Archived: Balliol Road Surgery

Updated 30 November 2016

Balliol Road Surgery is located in the northern part of Coventry. The area is urban and has a significant number of patients from ethnic minority groups, with eastern European being the most common.

The practice is a group practice and had 5849 patients registered at the time of our inspection. The practice had seen an increase of patients within the last 12 months due to the closure of another local GP practice.

Balliol Road Surgery has a General Medical Services (GMS) contract with NHS England. The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities. The practice is part of a local GP federation known as the GP Alliance. A federation is formed of a group of practices who work together to share best practice and maximize opportunities to improve patient outcomes.

The practice has four partner GPs (one male and three female), along with one locum GP (male) who is permanently based at the practice. There is also a practice nurse. They are supported by a practice manager and administrative and reception staff.

The practice is open from 8.00am to 6.30pm during the week. Appointments are available throughout those times. Extended hours appointments are available on Mondays from 6.30pm to 7.45pm.

When the practice is closed, patients can access out of hours care provided by the Coventry & Warwickshire Partnership NHS Trust located in the City of Coventry Healthcare Centre through NHS 111. The practice has a recorded message on its telephone system to advise patients. This information is also available on the practice’s website.

Home visits are available for patients who are unable to attend the practice for appointments. There is also an online service which allows patients to order repeat prescriptions and book new appointments without having to telephone the practice. Telephone appointments are available for patients who are unable to reach the practice during normal working hours.

The practice treats patients of all ages and provides a range of medical services. This includes minor surgery and disease management such as asthma, diabetes and heart disease.

Updated 30 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Balliol Road Surgery on 27 September 2016. Overall the practice is rated as good.

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

• Patients said they were treated with dignity, respect and compassion. Patients were involved with decisions about their care and treatment.
• Risks to patients were assessed and well managed.
• There were clearly defined processes and procedures to ensure patients were safe and an effective system was in place for reporting and recording significant events.
• Patients’ needs were assessed and care delivered in line with current guidelines. Staff had the appropriate skills, knowledge and experience to deliver effective care and treatment.
• Care planning needed development. The practice used care plans produced by other providers, for example, the district nursing team, for palliative care (end of life) patients, instead of its own.
• Urgent same day patient appointments were available when needed. The majority of patients we spoke with and those who completed comment cards before our inspection said they were always able to obtain same day appointments, although a small number said it could be difficult at times. Some patients told us their appointments were often late.
• Patients said GPs gave them enough time and treated them with dignity and respect.
• Information about how to complain was available and easy to understand.
• Owing to the practice taking on a number of patients from a nearby practice which had recently closed, recorded patient outcomes recorded via the Quality and Outcomes Framework (QOF) system were mostly below average when compared with the Clinical Commissioning Group average and national average. However we saw evidence improvement was being made.

The areas where the provider should make improvements are:

• Continue to closely monitor practice performance and identify areas for improvement.

• Resolve maintenance issues in a timely way.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 30 November 2016

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

• The practice had a register of patients with long term conditions to enable their health to be effectively monitored and managed.
• Longer appointments and home visits were available when needed.
• Patients had a named GP and a review every six to 12 months to monitor their condition and ensure they received correct medicines. This also included carers if the patient had one. The frequency of the review depended on the severity of the patient’s condition. The practice had just started to change to a system of reviewing patients during their birthday month to make this easier to manage for the practice and easier to remember for patients.
• All patients who had been prescribed eight or more medicines had a medicines review within the last 12 months.
• The practice achieved a 99% flu vaccination record for diabetes patients during 2015/16. This was above the Clinical Commissioning Group (CCG) average of 93% and the national average of 94%.

Updated 30 November 2016

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

• A total of 81% of eligible patients had received cervical screening in the last 12 months. This was similar to the Clinical Commissioning Group (CCG) average of 81% and the national average of 81%.

• There were appointments outside of school hours and the practice building was suitable for children and babies.

• Outcomes for areas such as child vaccinations were in line with the average for the CCG.

• We saw positive examples of joint working with midwives and the local health visitor. Midwife appointments were available at the practice every week.

• A monthly multi-disciplinary team meeting was held with the midwife and health visitor. The child protection register and non-attendance for immunisations and checks were reviewed at this meeting.

• A full range of family planning and sexual health services were available within the practice building.

Updated 30 November 2016

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

• Care plans were in place with the most vulnerable older patients (2%) and used with multi-disciplinary teams to reduce unplanned hospital admissions. These patients had an alert placed on their patient records to ensure clinical staff were aware.

• The most vulnerable patients were given ‘patient care reviews’ which included both the patient and their carer if they had one. The practice also liaised with the district nursing team when appropriate, to ensure the right package of care was provided.

• Care plans were not developed for palliative care (end of life patients). The practice used care plans produced by other providers.

• Older patients were given personalised care which reflected their needs.

• Over the last 12 months all patients aged 75 and over had been invited for a health check. This included blood tests, fracture assessment, frailty assessment, and checks for depression and dementia. From those checks, the practice identified patients who needed further investigation and referred them appropriately.

• Home visits were offered to patients who could not reach the practice.

Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people.

Updated 30 November 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The practice ensured it provided services to meet the needs of the working age population, For example, extended hours appointments were available on Mondays from 6.30pm to 7.45pm.

• Telephone consultations were available for patients who were unable to reach the practice during the day.

• Regular reviews of the appointment system were held to ensure patients could access the service when they needed to. This had recently resulted in additional telephone appointments being made available.

• A full range of services appropriate to this age group was offered, including travel vaccinations and smoking cessation.

Updated 30 November 2016

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

• The practice had a register of patients with poor mental health to enable their health to be effectively monitored and managed.

• The practice worked with multi-disciplinary teams to provide appropriate care for patients with poor mental health. This included patients with dementia.

• Patients were signposted to appropriate local and national support groups.

• Staff demonstrated a good working knowledge of how to support patients with mental health needs and dementia.

Updated 30 November 2016

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

• The practice had a register of patients who were vulnerable to enable their health to be effectively monitored and managed. This included patients with a learning disability.

• The practice participated in the learning disability enhanced service and offered comprehensive reviews by clinical staff who had undertaken relevant training.

• The practice supported vulnerable patients to access various support groups and voluntary organisations.

• Longer appointments were available for patients with a learning disability.

• The practice worked with other health care professionals to provide care to vulnerable patients, for example, the district nursing team and community matron. Vulnerable and complex patients were discussed at the monthly multi-disciplinary team meeting.

• Staff could recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities to share appropriate information, record safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours. Staff training had included recognition of many forms of abuse and neglect, for example physical and sexual abuse.