Background to this inspection
Updated
16 July 2015
Hodge Hill Family Practice is situated in Birmingham. The practice operate as part of a larger organisation called Phoenix Primary Care who provide services under an alternative primary medical services (APMS) contract and has expanded its contracted obligations to provide enhanced services to patients. An enhanced service is above the contractual requirement of the practice and is commissioned to improve the range of services available to patients. The increased range of services provided included in house diabetes care and phlebotomy (taking of blood samples).
The practice building is purpose built, with treatment areas on the second floor. The building has car parking, with allocated spaces and access for those with a disability.
There are just over 3,500 patients of all ages registered and cared for at the practice, including a younger than national average practice population.
The practice team consists of one female and two male GPs and two nurses. The administrative team take care of the day to day running of the practice and consist of a practice manager and four reception/secretarial team members.
Appointments were available from 8.30am to 6pm on all weekdays and the practice offered extended hours on Thursdays until 8pm and on Saturdays from 9am to 2pm. Appointments could be booked in person or via telephone. The practice does not routinely provide an out-of-hours service to their own patients but they have alternative arrangements for patients to be seen when the practice is closed.
Updated
16 July 2015
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Hodge Hill Family Practice on 9 June 2015. Overall the practice is rated as good.
Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led services. It was also good for providing services for older people; people with long-term conditions; families, children and young people; working age people; people whose circumstances may make them vulnerable and people experiencing poor mental health.
Our key findings across all the areas we inspected were as follows:
- Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
- The practice had good facilities and was well equipped to treat patients and meet their needs. Cleanliness and infection control was well maintained at the practice.
- Patients’ needs were assessed and care was planned and delivered following best practice guidance. We found that the practices audits were mostly driven by the medicines management team at the CCG (Clinical Commissioning Group). The practice recognised the need to conduct more clinical audits and they shared a summary of other audits due to be carried out at the practice.
- Staff had received training appropriate to their roles and any further training needs had been identified and planned for. However, there was some inconsistency regarding awareness of lead roles within the practice. For example, some staff were unaware of the lead for safeguarding.
- Patients said they were treated with compassion, dignity and respect.
- Information about services and how to complain was available and easy to understand.
- There was a clear leadership structure and staff felt supported by management. Patients and staff told us how continuity of care was improving with permanent GPs in place; however we found that patients over the age of 75 did not have a named GP.
There were areas of practice where the provider needs to make improvements.
Importantly the provider should:
- Ensure processes are robust with regards to the management and dissemination of national patient safety alerts and ensure communication is consistent amongst clinical staff at the practice.
- Ensure risks to patients are assessed and recorded in relation to health and safety.
- Continue to strengthen a programme of clinical audits in the practice, ensuring that full cycle audits are completed with improvements recorded.
- Ensure support is offered to families who have suffered bereavement and ensure information is available for carers to offer support and signpost carers to local support services.
- Ensure a consistent approach is applied when applying learning points to complaints made regarding locum GPs who may fail to respond to complaints once they have left the practice.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
16 July 2015
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. Longer appointments and home visits were available when needed. All these patients had a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the GPs and nurses worked with relevant health and care professionals to deliver a multidisciplinary package of care.
Families, children and young people
Updated
16 July 2015
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. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.
Updated
16 July 2015
The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. However, we found that patients over 75 years of age did not have a named GP. The practice told us that this was previously due to using a large number of locum GPs. Staff told us that this was an area they planned on addressing however we saw no documented plans in place to support this. The practice was strengthening the relationships with the local care homes. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.
Working age people (including those recently retired and students)
Updated
16 July 2015
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 a full range of health promotion and screening that reflected the needs for this age group.
People experiencing poor mental health (including people with dementia)
Updated
16 July 2015
The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Ninety Seven percent of people experiencing poor mental health had received an annual physical health check; this was higher than the national average of 83%. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia.
The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. Staff had received training on how to care for people with mental health needs and dementia.
People whose circumstances may make them vulnerable
Updated
16 July 2015
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, travellers and those with a learning disability. It had carried out annual health checks for people with a learning disability and care plans were in place for 83% of these patients. It offered longer appointments for people 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.