Archived: Birstall Medical Centre

Updated 19 October 2016

Birstall Medical Centre provides primary medical services to approximately 7,500 patients from two sites, Birstall Medical Centre and Border Drive Surgery, Leicester. The two sites share a common patient list. We inspected Birstall Medical Centre only.

The practice has two GP partners and three salaried GPs. The nursing team consists of a nurse, advanced nurse practitioner and two healthcare assistants. They are supported by two Practice Managers and reception and administrative staff.

West Leicestershire Clinical Commissioning Group (WLCCG) commission the practice’s services.

Border Drive Surgery is located in Mowmacre Hill which is a relatively less affluent area compared to Birstall. The practice is located in a converted house. Birstall Medical Centre is located in a purpose-built two-storey building. All patients’ facilities are located on the ground floor at both sites.

Birstall Medical Centre is open between 8am and 6.30pm Monday to Friday. Border Drive Surgery is open between 8.30am to 6pm Monday to Wednesday and Friday, it is open from 8.30am to 1pm on Thursdays. GP consultations are available between 8.30am and 11.30am. In the afternoon, consultations start at either 2pm or 3pm and usually finish at 5.30pm.

Patients can access out of hours support from the national advice service NHS 111. The practice also provides details for the nearest urgent care centres, as well as accident and emergency departments.

Updated 19 October 2016

Letter from the Chief Inspector of General Practice

Birstall Medical Centre was first inspected on 21 and 29 May 2015 when the practice was rated as ‘inadequate’. The practice was placed into Special Measures in September 2015 and required to make significant improvements. An announced follow-up inspection was carried out on 15 March 2016 and we found the practice had made improvements across all five domains of safe, effective, caring, responsive and well led and was rated as ‘requires improvement’.

The practice submitted an action plan detailing how they would meet the regulations governing providers of health and social care and we carried out a further announced follow-up inspection at Birstall Medical Centre on 17 August 2016.

At our inspection, we found the practice had made improvements across all five domains of safe, effective, caring, responsive and well led. Overall the practice is rated as good.

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

• There was a system in place for reporting and recording significant events and lessons were shared to make sure action was taken to improve safety in the practice.

• Appropriate checks were carried out before staff started employment, however there was no process to ensure nursing staff and GPs renewed their registration with the relevant professional body on an annual basis.

• Staff assessed needs and delivered care in line with current evidence based guidance.

• Staff had the skills, knowledge and experience to deliver effective care and treatment and had access to relevant training.

• Data from the national GP patient survey showed patients rated the practice lower than others for several aspects of care. The practice were aware of this and were working with the patient participation group.

• We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.

• Information about how to complain was available and easy to understand and evidence showed the practice responded quickly to issues raised. Learning from complaints was shared with staff and other stakeholders.

• The practice had a vision and clear objectives to deliver quality care and promote good outcomes for patients. Staff were clear about the vision and their responsibilities in relation to it.

• The provider was aware of and complied with the requirements of the duty of candour. The partners encouraged a culture of openness and honesty.

• The practice sought feedback from staff and patients, which it acted on. The patient participation group was active.

The areas where the provider should make improvement are:

• To review the system in place to ensure nursing staff and GPs renew their registration with the relevant professional body.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 October 2016

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

• Patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators, for example monitoring of blood sugar levels, was better compared to the national average. 89% compared to the national average of 78%.

• Longer appointments and home visits were available when needed.

• Patients with a new diagnosis of diabetes were offered a longer appointment.

• Patients had a named GP and this was identified on the patient record system.

• An annual review was carried out to check patients’ health and medicines needs were being 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 19 October 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.

• Immunisation rates were relatively high for all standard childhood immunisations.

• 72% of patients diagnosed with asthma had an asthma review in the last 12 months. This was comparable to the national average of 75%.

• The practice’s uptake for the cervical screening programme was 75%, which was comparable to the CCG average of 78% and the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice provided facilities for baby changing and mothers wishing to breastfeed.

• The practice provided a room for antenatal visits so pregnant women could be seen at the surgery.

Updated 19 October 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.

• Those patients identified as high risk had a care plan in place and the practice worked with other health and social care professionals to ensure their needs were met.

• Patients over 75 and requiring an urgent home visit were referred to the Acute Visiting Service (AVS).

Updated 19 October 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. This included offering late appointments to see a GP.

• The practice offered online services to book appointments and request repeat prescriptions, as well as a full range of health promotion and screening that reflected the needs for this age group.

• NHS Health Checks were offered to patients, which were repeated every five years.

• Telephone triage was offered to patients to minimise the need for patients to attend the practice.

Updated 19 October 2016

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

• 100% of patients with a diagnosis of schizophrenia, bipolar affective disorder or other had a comprehensive and agreed care plan in place, compared to the national average of 88%.

• 85% of patients with a diagnosis of dementia had their care reviewed in a face-to-face review, compared to the national average of 84%.

• The practice referred patients to support groups including community mental health teams.

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those living with dementia.

• 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 those living with dementia.

Updated 19 October 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 including homeless people and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability, as well as an annual health check.

• The practice worked with multi-disciplinary teams in the case management of vulnerable people and had improved the vulnerable patient register to ensure the correct health and social care professionals were involved in the patients care.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. However, administrative staff were unaware of relevant agencies that would need to be contacted if they had a safeguarding concern.

• The practice had a named safeguarding lead.