Birmingham And District General Practitioner Emergency Room Limited (Badger)

Updated 1 March 2024

The provider Birmingham and District General Practitioner Emergency Room Limited (BADGER) is registered with CQC to provide the following regulated activities:

• Transport services, triage and medical advice provided remotely
• Treatment of disease, disorder or injury

Birmingham And District General Practitioner Emergency Room Limited (Badger) is the registered location and head office for the out-of-hours GP service provided by BADGER. The head office is based at Badger House, 121 Glover Street, Birmingham, B9 4EY.

The service provides a range of services including:

• In-hours and out-of-hours (OOH) GP services for its GP member practices.
• The provider has contracts with Birmingham and Solihull Integrated Care Board (BSOL ICB) to provide urgent treatment and primary medical services in-hours and out-of-hours when GP practices are closed.
• The provider delivers GP services to St Giles Hospice in Whittington and to HMP Birmingham. We did not visit these locations as part of the inspection. These locations are registered independently with CQC and have been inspected under their respective registrations.

The service, which originally started as a GP co-operative, is a not for profit, social enterprise and holds the social enterprise mark (independently assessed criteria that provides assurance that profits are used to benefit the community).

The service covers a population of approximately 1.4 million and sees approximately 160,000 patients per year.

Patients access the out-of-hours service through NHS111 or directly by telephone if they are from one of the GP member practices that contract with Badger directly.

Patients who need to be seen face to face, can book an appointment at one of the urgent treatment centres, the drive-through service or be offered a home visit. Patients may also receive a telephone consultation with a clinician where a face to face appointment is not deemed necessary.

The service has a call centre which is located in Aston. The call centre is where calls are received, advice given and appointments booked.

The urgent treatment centres are located at:

• Erdington Stockland Green, Primary Care Centre, 192 Reservoir Road, Erdington, B23 6DJ. Open 10:30am to 11.00pm Monday to Sunday.
• Solihull Hospital, Lode Lane, Solihull, B91 2JL. Open 8am to 8pm Monday to Sunday.
• There is a drive-through service at 1-2 Bourne Road, Aston, Birmingham, B6 7RD. Open 7.00pm to 11.00pm Monday – Sunday.

The service is open for out-of-hours cover Monday to Friday 6.30pm to 8.30am and all weekend and on bank holidays.

The call centre is open 24 hours a day, 7 days a week.

As part of this inspection we visited the following sites:

• Aston Bourne Road call centre and drive-through service: 1-2 Bourne Road, Aston, Birmingham, B6 7RD
• The provider’s head office at the registered location Glover Street: Badger House, 121 Glover Street, Birmingham, B9 4EY.
• Urgent treatment centre at Solihull Hospital Lode Lane, Solihull, B91 2JL.

The service is led by a board of six GPs and the chief executive, elected by the member practices. The service has approximately 400 staff, some are directly employed by the organisation others such as the GPs work for the service on a self-employed contractor basis. The service provides training opportunities in the out-of-hours period for qualified doctors training to be GPs and for third year medical students.

Updated 1 March 2024

This practice is rated as Outstanding overall. (Previous inspection November 2017 – Good).

The key questions are rated as:

Are services safe? – Good

Are services effective? – Outstanding

Are services caring? – Outstanding

Are services responsive? – Outstanding

Are services well-led? – Outstanding

We carried out an announced comprehensive inspection at Birmingham And District General Practitioner Emergency Room Limited (Badger) between 29 November and 11 December 2023. We inspected this service due to the length of time since our previous inspection, in line with Care Quality Commission’s inspection priorities.

At this inspection we found:

• The leadership, governance and culture within the service drove the delivery of high-quality person-centred care.
• There was clear evidence of working in partnership with others to continue to improve the service by finding innovative solutions.
• The service had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the service learned from them and improved their processes.
• There were comprehensive and effective systems in place to safeguard children and vulnerable adults and to ensure there were no lost contacts.
• The service consistently met or exceeded its key performance targets even during periods of extreme urgent care system pressure.
• The provider ensured that care and treatment was delivered according to evidence-based guidelines.
• The provider had an embedded program of audit that helped to drive further improvements. There was clear evidence of action to resolve concerns and improve quality.
• Feedback from people who used the service, those who were close to them, and stakeholders, were consistently positive about the way staff treated people. People thought that staff went above and beyond their duties to provide great care. The provider monitored patient feedback and used this to further improve their service.
• Patients were able to access out-of-hours care at a location of their choice and at a time that suited them. Where appropriate, patients where offered a home visit or a telephone call with a clinician.
• From patient feedback, we saw that patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• Leaders strove to inspire and motivate staff to deliver high quality patient centred care. Staff feedback was positive about the changes in leadership and culture.

• The provider had recognised that transformation in leadership and governance structures was needed to continue to deliver high quality patient centred services. We saw that changes that had been implemented had strengthened leadership, provided greater oversight over governance processes and provided stability for the future.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services