Archived: Halesowen Health Centre

Updated 4 April 2016

Stourside Medical Practice is based within the Halesowen area of Birmingham. There are three surgery locations that form the practice; these consist of the main practice at Halesowen Health Centre and the branch sites at Coombswood surgery and Tenlands Road Surgery. There are approximately 6,600 patients of various ages registered and cared for across the practice. 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.

The clinical team includes a principle GP, two salaried GPs, several long term locum GPs and a team of three practice nurses. The principle GP and the practice manager form the practice management team and they are supported by a team of several receptionists.

The practice is open between 8:30am and 6.30pm on Monday to Friday. There is a GP on call each morning from 8am to 8:30am and during the afternoons between 1pm and 2:30pm when appointments are closed. There are also arrangements to ensure patients received urgent medical assistance when the practice is closed during the out-of-hours period.

Updated 4 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stourside Medical Practice on 16 February 2016. As part of our inspection we attended the main practice based at Halesowen Health Centre and we also visited one of the practice branches, Coombswood Surgery. Overall the practice is rated as requires improvement.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Arrangements were in place to safeguard children and vulnerable adults from abuse that reflected relevant legislation and local requirements.

• There was a system in place for reporting and recording significant events. Staff explained that significant events were usually discussed on an informal basis in the practice. However, the minutes from the practice meeting did not demonstrate that significant events and were discussed as a team to support shared learning.

• There were some arrangements for identifying, recording and managing risks, issues and implementing mitigating actions. However, record keeping was not robust across all areas.

• Staff demonstrated a commitment to providing a high quality service to patients. The team made use of systematic alerts to prompt clinicians to conduct opportunistic medical checks to patients across the practice registers.

• The process for disseminating national patient safety alerts was facilitated by the practice manager, we found that the process did not cover periods in the event of the practice manager being absent from the practice.

• Data showed that patients rated the practice lower than others for some aspects of care. The practice had not developed an action plan to address the areas for improvement identified in the national GP patient survey.

• The practice had an active patient participation group which influenced practice development.

• Most staff spoke positively about working at the practice. However, we received mixed feedback from staff with regards to staff support.

The areas where the provider must make improvements are:

• Strengthen current systems for receiving national patient safety alerts by ensuring all clinicians are signed up to receive alerts in the absence of key staff members.

The areas where the provider should make improvements are:

• Ensure appraisals are completed for all staff to provide support where needed.

• The provider should improve governance arrangements including systems for recording, assessing and mitigating risks across the practice.

• Address areas for improvement highlighted through patient feedback such as national survey results.

• To continue to improve and promote a culture of learning at the practice and ensure governance is improved to document shared learning. Ensure that records are well maintained to reflect emergency protocols such as fire tests and to adequately track prescriptions.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 4 April 2016

• The practice is rated as requires improvement for providing safe and caring services; this affects all six population groups.
• Clinicians had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Performance for overall diabetes related indicators was 95% compared to the CCG average of 88% the national average of 89%.
• There were 317 patients on the practices diabetes register, 91% of these patients had received a foot risk assessment and 94% had received a flu vaccination within the last 12 months.
• We saw minutes of meetings to support that joint working took place and that patients with long term conditions and complex needs were regularly discussed.

Updated 4 April 2016

• The practice is rated as requires improvement for providing safe and caring services; this affects all six population groups.
• 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.
• Childhood immunisation rates for under two year olds ranged from 79% to 100% compared to the CCG averages which ranged from 83% to 100%.
• Immunisation rates for five year olds ranged from 97% to 100% compared to the CCG average of 95% to 98%.
• The practice offered urgent access appointments were available for children, as well as those with serious medical conditions.  

Updated 4 April 2016

• The practice is rated as requires improvement for providing safe and caring services; this affects all six population groups.
• The practice offered proactive, personalised care to meet the needs of the older people in its population. All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice had systems in place to identify and assess patients who were at high risk of admission to hospital.
• Flu vaccination rates for the over 65s was 67%, compared to the national average of 73%. 

Updated 4 April 2016

• The practice is rated as requires improvement for providing safe and caring services; this affects all six population groups.
• The practice was proactive in offering a full range of health promotion and screening that reflects the needs for this age group.
• The practice’s uptake for the cervical screening programme was 82%, compared to the national average of 81%.
• Patients could access appointments and services in a way and at a time that suited them.
• Appointments could be booked over the telephone, face to face and online.
• The practice used the text messaging system to identify patients who smoke and to offer them advice and further support, 79% of the practices patients identified as smokers were given smoking cessation advice.

Updated 4 April 2016

• The practice is rated as requires improvement for providing safe and caring services; this affects all six population groups.
• The practice offered structured reviews for their patients experiencing poor mental health (including dementia).
• Performance for mental health related indicators was 88% compared to the CCG average of 83% and national average of 92%. 100% of these patients had their thyroid hormone levels checked during the last 12 months. Therefore, patients experiencing poor mental health were proactively reviewed to check hormone balance and emotional well-being.
• Data showed that diagnosis rates for patients identified with dementia were 100%, with an exception rate of 0%.
• 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. 

Updated 4 April 2016

• The practice is rated as requires improvement for providing safe and caring services; this affects all six population groups.
• The practice used clinical templates developed by the principle GP to identify and regularly review patients on the practices learning disability register.
• There were 31 patients on the practices learning disability register. Most of these patients had a care plan in place and were receiving regular reviews.
• The practice regularly worked with other health and social care organisations in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations.