Archived: Oakham Surgery

Updated 31 October 2014

Oakham surgery has seven permanent GPs, two specialist nurse practitioners and two practice nurses. There are also two healthcare assistants, 16 administrative staff and a practice manager. The practice is part of NHS Sandwell and West Birmingham Clinical Commissioning Group (CCG) which has a membership organisation involving 110 GP practices serving around 530,000 patients. A CCG is an NHS organisation that brings together local GPs and experienced health professionals to take on commissioning responsibilities for local health services.

The practice had opted out of providing out-of-hours services to their own patients. This service was provided by an external out of hours service contracted by the CCG.

Updated 31 October 2014

We inspected Oakham Surgery 213 Regent Road, Tividale, Oldbury, West Midlands, B69 1RZ which provides primary medical services for a local population of approximately 11595 patients. The practice is a training practice for GP Registrars (fully qualified doctors who wish to become general practitioners) and an approved teaching practice for medical students. At the time of our inspection the practice employed seven permanent GPs, two specialist nurse practitioners and two practice nurses. There were also two healthcare assistants, 16 administrative staff, and a practice manager.

We spoke with 13 patients including two members of the patient participation group (PPG). PPGs are a way in which patients and GP surgeries can work together to improve the quality of the service. We spoke with clinical, administrative staff and members of the management team. We also reviewed a range of information we hold about the service and we asked other organisations to share what they knew about the service.

Systems were in place to ensure patients were safe, this included effective safeguarding policies and procedures that were fully understood and acted on by staff. There was an open culture within the practice and staff felt they were able to raise and discuss any issues with the practice manager or the GP partners.

There was evidence of completed audit cycles undertaken to ensure patients’ care and treatment was effective and which improved the quality of the service.

Patients described staff as caring and told us that their privacy and dignity was respected and they were involved in making decisions about their care and treatment.

The practice had suitable arrangements in place to respond to patients with a variety of health needs.

We determined that the practice was well-led as leadership roles and responsibilities were well established with clear lines of accountability. There was evidence that the practice had robust systems in place for assessing and managing risks and monitoring the quality of service provision.

Data that we reviewed showed that the practice population included around 12% of patients from a minority ethnic  group and a higher percentage of the practice population than the England average were aged 18 or below. The data showed that the practice was one of a number of practices in NHS Sandwell and West Birmingham Clinical Commissioning Group (CCG) that had a high deprivation score than the England average with poverty affecting children and older people. A CCG is an NHS organisation that brings together local GPs and experienced health professionals to take on commissioning responsibilities for local health services.

Patients over the age of 75 years had a designated GP and specific care pathways in place to ensure coordinated continuity of care.

Patients with long term conditions were reviewed by the GP, the practice nurse and at the chronic disease management clinic.

The practice had a midwife clinic three times a week to provide ante natal care and access to health visiting services so that children under the age of 5 years had access to the Healthy Child Programme.

There were late evening and weekend surgeries to accommodate the needs of working age patients.

The practice was part of the scheme to avoid unplanned admissions. This focused on coordinated care for the most vulnerable patients with the aim to avoid admission to hospital by managing their health needs at home.

The practice had joint working arrangements with local mental health services.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

Updated 31 October 2014

Patients with long term conditions were reviewed by the GPs, the practice nurses and at the chronic disease management clinic to assess and monitor their health condition so that any changes could be made. Patients on repeat prescriptions were reviewed to assess their progress and ensure that their medications remained relevant to their health need.

Updated 31 October 2014

The practice had a midwife clinic three times a week to provide ante natal care and a health visiting services for children under the age of 5 years so they had access to the Healthy Child Programme. Babies and children were offered same day appointments when they were unwell to ensure they were assessed promptly. The GPs undertook six week checks for babies and this was coordinated with the mother’s post natal check. Immunisations clinics were held for childhood vaccinations.

Updated 31 October 2014

Patients over the age of 75 years, including those living in care homes had a designated GP. This was an accountable GP to ensure patients over the age of 75 years received co-ordinated care. There were specific care pathways appropriate for older patients such as the falls clinic. Home visits were available for those older patients who were unable to attend the practice. A GP undertook a surgery at the care home’s every two weeks. These ensured patients’ needs were reviewed.

Updated 31 October 2014

There were late evening and weekend surgeries to accommodate the needs of working age patients. The practice was opened on an alternate Tuesday and Thursday from 6:30pm to 7:30pm and every third Saturday from 8:40am. This enabled patients who worked to attend in an evening or at weekend. NHS checks were available for people aged between 40 years and 74 years.

Updated 31 October 2014

The practice had joint working arrangements with local mental health services, a counsellor undertook a clinic at the practice twice weekly to support patients with mental health needs and there was a substance misuse worker who undertook a clinic once a month at the practice.

Updated 31 October 2014

Patients who were vulnerable due to their health or social circumstances were offered health checks. Appropriate information was shared and referrals were made to relevant agencies and health care professionals to ensure their health and wellbeing. The practice had access to interpreting service for patients whose first language was not English and information on the practice website was accessible in 81 languages.

The practice was part of the scheme to avoid unplanned hospital admissions by providing an enhanced service. This focused on coordinated care for the most vulnerable patients with the aim to avoid admission to hospital by managing their health needs at home. An enhanced service is a service that is provided above the standard general medical service contract.