Archived: Dr Ainsworth & Partners Also known as The Harlequin Surgery

Updated 16 February 2017

Dr Ainsworth & Partners provides primary medical services in Shared End, Birmingham from Monday to Friday.

The practice is open 8am to 6:30pm Monday to Friday, only closing between 12:30pm and 2:30pm Wednesdays. Appointments with a GP or advanced nurse practitioner were available Monday to Friday, Mondays are on the day appointments only, Tuesday to Friday pre bookable appointments are available from 8:30am to 12pm and 2pm to 6pm, urgent on the day appointments are available via a triage system.

The practice is situated within the geographical area of NHS Birmingham Crosscity Clinical Commissioning Group (CCG).

The practice has a General Medical Services (GMS) contract. The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

Dr Ainsworth & Partners is responsible for providing care to 11327 patients.

The practice during 2015/16 saw significant staff changes including the retirement of Dr Ainsworth and staff shortages due to maternity leave and sickness and difficulties recruiting new clinical staff resulting in an increased use of locum GPs. At the time of our inspection the clinical team was stable with two GP partners, four salaried GPs and two long term locum GPs, five of whom were female. Alongside the GPs there are three advanced nurse practitioners, a minor illness nurses, three practice nurse and two health care assistants.

The practice is supported by a practice manager, one administrative supervisor, three administrators, secretary, senior administrator, two senior receptionists and six receptionists.

When the practice is closed patients are directed to the out of hours service by calling 111.

Updated 16 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the practice of Dr Ainsworth & Partners on 5 January 2017. Overall the practice is rated as good.

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.
• Risks to patients were assessed and well managed, including those relating to recruitment checks.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• Data showed patient outcomes were comparable to those locally and nationally.
• Feedback from patients about their care was strongly positive,

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

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a result of feedback from patients.

• Information about services and how to complain was available and easy to understand.

• Patient’s views were in the main positive when asked how easy it was to make an appointment including availability of same day appointments.

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

• 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 areas where the provider must make improvement are:

• Arrangements were in place to safeguard adults and children from abuse that reflected relevant legislation and local requirements and policies were accessible to all staff. We noted however there was no formal system in place to routinely review and monitor children on the at risk register.

The provider should also:

• Consider assessing the need for all electrical equipment including computers to be checked in line with good practice guidance.
• Consider a formal means of disseminating safety alerts such as drug safety alerts and alerts from the Medicines and Healthcare products Regulatory Agency (MHRA) to all relevant staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 February 2017

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.
• Where appropriate, patients with more than one long-term condition were able to access a joint review to prevent them having to make multiple appointments.
• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For patients with complex needs, a named GP and practice nurse worked with relevant community and healthcare professionals to deliver multidisciplinary support and care. Multidisciplinary meetings were held to review patients’ needs and to avoid hospital admissions.
• Patients with COPD and asthma had self-management plans and those with chronic conditions were provided with care plans.
• Patients who were diagnosed with a long term conditions such as diabetes were directed to a structured education programme.

Updated 16 February 2017

The practice is rated as requires improvement 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. We noted however there was no formal system in place to routinely review and monitor children on the at risk register.

• 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 and health visitors.

Updated 16 February 2017

The practice is rated as good for the care of older people. The practice had a higher than average percentage of patients over the age of 75 with 12.3% compared to 8.9% for the CCG.

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.
• One of the GP partners took the lead for avoiding unplanned admissions and met monthly with the integrated care team to review and monitor the care and treatment provided to vulnerable patients.
• The practice embraced the Gold Standards Framework for end of life care. 

Updated 16 February 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.

• Patients could access appointments with a clinician from 8:30am and up to 6pm to enable patients to access appointments outside of normal working hours. The practice also provided Long term health conditions clinics twice a month on a Saturday.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 16 February 2017

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

• 85.2% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months comparable to the CCG and national average.
• 92.6% of patients with poor mental health had a comprehensive care plan documented in the record agreed between individuals, their family and/or carers as appropriate.
• The practice regularly worked with multi-disciplinary teams in the case management of patients 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 how to access various support groups and voluntary organisations.
• Staff had a good understanding of how to support people with mental health needs and dementia.

Updated 16 February 2017

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 those with a learning disability.
• The practice was aware of those patients who required an interpreter and used a translation telephone service where required.

• Vulnerable patients were identifiable with alerts noted on the secure computer system to ensure staff were alerted to needs.
• The practice supported patients in relation to substance misuse. One GP took a lead on substance misuse, working together with a drugs worker the GP would prescribe and monitor patients, signpost to relevant agencies and where required provided testing for blood borne virus and referral if necessary to hospital specialists.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• The practice had told vulnerable patients 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.