Hillfields Health Centre - 1 Also known as Dr Garba Sani Gusau

Updated 9 January 2017

Dr Garbi Sani Gusau’s practice is a GP practice which provides primary medical services under a General Medical Services (GMS) contract to a population of approximately 3,400 patients living in Foleshill and surrounding areas of Coventry. A GMS contract is a standard nationally agreed contract used for general medical services providers.

The practice operates from the first floor of a four storey building which accommodates other GP practices in the area and many community services including the Walk-in centre. All staff operate from the first floor of the building. There is a ramp and electronically operated automatic doors to allow access for patients with disabilities and a lift to enable easy access to all floors in the building. The practice population has a higher than average number of patients aged 25 to 35 years, 55 to 70 years and those over 85 years. National data indicates that the area is one that experiences high levels of deprivation. The practice population is mixed but predominantly white with pockets of ethnic minority groups such as Asian, Indian, Bangladeshi and African. Dr Gusau carried out minor surgery procedures and was a member of the Association of Surgeons in Primary Care.

Dr Gusau is a male registered sole provider of services and employs a salaried female GP. There are two practice nurses, a business/practice manager who are supported by a team of reception and administration staff.

The practice is open on Monday to Friday from 8.15am until 6.30pm and provides extended hours appointments on Monday from 6.30pm until 7.30pm offered by a male GP and Tuesdays from 6.30pm until 7.30pm offered by a female GP.  The practice is part of the GP Alliance which offers a service allowing patients to see a GP or nurse from Monday until Friday from 6pm until 10pm and on Saturday and Sunday from 10am to 4pm. When the surgery is not open during core hours, from 8am until 8.15am, calls are taken by the out of hours service who provide access to a GP service. When the practice is closed, out of hours services are provided by Virgin Healthcare via the NHS 111 service.

Updated 9 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Garba Sani Gusau’s practice on 27 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 generally assessed and well managed, although the practice had not ensured the appropriate recording and storage of a controlled drug. However, this had been immediately removed and appropriately disposed of.

• 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 and patients had easy access to a number of support services within the building.
• 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:

• Ensure the system for recording MHRA alerts is revisited to ensure actions and learning have taken place and that all significant events are captured to promote learning.
• The practice should ensure they keep a separate controlled drugs register and appropriate recording and storage in line with legislation if they decide to keep controlled drugs in the future.
• Carry out appraisal for all staff as planned and review the system to ensure appraisal continues regularly.
• Explore ways of increasing the identification of carers, to enable them to receive appropriate support.
• Consider ways of encouraging uptake of breast and bowel screening.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 9 January 2017

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. For example nurses had additional training in chronic obstructive pulmonary disease (COPD) and diabetes.
• The practice offered in house electrocardiograms (ECG)s to prevent the need to attend the local hospital.
• The percentage of patients with diabetes, on the register, in whom the last blood pressure reading was 140/80 mmHg or less was 80% compared to the clinical commissioning group (CCG) average of 77% and national average of 78%.
• The retinal screening service attended the practice annually for screening of specific eye conditions for patients with diabetes.
• Longer appointments and home visits were available when needed.
• All these 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 clinical staff worked with relevant health and care professionals to deliver a multidisciplinary package of care such as the district nurses and community matron.

Updated 9 January 2017

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 relatively 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.
• Cervical screening rates were below the national and CCG average. For example, the percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years was 71% compared with the CCG and national average of 81%.
• The practice always provided appointments on the same day for children. If no appointments were available the child would be seen either at the beginning or end of surgery. Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwife and health visitor.

Updated 9 January 2017

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.
• They provided domiciliary visits for housebound patients who required flu vaccination.
• The practice accommodated older patients to book appointments to be seen between 9.30am and 3pm as this was the preference expressed using patient feedback.

Updated 9 January 2017

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

• Screening rates for bowel and breast screening were below the CCG and national averages and there was no evidence of action taken to improve this.
• 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. For example, access to electronic prescription service.
• Extended hours appointments were available for patients who could not attend during normal hours. The practice was also part of the local GP Alliance where patients could access a GP or nurse between 6pm and 10pm.

• 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.

Updated 9 January 2017

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

• 100% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is above to the CCG and national average of 81% and 84% respectively.
• 98% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record, in the preceding 12 months

compared to the CCG and national average of 86% and 89% respectively.

• 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. We saw care plans were used consistently and demonstrated continuity of care.
• 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 9 January 2017

The provider 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. 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 3rd floor which offered sexual health services and contraception.
• Patients who did not attend their appointments were followed up by practice staff.
• The practice offered longer appointments for patients with a learning disability or any patients who required it.
• The practice provided interpreters for patients whose first language was not English.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients such as the heath visitor and the Integrated Neighbourhood Teams.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations. The local carers trust attended the practice for drop in sessions to provide information regarding support available for carers. The practice had identified 9 carers which represented less than 1% of the practice population.
• Staff had received training and 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.