Archived: Newtown Health Centre Also known as Raydocs

Updated 24 August 2016

Newtown Health Centre is part of the NHS Sandwell and Wes Birmingham Clinical Commissioning Group (CCG). CCGs are groups of general practices that work together to plan and design local health services in England. They do this by 'commissioning' or buying health and care services.

The practice is registered with the Care Quality Commission to provide primary medical services. The practice has a general medical service (GMS) contract with NHS England. Under this contract the practice is required to provide essential services to patients who are ill and includes chronic disease management and end of life care.

The practice is located in an inner city area of Birmingham with a list size of approximately 7,500 patients. The premises are purpose built for providing primary medical services.

Based on data available from Public Health England, the practice is located in the most deprived areas. Compared to the national average the practice had a higher proportion of patients between 0 and 50 and lower proportion of patients over 50 years of age

Practice staff consist of two partners (both male), four nurses (including one nurse practitioner and a nurse manager), five health care assistants and a team of administrative staff. The practice did not have a practice manager but the senior management team took on these responsibilities. For example, the performance manager was responsible for Human Resources (HR), Quality and Outcomes Framework (QOF) as well as IT. The finance manager took other responsibilities along with the nurse manager and reception manager.

The practice telephone was open between 8am and 6.30pm Monday to Friday. Appointments were from 8.30am to 11am every morning and 3.30pm to 6pm daily. Extended hours appointments were offered from 6.30pm to 7.30pm on Mondays, Wednesdays and Fridays.

The practice is a training practice for qualified doctors training to become GPs. Nurse also mentored student nurse from local universities. The practice also planned to take on medical students from a local university which was opening a medical school from 2017.

The practice had been inspected previously under our current methodology but had not been rated.

Updated 24 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Newtown Health Centre on 23 June 2016. 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 report incidents and near misses.

• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example the practice took part in a CCG funded project to offer individualised care plans to the practices top 50 patients who either attended accident and emergency (A&E) frequently or had high unplanned hospital admissions.

• The practice was trying to improve its dementia diagnosis through the use of an iPad with bespoke software for memory testing.

• Feedback from patients about their care was consistently positive.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. For example the appointment system was being reviewed after consultation with patients and staff. The proposals were being taken to the PPG for approval.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice actively reviewed complaints and how they were managed and responded to, and made improvements as a result.
• The practice had a clear vision which had quality and safety as its top priority.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw several areas of outstanding practice including:

• The practice took part in a CCG funded project to offer individualised care plans to the practices top 50 high cost patients who either attended accident and emergency (A&E) frequently or had high unplanned hospital admissions. Data we looked at showed that the practice had significantly reduced admissions to secondary care for these patients.

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

• Consider how to further identify the number of carers registered at the practice in order to offer further support and guidance.

• Continue to monitor patient survey results and patient feedback following implementation of new appointment systems.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 August 2016

The practice is rated as good for the care of people with long-term conditions. Clinical staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority, this included patients with long term conditions. The practice took part in a CCG funded project to offer individualised care plans to the practices top 50 high cost patients who either attended accident and emergency (A&E) frequently or had high unplanned hospital admissions. The aim was to develop a care plan with the patient along with contact details of other services such as medical, social and voluntary who were involved with the care of the patient. Patients identified with a long term condition that would benefit from being receiving care under this project were also included in the project. Results showed that significant reduction to unplanned admissions was made. The practice operated specialist clinics to review and monitor patients with specific long term conditions such as diabetes, hypertension, asthma and COPD. Overall performance for diabetes related indicators (2014/15) was similar to the CCG and national average. The practice proactively referred patients to a diabetes education programme. The nurse manager and a healthcare assistant had attended the programme themselves so that they could then advise patients on what they could expect when referred the course. Longer appointments and home visits were available when needed. For patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 24 August 2016

The practice is rated as good 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. The practice was working with the voluntary sector and was due to attend the launch event on the ‘Family Fit’ project with the Lord Mayor of Birmingham. The project aimed to work with local families to improve their health. The focus would be on families as opposed to the individuals with an aim to address obesity in school children. The practice nurses ran weekly clinics providing a programme of childhood immunisations. Immunisation rates were relatively high for all standard childhood immunisations. There was a GP led baby clinic for child surveillance. Post-natal checks, family planning and contraceptive advice were also available. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw positive examples of joint working with midwives and health visitors.

Updated 24 August 2016

The practice is rated as good for the care of older people. The practice offered proactive, personalised care to meet the needs of the older people in its population. Patients over the 75 years were allocated a named GP to support their needs and care plans were in place for those with complex care needs. The practice took part in a CCG funded project to offer individualised care plans to the practices top 50 patients who either attended accident and emergency (A&E) frequently or had high unplanned hospital admissions. A high percentage of these patients were over 75 years of age. The aim was to develop a care plan with the patient along with contact details of other services such as medical, social and voluntary who were involved with the care of the patient. Results showed that significant reductions were made to unplanned admissions and patient feedback was positive. The practice was responsive to the needs of older people, and offered home visits. The practice was accessible to patients with mobility difficulties and vaccinations appropriate for this age group were available for patients in this age group. The practice proactively offered vaccination to carers with 60% of registered carers receiving a flu vaccination last year. The practice regularly met as part of a multi-disciplinary team to discuss and review the care of those with end of life care needs.

Updated 24 August 2016

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. Extended hours were available. Online booking of appointments and ordering prescriptions were also available. The practice had also signed up to a service commissioned by the CCG which had a smart phone application giving patients an option to book appointments designated for online access. The practice offered a full range of health promotion and screening that reflected the needs for this age group.

Updated 24 August 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Sixty nine percent of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which was lower than the national average. The local CCG average was 84%. The national average was also 84%. However, the practice was also improving its dementia diagnosis through the use of an iPad with bespoke software for memory testing. The practice had purchased two iPads which were given to patients who went through series of questions after which the results and analysis were forwarded to the GP. The software could be used in 16 different languages. The practice had screened 34 patients over the last year. National reported data for (2014/15) showed 65% of patients with poor mental health had comprehensive, agreed care plan documented, in the preceding 12 months which was below to the CCG average 87% and national average 89%. The practice had a named GP responsible for mental health patients. The practice was able to signpost patients to support services.

Updated 24 August 2016

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 organised training for staff to ensure they were aware of the needs of vulnerable groups such as travellers and asylum seekers enable them to receive easy access to primary care. This was identified as a training need due to the increase of these population groups in to the local area. The practice offered longer appointments for patients with a learning disability. The practice regularly worked with other health care professionals in the case management of vulnerable patients. The practice informed vulnerable patients about 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.