments were available during the week and throughout the day on Saturdays.

• Telephone consultations were available for patients who were unable to reach the practice during the day.

• A full range of services appropriate to this age group was offered, including travel vaccinations.

• A total of 79% of eligible patients had received cervical screening in the last 12 months. This was slightly below the Clinical Commissioning Group (CCG) average of 81% and the national average of 81%.

• The practice participated in the Meningitis vaccination programme for students.

Updated 10 January 2017

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

• The practice had a register of patients with poor mental health to enable their health to be effectively monitored and managed.

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  Patients within this population group saw the same GP as much as possible.

• The practice worked with multi-disciplinary teams to provide appropriate care for patients with poor mental health. This included patients with dementia.

• Patients and their carers were signposted to appropriate local and national support groups.

• Patients who were diagnosed with depression received a follow up from a GP within eight weeks of diagnosis.

• Staff demonstrated a good working knowledge of how to support patients with mental health needs and dementia.

Updated 10 January 2017

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

• Longer appointments were available for patients with a learning disability.

• The practice had a register of patients who were vulnerable to enable their health to be effectively monitored and managed. This included patients with a learning disability.

• The practice signposted relevant patients to appropriate services. Patients who were homeless were signposted to the Anchor Centre which provided local services for this group of patients. Patients who were refugees were signposted to the Meridian Refugee Centre. Sex workers were signposted to a specific service situated on the third floor of the health centre which offered sexual health services and contraception.

• The practice supported vulnerable patients to access various support groups and voluntary organisations.

• The practice worked with other health care professionals to provide care to vulnerable patients, for example, the district nursing team and community matron. Vulnerable and complex patients were discussed at the monthly multi-disciplinary team meeting.

• Staff could recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities to share appropriate information, record safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.