Background to this inspection
Updated
25 February 2016
Maple View Medical Practice is situated in Church Hill Centre, Redditch. The building is purpose built. The practice has a list size of 6,000 patients.
The practice offers a wide range of services to their patients such as cervical screening , electrocardiograms (ECGs) which record electrical activity in the heart, wound dressings, removing sutures, travel advice, contraception care and immunisations. The practice also runs clinics for diabetes, asthma and Chronic Obstructive Pulmonary Disease (COPD) which is a lung disease
The practice has six GP partners (this includes the support of the partners at St Stephen's Practice also located in Redditch) and two salaried GPs. There is a mix of male and female GPs.The GPs have contracts of employment which allow them to work at both practices to enable cross site cover. The practice has two nurses and a healthcare assistant.
The clinical team are supported by a practice manager, a deputy practice manager, a head receptionist and a team of reception staff and medical secretaries. The practice has a General Medical Services (GMS) contract with NHS England. This is a contract for delivering primary care services to local communities.
The practice is open between 8.30am and 6pm Monday to Friday. Appointments are available from 8.30am to 11.30am and 2pm to 6pm every weekday. Extended hours are available on a Tuesday until 7.30pm.
The practice does not provide out of hours services to their own patients but provided information about the telephone numbers to use for out of hours GP arrangements (NHS 111).
Updated
25 February 2016
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Maple View Medical Practice on 14 October 2015. Overall the practice is rated as good.
Our key findings were as follows:
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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. For example significant events were discussed on the day with the lead GP and a formal meeting was arranged following this.
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Patients’ needs were assessed and care was planned and delivered following best practice guidance. For example the practice worked closely with YMCA to ensure that vulnerable adults were protected and safe.
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The practice had good facilities and was well equipped to treat patients and meet their needs.
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There was a clear leadership structure and staff felt supported by management. The practice management team were particularly focussed on training and development. The practice management team had introduced workbooks to help all staff in this area.
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Risks to patients were assessed and well managed.
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Patients described staff as kind, caring and considerate.
However, there were also areas of practice where the provider needs to make improvements.
Importantly the provider should:
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
25 February 2016
The practice is rated as good for the care of people with long term conditions. The practice had a higher than national prevalence for many chronic diseases and they scored highly in the Quality and Outcomes Framework system (QOF) for their care of these patients.
The practice ran clinics for asthma, Chronic Obstructive Pulmonary Disease (COPD) the name for a collection of lung diseases, including chronic bronchitis and emphysema, diabetes, heart disease and rheumatoid arthritis and had protocols for diagnosis and management of chronic disease. Patients with long term conditions were reviewed annually. The practice combined their recall systems with their prescribing so that all patients had a review date on their prescriptions. At this point the doctors would check that the patient has had the appropriate checks, blood tests and monitoring of their condition and medication. If a patient was due a review the doctors would send a message to the receptionists to see the patient. The review date on the prescription would not be altered until the patient had attended.
The practice kept a register of those patients who were identified as being at risk of diabetes. They were provided with lifestyle advice and they ran an annual recall to check their progress.
The practice offered NHS health checks to those eligible patients between 40 and 74. High risk patients identified by this were followed up by the doctor.
Families, children and young people
Updated
25 February 2016
The practice is rated as good for the care of families, children and young people. The practice offered antenatal care and participated in child health surveillance checks. The practice worked closely with their community midwife who ran an antenatal clinic within the practice once a week.
The eight week checks were done at the same time as the child immunisation clinics so that parents could have their child immunised immediately after their health check.
The practice ran an emergency triage service which meant that patients could access emergency advice or obtain an appointment depending on their need. If for example a child was sent home from school they would be seen by a doctor the same day.
The practice had a suite of gynaecology protocols developed with consultants of the local hospital. This enabled the practice to offer appropriate evidence based care of some of the more common gynaecological problems.
The practice was signed up as a young person friendly practice. For example if a patient needed emergency contraception they would be able to access this. The practice also ran contraception clinics and did coil fittings.
Updated
25 February 2016
The practice is rated as good for the care of older people. The practice had developed a dementia screening protocol and encouraged a proactive approach so that older patients with dementia could be identified with appropriate investigation and referral. All of the patients identified were reviewed annually.
The practice participated in the avoiding unplanned admissions service which focussed on their top 2% of elderly and vulnerable patients most at risk of an admission. Care plans were in place where considered appropriate. The practice held monthly palliative care meetings which were aligned with the gold standards framework which included cancer patients, patients with chronic disease and the frail elderly. These meetings were governed by the practice’s palliative care protocol. Responsible doctors were assigned at these meetings for each patient in order to ensure follow up and continuity.
Working age people (including those recently retired and students)
Updated
25 February 2016
The practice is rated as good for the care of working age people, recently retired people and students.
The practice started clinics at 8.30am and offered extended hours on a Tuesday from 6.30pm to 7.30pm. Telephone consultations were available for those who worked or were housebound.
The practice had physiotherapy on site which was available within one or two weeks. This minimised the time patients would need to take off work as they would not have to make anotherappointment in the community.
People experiencing poor mental health (including people with dementia)
Updated
25 February 2016
The practice is rated as good for the care of people living in vulnerable circumstances. The practice had a checklist for mental capacity which all staff had access to.
The practice offered extended appointments for patients who experienced poor mental health and carried out annual reviews for all such patients.
QOF performance for mental health related and hypertension indicators was 87% which was above the CCG average of 85.5% and above the national average of 81.5%.
There was a practice based counsellor who saw patients who were in need of counselling if it was felt to be appropriate.
People whose circumstances may make them vulnerable
Updated
25 February 2016
The practice is rated as good for the care of people living in vulnerable circumstances.
The practice had a safeguarding lead and all staff had updates in safeguarding.
Patients who had a learning disability and patients who experienced poor mental health received annual health checks.
All child protection reports and domestic violence reports were coded in the patient’s notes on the practice computer system appropriately so that when a record was opened this information was automatically flagged up. The practice was working closely with the YMCA support worker to improve access and support for vulnerable patients.