Archived: Dr A Yi Also known as Aung Min Galar Surgery

Updated 3 March 2016

Dr A Yi is located within Hednesford Valley Health Centre, Hednesford, Staffordshire. The practice is part of the NHS Cannock Chase Clinical Commissioning Group. We found there had been changes to the practice registration, as an additional partner had been appointed. The provider had not amended the registration with the CQC to reflect these changes. At the time of our inspection there were 3,144 patients on the patient list.

A team of three GP partners (one male and two female), and a practice nurse provide care and treatment to the practice population. They are supported by a practice manager, secretary and a team of reception staff. The practice is open from 8am until 6.30pm from Monday to Friday. Each GP works specific days each week and appointments are available every day. Consultation times vary each day and are as follows: Mondays 9.30am to 12.10pm and 3pm to 6pm; Tuesdays 9am to 12 noon and 2pm to 6pm; Wednesdays 8am to 12.noon and 3pm to 6pm; Thursdays 9.am to 12.10pm and 3.30pm to 5.30pm, and Fridays 9am to 12 noon and 4.30pm to 6pm. Extended hours appointments are available with a GP until 7.15pm on a Monday evening and 7.10pm on a Tuesday evening. Nurse appointments were available from Monday to Thursday. The appointment times vary each day and are as follows: Mondays 9am to 12 noon; Tuesdays and Wednesdays 8.30am to 1pm and 2pm to 5.30pm and Thursdays 8.30am to 12 noon.

The practice does not provide an out-of-hours service to its own patients but has alternative arrangements for patients to be seen when the practice is closed through Staffordshire Doctors Urgent Care, the GP out-of-hours service provider. The practice has a Personal Medical Services (PMS) contract and also offers enhanced services for example: various immunisation schemes, hospital admission avoidance scheme and minor surgery.

The practice also provides placements for third, fourth and fifth year medical students studying at Keele University.

Updated 3 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr A Yi on 15 January 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, although significant event meetings did not take place on a regular basis.
• Patients were at risk of harm because some systems and processes were not in place to keep them safe. For example appropriate recruitment checks on staff had not been undertaken prior to their employment, and risk assessments were not in place to monitor safety of the premise or use of equipment.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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.
• Patients told us they could usually get an appointment when they needed one, with urgent appointments available the same day. Patients could also access urgent appointments via the Cannock Network Project. Appointments with a GP or nurse were available between 3.30pm and 8pm at the Network if appointments were not available at their own practice.
• 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 the 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.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Ensure recruitment arrangements include all necessary legislative employment checks for all staff.
• Ensure that the practice nurse has indemnity insurance in place.
• Introduce systems to monitor the use of prescription pads and blank computer prescription forms.
• Carry out a risk assessment to support the rationale for stocking a limited range of emergency medicines.
• Implement systems for assessing and monitoring risks.

In addition the provider should:

• Introduce regular significant event meetings.
• Provide staff with health and safety training.
• Complete a second cycle on the clinical audits already carried out.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 March 2016

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

• The practice nurse had the lead role in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Performance for the five diabetes related indicators were comparable to or better than the national average. For example: The percentage of patients with diabetes, on the register, in whom a specific blood test was recorded was 83.26% compared with the national average of 77.54%.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and a structured annual review to check their health and medicines needs were 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 3 March 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 on child protection plans.
• Immunisation rates were relatively high for all standard childhood immunisations.
• The percentage of patients with asthma, on the register, who have had an asthma review in the preceding 12 months was 77.94%, which was above the national average of 75.35%.
• The practice’s uptake for the cervical screening programme was 82.95%, which was comparable to the national average of 81.83%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice offered family planning and contraception services including implant/coil fitting.

Updated 3 March 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 percentage of people aged 65 or over who received a seasonal flu vaccination was lower than the Clinical Commissioning Group and national averages. The practice was proactively identifying eligible patients and offering the vaccination opportunistically when patients attended an appointment.

Updated 3 March 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 offered extended hours with the GPs on Monday and Tuesday evenings and appointments from 8am on Wednesday mornings. booked patients into the Cannock Network Project for appointments outside of normal 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.

Updated 3 March 2016

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

• Performance in the four mental health related indicators were better than the national average. For example, the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record was 95.83% when compared with the national average of 88.47%.
• The practice held registers of patients with poor mental health and dementia. Patients experiencing poor mental health were offered an annual physical health check.
• Patients with a suspected diagnosis of dementia could be referred to the Memory Clinic, which was held on site.
• Staff had a good understanding of how to support patients with mental health needs and dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

Updated 3 March 2016

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

• The practice offered longer appointments and annual health checks for patients with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• 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.