Great Bridge Partnership for Health

Updated 16 October 2018

Great Bridge Partnerships for Health is a long established practice located in the area of Tipton, in the West Midlands. There are three locations that form the practice; these consist of the main practice at Slater Street Surgery (also known as Sai Surgery) and two branch practices which are Cordley Street Surgery and Yew Tree Healthy Living Centre. At this inspection we visited the main practice only.

The practice has one patient list of approximately 11,800 patients of various ages registered and cared for across the practice. Patients can be seen by staff at any of the practices and systems and processes are shared across the three sites. Services to patients are provided under a General Medical Services (GMS) contract with NHS England. The practice 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.

Great Bridge Partnerships for Health is led by three partners; a GP and two directors. The partners and the practice manager form the general management team across the practices. The clinical team includes six GPs, a nurse consultant, an advanced nurse practitioner, three practice nurses and a health care assistant. The clinical team is also supported by two clinical pharmacists. The practice has a non-clinical team of 17 staff members who cover reception, administration and secretarial duties.

Slater Street Surgery is open for appointments from 8am to 6:30pm during weekdays, except on Thursdays when the practice closes at 12:30pm; patients are directed to access appointments at Cordley Street Surgery on Thursday afternoons. Extended hours are provided at Slater Street Surgery between 6:30pm and 8pm on Monday evenings.

Cordley Street Surgery is open for appointments from 8am to 6:30pm during weekdays. Extended hours are available on Monday evenings between 6:30pm to 8pm, as well as Saturdays between 9:30am and 1pm and then from 2pm to 5pm.

Yew Tree Healthy Living Centre is open for appointments between 8am and 6pm on Mondays, Wednesdays and Fridays. Patients are directed to access appointments at Cordley Street Surgery when the surgery closes at 6pm and on Thursdays when the surgery closes at 12:30pm. Extended hours are provided at Yew Tree Healthy Living Centre from 6:30pm to 8pm on Tuesday evenings.

There are also arrangements in place to ensure patients received urgent medical assistance when the practice is closed during the out-of-hours period.

Updated 16 October 2018

This practice is rated as Good overall. (Previous inspection July 2017 – Good overall, with requires improvement rating for providing Safe services)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services well-led? – Good

We inspected Great Bridge Partnerships for Health on 28 April 2016. As a result of our inspection, the practice was rated as requires improvement overall with a requires improvement rating for providing effective, caring and well led services; the practice was rated good for providing safe and responsive services. A requirement notice was issued to the provider. A second announced follow up inspection was carried out on 20 July 2017, in order to review progress made by the practice. The practice was rated requires improvement for providing safe services. The practice was rated as good for providing effective, caring, responsive and well led services and rated good overall. You can read the reports from our previous inspections by selecting the 'all reports' link for Great Bridge Partnership for Health on our website at www.cqc.org.uk

This inspection was an announced focused inspection carried out on 16 August 2018. This was to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations identified at the previous inspection. As part of this inspection we also reviewed if the practice was providing a well led service. This report covers our findings in relation to those requirements.

At this inspection we found:

• The practice had improved its safeguarding processes to ensure concerns about children and vulnerable adults were easily identifiable and could be acted on.
• Records for the maintenance of the premises was accessible and could be referred to as required.
• Patients records reflected if they were on high risk medicines or had major active problems.
• The system for recording and learning from significant events was not always clear or consistent to support learning and improvements.
• The practice had taken action to improve patient satisfaction in relation to accessibility and monitored this through surveys. However, patient feedback showed ongoing improvements were required.

The areas where the provider should make improvements are:

• Ensure the system for recording and learning from significant events is clear and consistent to support learning and improvements.
• Ensure learning from patient’s safety alerts is shared with all staff.
• Continue acting to improve patient satisfaction in relation to access to appointments and getting through to the practice by phone.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Updated 5 September 2017

• We saw evidence that multidisciplinary team meetings took place on a regular basis and that discussions took place to understand and meet the range and complexity of people’s needs and to assess and plan ongoing care and treatment.

• Unverified data provided by the practice on the day of our inspection highlighted diabetic patients were generally up to date with their required blood monitoring and received regular reviews.

• Additionally, unverified data provided by the practice on the day of our inspection showed that 95% of the practice diabetic patients had received a flu vaccination.

• The practice had systems in place to identify and assess patients who were at high risk of admission to hospital. 

Updated 5 September 2017

• During our inspection we found that the practices systems to support effective safeguarding processes were not always effective. For instance in some cases it was not clear if some of the patients listed on the practices child protection register had child protection plans in place.

• The practice operated an effective system for scheduling childhood immunisations and ensuring appropriate actions were taken if immunisation appointments were missed or risk factors identified.

• 2015/16 childhood immunisation rates for the vaccinations were above CCG and national averages. For example, 98% of children aged one had received the full course of recommended vaccines compared to the national standard of 90%.

• The practice offered urgent access appointments for children, as well as those with serious medical conditions.  

Updated 5 September 2017

• The practice offered home visits and urgent appointments for those with enhanced needs.

• Immunisations such as flu and shingles vaccines were also offered to patients at home, who could not attend the surgery.

• Patients received continuity of care with a named GP and a structured annual review to check that their health and medicines needs were being met.

• Patients had access to appropriate health assessments and checks. These included health checks for new patients and NHS health checks for people aged over 75.

Updated 5 September 2017

• Appointments could be booked over the telephone, face to face and online.

• The practice offered extended hours on Monday evenings between 6:30pm and 8pm at both Slater Street surgery and Cordley Street Surgery. Extended hours also operated on Tuesdays at Yew Tree Healthy Living Centre between 6:30pm and 8pm on Tuesdays. Additionally, the practice was open for appointments on Saturdays at Cordley Street Surgery between 9:30am and 1pm and then from 2pm to 5pm.

• Patients had access to appropriate health assessments and checks. These included health checks for new patients and NHS health checks for people aged 40–74.

• Practice data showed that they had offered smoking cessation advice and support to 2150 (18%) of their patients and five (0.2%) had successfully stopped smoking.

Updated 5 September 2017

• The practice regularly worked with other health and social care organisations in the case management of people experiencing poor mental health, including those with dementia.

• Practice data highlighted that 87% of the practices patients who were experiencing poor mental health had a comprehensive care plan in place; exception reporting had also decreased to 5%.

• Patients diagnosed with dementia were referred to the memory assessment service. Practice data indicated that performance was at 88% for dementia reviews.

• Patients with complex needs and patients experiencing poor mental health were regularly discussed during MDT meetings.

Updated 5 September 2017

• There were facilities in place for people with a disability and for people with mobility difficulties. There were hearing loop and translation services available.

• Patients with a learning disability received regular health and medicines reviews.

• Vulnerable patients were regularly reviewed and discussed as part of the Multi-disciplinary team (MDT) meetings to support the needs of patients and their families.

• The practice also supported patients by referring them to a gateway worker who provided counselling services on a weekly basis across the practice.