Archived: Dr Ali & Partners

Updated 2 June 2017

Dr Ali and Partners is based in Northfield Health Centre which is located in the Birmingham South Central Clinical Commissioning Group (CCG). The practice has a General Medical Services (GMS) contract with NHS England and provides primary medical services to approximately 5,600 patients locally. The practice population is mostly white British.

There is one male and one female GP partner working at the practice, and one female salaried GP which gives patients a choice. There is currently one female GP trainee who is a qualified doctor currently working at the practice as part of their GP training. Additionally there are two practice nurses, a healthcare assistant and a trained phlebotomist (phlebotomists are people trained to draw blood from patients).

The clinical team are supported by a practice manager, a deputy practice manager, and a team of administrative, secretarial and reception staff.

The practice is open from 8am to 6.30pm on weekdays. The practice is not open at weekends.

Morning appointments are available from 8am to 12pm. Afternoon appointments are from either 12pm (Wednesdays), 1.20pm (Tuesdays and Thursdays) or 2.50pm (Mondays and Fridays) until 6pm.

The practice offers some pre-bookable out of hours and weekend appointments as part of a federation arrangement with other practices locally. The practice also provides information about the telephone numbers to use for additional GP out of hours arrangements, which were provided by South Doc Services and Badger Medical. Alternatively patients can be provided with the details of the South Birmingham GP Walk-in Centre at Katie Road, which is about 2 miles away.

We previously carried out an announced comprehensive inspection at Dr Ali & Partners on 2 December 2015. The practice was rated requires improvement for providing safe services and for being well-led. The overall rating for the practice was requires improvement.

Updated 2 June 2017

Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Dr Ali & Partners on 2 December 2015. The practice was rated requires improvement for providing safe services and for being well-led. The overall rating for the practice was requires improvement.

We found the practice required improvement in these areas due to breaches in regulations relating to safe care and treatment. This was because the practice did not have an emergency medicine in stock which can be required during coil fitting to keep patients safe. The practice had not assessed the risk of not having this in stock at the time of the inspection.

We also found other areas where the practice should improve. These findings were as follows:

• Proof of identity was not always checked for locum doctors employed by the practice.

• The practice did not fully complete clinical audits to identify improvements made.

• Not all GPs at the practice could evidence how they understood how the Quality and Outcomes Framework (QOF) could be used to improve practice.

• Patient consent for medical procedures was not always documented.

The full comprehensive report on the December 2015 inspection can be found by selecting the ‘all reports’ link for Dr Ali & Partners on our website at www.cqc.org.uk.

On 5 April 2017 we carried out an announced, follow-up comprehensive inspection to confirm the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 2 December 2015. This report covers our findings in relation to those requirements.

Our key findings were as follows:

• People were protected by a strong, comprehensive safety system and a focus on openness, transparency and learning when things went wrong. Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Opportunities for learning from internal and external incidents were maximised.

• Risks to patients were comprehensively assessed and well managed.

• The practice had added the emergency medicine required for coil fitting to their stock. We saw that a specific coil fitting emergency drug box, containing the emergency medicine required, was situated in the treatment room used for coil fitting.

• Proof of identity was now requested consistently as part of a staff recruitment template.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff were sufficiently trained and had the appropriate knowledge and experience to effectively deliver care and treatment.

• Patient outcomes were in line with or above local and national averages.

• All GPs fully understood how they could use QOF to monitor and improve performance.

• The practice had implemented a programme of continuous clinical audit, which included completed audit cycles to assess the effectiveness of improvements made.

• Patients said they were treated with compassion, dignity and respect and that they were suitably involved in their care and decisions about their treatment.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.

• There was a clear leadership structure and staff felt supported by 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.

The practice is now rated as good for providing safe services and for being well-led. The overall rating for the practice is now good.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 2 June 2017

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

• The practice held registers of those patients 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. We saw that nursing staff utilised, reviewed and kept up to date care plans for patients with long term conditions.

• Performance for diabetes related indicators was in line with CCG and national averages. For example, 87% of patients with diabetes had a total cholesterol measurement at or under the recommended level, compared with CCG and national averages of 78% and 80% respectively. The practice’s exception reporting rate for this indicator was 5%, compared with the CCG average of 10% and the national average of 13%.

• Longer appointments and home visits were available when needed.

• All patients with long-term conditions had a named GP clinical lead.

• Structured annual reviews were provided to check health and medicine 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 2 June 2017

The practice is rated as good for the care of families, children and young people.

• There were systems to identify and follow up children who were at risk, for example, children and young people who had a high number of Accident and Emergency (A and E) attendances.

• Immunisation rates were high for all standard childhood immunisations.

• All children were invited to eight week and three year developmental checks.

• Children and young people were treated in an age-appropriate way and were recognised as individuals. We saw evidence to confirm this including care planning.

• The practice offered appointments for young people (teenagers aged 14 to 17 years) without their parents or guardians and was engaging in promoting this service.

• Performance for cervical screening indicators was in line with CCG and national averages. For example the percentage of women aged 25-64 receiving a cervical screening test in the last five years was 74%, compared with CCG average of 80% and the national average of 81%.

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

• The practice provided combined parent and baby clinics carrying out post-natal and early child development checks.

• We saw positive examples of engagement and joint working with midwives and health visitors

Updated 2 June 2017

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 same-day appointments when needed.

• Practice staff worked closely with other health care professionals to deliver care to older people, for example community nursing staff.

• The practice offered enhanced checks, medicines reviews, falls assessments and dementia screening for patients aged 75 and above.

• The practice offered double appointments for older people.

• The practice directed older people to appropriate support services.

Updated 2 June 2017

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 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. Patient engagement with online services was high.

• Appointments were offered to accommodate those unable to attend during normal working hours.

Updated 2 June 2017

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 in line with CCG and national averages. For example, the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption has been recorded in the preceding 12 months was 97%, compared with CCG and national averages of 94% and 89% respectively. The practice’s exception reporting rate for this indicator was 10%, compared with the CCG average of 6% and the national average of 10%.

• Patients experiencing poor mental health (including those with dementia) were placed on a register, had a care plan in place and were invited to see a GP for a comprehensive review at least once a year.

• Longer appointments were available for those patients with mental health needs or dementia.

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

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 2 June 2017

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

• The practice held registers of patients living in vulnerable circumstances.

• We saw evidence that circumstances were considered in care planning and treatment for vulnerable patients and the practice regularly worked with other health care professionals to deliver care and treatment.

• The practice had a dedicated list of patients registered as having a learning disability and had offered health checks for all of these patients. The practice used information to support care planning and offered longer appointments for patients with a learning disability.

• The practice provided help and support for patients who were carers.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• 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.