Archived: Quinborne Medical Practice

Updated 10 March 2016

Quinborne Medical Practice in one of three practices registered with CQC to provide primary medical services under the provider organisation Lordswood House Group Medical Practice. Collectively the practices have approximately 25,000 patients. This is the second largest of the three practices with approximately 5,000 registered patients. Data available and reported nationally and in this report relates to all three practices.

The staffing, policies, systems and procedures are centrally managed and are reflective across all three registered practices. We inspected the main site Lordswood House Group on the 11 September 2015 and have inspected both remaining sites Quinborne Medical Practice and Quinton Family practice on the 20 November 2015. All three practices are registered individually with CQC, and therefore each site has an individual report and rating. However, as the provider has one General Medical Services (GMS) contract, patient list and clinical data system the data included in this report reflects all three practices.

The practice is part of the NHS Birmingham Cross City Clinical Commissioning Group (CCG). CCGs are groups of general practices that work together to plan and design local health services in England. They do this by 'commissioning' or buying health and care services. The practice has a general medical service (GMS) contract with NHS England. Under the GMS contract the practice is required to provide essential services to patients who are ill and includes chronic disease management and end of life care.

The practice is located in a purpose built health centre where services are primarily provided. However, patients may sometimes use services delivered at one of the provider’s other two locations. Based on data available from Public Health England, deprivation in the area served by the three practices is slightly higher than the national average.

The practice is open:

Monday 8.30am – 6.30pm

Tuesday 8am – 6.30pm

Wednesday 7am – 1pm

Thursday 7am – 6.30pm

Friday 7am – 6.30pm

Patients are able to make appointments with clinicians throughout the day. Before 9am and on a Wednesday afternoon calls are handled by another provider.

The practice’s extended opening hours are between 7am and 8.am Wednesday, Thursday and Friday.

When the practice is closed during the out of hours period (6.30pm to 8am) patients receive primary medical services through an out of hours provider (BADGER).

The practice has four GP partners (one male and three female) and one salaried GP. Other practice staff consists of a practice nurse and healthcare assistant, a practice manager and a team of administrative staff. Some of the administrative functions are shared with the provider’s other locations. The practice is also a training practice for doctors who were training to be qualified as GPs and a teaching practice for medical students.

The practice has not previously been inspected by CQC.

Updated 10 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Quinborne Medical Practice on 20 November 2015. 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.
• Patients’ needs were assessed and care delivered in line with current evidence based guidance.
• Staff had the skills, knowledge and experience to deliver effective care and treatment and worked with other health and care professionals to meet those needs.
• Patients said they were treated with compassion, dignity and respect and that 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 said they found it easy to make an appointment. Urgent appointments were available the same day. The practice regularly reviewed appointment capacity and worked flexibly to meet patient needs.
• The practice had good facilities and was well equipped to treat patients.
• There was a clear leadership structure and staff felt supported by management and senior partners. 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. There was a culture of openness and honesty.

The areas where the provider should:

• Establish systems for the ongoing monitoring of staff registration with their appropriate professional bodies.

• Maintain version control of policies so that it is clear to staff that they are referring to the latest policies and guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 March 2016

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

• Patients with long term condition had a named GP responsible for the co-ordination and management of their care needs.

• The practice worked with other health and care professionals to plan to deliver a multidisciplinary package of care for those with the most complex needs.

• Clinical staff had lead roles in chronic disease management to provide appropriate support to patients and were trained for these roles.

• Nationally reported data showed that the outcomes for patients with long term conditions were consistently better than other practices in the CCG area and nationally. For example, QOF points received for the management of patients with conditions such as diabetes, asthma and heart failure were all higher than the CCG and national averages.

• Performance for diabetes related indicators was at 97% which was higher than both the CCG and national average of 89%.

• Longer appointments and home visits were available for those who needed them.

Updated 10 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 and young people who had a high number of A&E attendances or failed to attend for immunisations.

• Uptake of childhood immunisation rates were comparable to the national average and a flexible approach was used to ensure children received their vaccinations.

• There was evidence of joint working with midwives and health visitors, clinics were co-ordinated to support effective communication between professionals and for patient convenience.

• Paediatric outpatient services were hosted at the Lordswood House Group site for the convenience of patients.

• Uptake of cervical screening was comparable to CCG and national averages.

• The premises were suitable for children and babies. Appointments were available outside of school hours and information was displayed about services and groups for young mums.

Updated 10 March 2016

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

• Patients received personalised care from a named GP to support continuity of care.

• The practice was responsive to the needs of older people offering home visits and urgent appointments for those who needed them.

• Patients in the older age group had a named GP responsible for the management and co-ordination of their care.

• The premises were accessible to patients with mobility difficulties.

• Secondary care services such as audiology and ophthalmology were available at Lordswood House Group which was the provider’s main practice, this offered convenience of patients.

• Nationally reported data showed that the outcomes for patients with conditions commonly found in older people were consistently better than other practices in the CCG area and nationally.

• The percentage of people aged 65 or over who received a seasonal flu vaccination was comparable to the national average.

• Shingles vaccinations were available for eligible patients.

• Those at high risk of hospital admission and end of life care needs were identified and reviewed regularly, this included working with other health professionals to provide co-ordinated care.

• Patient record systems were compatible with the local hospice so that patient information could be shared in real time, supporting timely care and treatment.

Updated 10 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 and flexible. For example extended opening and online services for the convenience of patients who worked or had other commitments during the day.

• A range of health promotion and screening was available including NHS health checks, smoking cessation and travel advice.

• Sexual health services and a full range of family planning services were available at the practice.

Updated 10 March 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 the CCG and national averages. For example 93% of patients with severe mental health conditions had a documented care plan in place that had been agreed with the individual, their family and/or carers as appropriate in the proceeding 12 months, compared to the CCG and national average of 88%.

• Although the practice was signed up to provide an enhanced service to support the early diagnosis of dementia the proportion of people diagnosed with dementia that had had their care reviewed in a face to face meeting in the last 12 months was lower than the CCG and national averages. The practice told us that they had looked into this and believed it to be a result of coding issues.

• The practice had increased the register for patients with dementia between April 2014 and March 2015 from 93 to 116. This showed that they were actively identifying patients in order to ensure they received appropriate support at the earliest opportunity.

• Although no formal meetings took place the practice described good working relationships with the community mental health team through regular telephone contact.

• Patients had access to counselling services and could also self-refer to the Improving Access to Psychological Therapies (IAPT) who provide support to those with common mental health conditions such as anxiety and depression.

Updated 10 March 2016

The practice 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 for example those with a learning disability and carers enabling additional support to be provided.

• The practice was in the process of training staff to provide comprehensive health checks for those with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people to support their care needs.

• Patients were referred to and signposted to access various support groups and voluntary organisations. For example counselling services and substance misuse services hosted at their main site.

• 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.

• HIV testing was available onsite.