Archived: Dr Faisal Yunas Also known as Heathview Medical Practice

Updated 29 April 2016

Dr Faisal Yunas’ Practice is situated in the Staffordshire town of Tamworth. The practice was established in 1963, and Dr Yunas took over as a single handed GP in 2006. The practice provides services from a purpose built building owned by NHS Properties. Until November 2015, the building was shared with another single handed GP practice. On 30 November 2015 the two practices began the process of merging. This was completed in February 2016 when the two computer systems were integrated. Following the merger, Dr Yunas recruited two additional GP partners and appointed an interim manager to oversee the administrative tasks.

The practice has a list size of 3,931 patients of which a higher than average percentage are under 18 years of age (22.6% compared to Clinical Commissioning Group (CCG) average of 19.6%) and a lower than average number of patients over 65 years of age (15.2% compared to a CCG average of 20.2%). The ethnicity data for the practice shows 97.4% of patients are white British. The area is one of higher deprivation when compared to national averages sitting in the third less deprived centile with a deprivation score (IMD 2015) of 30 compared to the CCG average score of 15. Prior to the merger Dr Yunas had a list size of 2,150 patients.

The three GP partners work a combined total of sessions per week equal to one point five whole time equivalents. The GP partners are assisted by a clinical team consisting of one full time salaried GP and two practice nurses. The administration team consists of a practice manager, a locality manager, three administration staff and five reception staff.

The practice telephone lines open from 8am to 6.30pm on a Monday, Tuesday, Wednesday and Friday. On a Thursday the lines are open from 8am to 2pm. The reception opens from 8.30am to 6.30pm, Monday to Friday and until 2pm on a Thursday. A GP is on call on a Thursday from 2pm until 6.30pm and patients are given an emergency mobile number to contact. Consulting times are from 9am to 11.30am and from 3.30pm to 5.30pm. When the practice is closed patients’ telephone calls were diverted to the NHS 111 service. The practice opted out of providing an out of hour’s service, choosing instead to use a third party provider. The nearest hospitals with A&E units are situated at Good Hope Hospital, Sutton Coldfield, Queen’s Hospital in Burton-Upon-Trent and Walsall Manor Hospital. There is a minor injury unit at the Sir Robert Peel Hospital in Tamworth.

Updated 29 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Faisal Yunas practice on 7 March 2016. Overall the practice is rated as Good.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the Care Quality Commission (CQC) at that time.

Our key findings were as follows:

• The practice had recently merged with another GP practice.
• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. Information about safety was recorded, monitored, reviewed and addressed. Risks to staff and patients were documented. Infection control, chaperoning and legionella testing assessments were not complete.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received some training appropriate to their roles but a training needs analysis had not been completed.
• Patients said they were treated with 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 get an urgent appointment when they needed one but a small number of patients mentioned difficulties when contacting the practice by telephone.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff understood their roles and responsibilities.

We saw a number of areas where the practice must make improvements.

The practice must:

• Complete a disclosure and barring service (DBS) check or a comprehensive risk assessment for all staff who act as chaperones.

We saw a number of areas where the practice should make improvements.

The practice should:

• Adopt nationally recognised guidelines when completing infection prevention control audits.

• Perform regular checks on the water system to minimise the risk of legionella.

• Include children’s pads for the defibrillator as part of the emergency equipment.

• Introduce a tracking system for prescription forms and pads.

• Identify and plan training for individual staff members.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 29 April 2016

The practice is rated as good for the care of people with long-term conditions. Patients were reviewed in nurse led chronic disease management clinics.  We found that the nursing staff had the knowledge, skills and competency to respond to the needs of patients with long term conditions such as diabetes and asthma. Longer appointments and home visits were available when needed. Written management plans had been developed for patients with long term conditions and those at risk of hospital admissions. For those people with the most complex needs, the GPs worked with relevant health and social care professionals to deliver a multidisciplinary package of care. The practice used the gold standards framework (GSF) to provide end of life care. Monitoring was in place for patients that had shared care agreements.

Updated 29 April 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 who were at risk, for example, children and young people who had protection plans in place. Appointments were available outside of school hours and the premises were suitable for children and babies. Same day emergency appointments were available for children. There were screening and vaccination programmes in place and the child immunisation rates were higher in eight of the 18 indicators when compared with the local CCG averages. The practice worked with the health visiting team to encourage attendance. New mothers were offered post-natal checks and development checks for their babies. A contraception advice service was offered and free condoms were provided at the practice.

Updated 29 April 2016

The practice is rated as good for the care of older people. Every patient over the age of 75 years had a named GP and all hospital admissions were reviewed. This included patients that resided in nursing and care homes. Housebound patients received visits from the GPs and had access to an acute visiting service provided by the local clinical commissioning group (CCG). The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, risk profiling and case management. All over 75 year olds had been identified as at risk of unplanned hospital admissions and had individual personalised care plans. The practice was responsive to the needs of older people and offered same day appointments for patients on a case management register. The practice had identified and supported patients who were also carers. The practice provided a falls clinic for elderly patients.

Updated 29 April 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. A range of on-line services were available, including medication requests, booking appointments and access to health medical records. The practice offered all patients aged 40 to 75 years old a health check with the nursing team. The practice offered a full range of health promotion and screening that reflected the needs for this age group.

Updated 29 April 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Patients who presented with an acute mental health crisis were offered same day appointments. People experiencing poor mental health were offered an annual physical health check. Dementia screening was offered to patients identified in the at risk groups. It carried out advance care planning for patients with dementia.

The practice had regular meetings with other health professionals in the case management of patients with mental health needs. The practiced waiting room had information to signpost patients to local support services, for example, ‘that place’, a counselling and support service for young adults.

The practice worked closely with the health visiting team to support mothers experiencing post-natal depression. It had told patients about how to access various support groups and voluntary organisations and signposted patients to support groups where appropriate. For example, the practice referred patients to the one recovery service for drug and alcohol addiction.

Updated 29 April 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable. We found that the practice enabled all patients to access their GP services and assisted those with hearing and sight difficulties. A translation service available for non-English speaking patients was clearly displayed at the reception. The reception staff told us of the policy to provide an open service to asylum seekers and homeless patients.

The practice held a register of patients with a learning disability and had developed individual care plans for each patient. Out of 20 patients on the learning disabilities register, three had received annual health checks for the year ending 21 March 2016. The practice had planned to complete the remainder in a dedicated clinic by both a GP and a nurse scheduled before the end of March 2016. Longer appointments were offered for patients with a learning disability and carers were encouraged by GPs to be involved with care planning.

The practice had a register of vulnerable patients and displayed information about how to access various support groups and voluntary organisations. For example there were posters for a local support group for patients with a bipolar disorder. 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.