Archived: Saltley Centre For Health Care

Updated 14 April 2016

• Saltley Centre For Health Care is located at Cradock Road, Saltley, Saltley, West Midlands, and provides care and treatment for just over 7000 patients (the practice has recently merged with another practice).
• There are three GP partners and three salaried GPs who work at the practice. Four GPs are male and two are female. The practice also has three practice nurses, one locum practice pharmacist, one healthcare assistant, two practice managers, two assistant managers and a team of administrative staff.
• The practice has a General Medical Services (GMS) contract. A GMS contract is a contract between NHS England and general practices for delivering general medical services.
• The practice is open between 9am and 7pm Monday to Friday. Appointments take place from 9am to 6.30pm daily. The practice offers extended hours Monday to Friday from 6pm to 7pm.
• The practice has opted out of providing out-of-hours services to their own patients and this service is provided by Primecare. Patients are directed to this service on the practice answer phone message from when the practice closes at 7pm to 8am the next day. Before the practice opens at 9am, an arrangement is in place with Primecare whereby a practice GP contact number is provided to the out-of-hours provider for any emergency contact between 8am and when the practice opens at 9am.
• The practice is located in an area with high levels of deprivation and is among one of the most deprived areas nationally. There is a much higher population average of younger patients aged below 34 years at the practice compared to the national average and a much lower number of patients over 35 years.

Updated 14 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Saltley Centre For Health Care on 10 March 2016. Overall the practice is rated as good.

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

• Staff we spoke with understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. We saw evidence to demonstrate that learning was shared amongst staff.
• Risks to patients were assessed and well managed. Risks linked to infection control which related specifically to the practice premises had been identified at a recent infection control audit and the practice had suspended minor surgery as a result. However, we found that despite attempts by the practice to make relevant improvements to the practice premises in order to improve infection control, they had been unable to do so due to strict modification restrictions imposed by the building landlord.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients we spoke with told us they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Patients commented that recent changes had led to improvements in the way they were treated.
• The practice had carried out clinical audits and repeat audits to improve and maintain patient outcomes.
• We saw evidence to demonstrate that the practice had carried out a comprehensive analysis of its patient population profile and developed targeted services and made changes to the way it delivered services as a consequence. For example by offering more in-house services such as diabetes care or 24 blood pressure monitoring.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day. Patients also commented that access had improved in recent months.

However, there were areas of practice where the provider should make improvements:

• Consider how the practice could proactively support and identify carers to improve outcomes.
• Consider the promotion of national screening programmes to improve uptake.
• Promote and encourage membership of the patient participation group and work with them to identify areas for improvement.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 14 April 2016

• Performance for diabetes related indicators was above the national average (practice average of 90% compared to a national average of 84%). The practice had set-up and established a dedicated diabetes clinic that offered a range of diabetes services and monitoring.

• The percentage of patients with hypertension having regular blood pressure tests was also above the national average (practice average of 88% compared to a national average of 84%). In-house 24 hour blood pressure monitoring was also available at the practice.
• Longer appointments and home visits were available when needed.
• Patients had a personalised care plan or structured annual review to check that their health and care needs were being met.
• For those patients with more complex needs, we identified that the GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 14 April 2016

• Same day appointments were available for children and those with serious medical conditions.
• Immunisation rates for childhood vaccinations were above CCG averages.
• The practice’s uptake for the cervical screening programme was 81% which comparable to the CCG average of 79% and the national average of 82%.
• Appointments were available outside of school hours.
• The practice had a dedicated healthcare assistant and health trainer who attended the practice once a week and offered a range of health promotion services and treatments.
• The practice also worked with health visitors to support young families.

Updated 14 April 2016

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The leadership of the practice had started to engage with this patient group to look at further options to improve services for them. For example, the practice had collaborated with Alzheimer’s Society to raise dementia awareness.
• Online appointments were available and patients who were housebound. They were also able to submit repeat prescription requests via the phone.
• There were longer appointments available for older patients and those over 75 were allocated a named GP.
• Home visits were available for older patients and patients who would benefit from these.
• The practice had a ramped access and automatic front entrance doors.
• There were marked disabled parking bays near the practice.

Updated 14 April 2016

• 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 offered extended hours Monday to Friday from 6pm to 7pm to accommodate working patients.
• Patients could book appointments or order repeat prescriptions online.
• Health promotion advice was available at the practice and the practice referred appropriate patients to the health trainer for more focused support.

Updated 14 April 2016

• Performance for mental health related indicators was higher than the national average (practice average of 100% compared to a national average of 89%). However, the exception reporting rates were also higher for the practice (15%) compared to the CCG (10%) and national (11%) reporting rate. (Exception reporting is the removal of patients from QOF calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of side effects).
• The practice carried out advance care planning for patients with dementia. For example, the practice had collaborated with the Alzheimer’s Society to raise dementia awareness and had hosted two dementia awareness and advice sessions.
• The practice had informed patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• The GP we spoke with had good knowledge of the relevant consent and decision-making requirements of legislation and guidance, including the Mental Capacity Act 2005. We saw evidence that the GP had completed online mental capacity training.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 14 April 2016

• The practice held a register of patients living in vulnerable circumstances and alerts were in place on the clinical patient record system.
• The practice offered longer appointments for these patients and where possible, patients were also seen without a booked appointment.
• Clinical staff had received specialised external training in order to better support patients who had been affected by domestic violence.
• The practice also worked with health visitors to identify children who may be vulnerable.
• The practice had policies that were accessible to all staff which outlined who to contact for further guidance if they had concerns about a patient’s welfare.
• There was a lead staff member for safeguarding and we saw evidence to show that staff had received the relevant training. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• Staff members we spoke with were able to demonstrate that they understood their responsibilities with regards to safeguarding.