Archived: Dr Uday Abhyankar Also known as Holly Road Surgery

Updated 20 July 2018

Dr Uday Abhyankar also known as Holly Road Surgery is located in an inner-city area of Birmingham. The practice has 1486 patients registered and a higher proportion of older patients with 19% of the population being over the age of 65 in comparison to the local average of 12%. The practice is located in a converted house and is in an area with high levels of social and economic deprivation, compared to England as a whole. The practice deprivation level is ranked as two out of 10, with 10 being the least deprived. Many of the people in the practice area are from Black and Minority Ethnic (BME) groups, with 66.9% of the practice population being within this group.

The practice team consists of two GP partners (both male). There is also a part time practice nurse, a health care assistant, a practice manager and a team of administrative and reception staff.

The practice is open between 8am to 1pm and 3.30pm to 6.30pm Mondays to Fridays except for Wednesday afternoons when the practice closes at 1pm. When the practice is closed between 1pm and 3.30pm and Wednesday afternoons, appointments are available at another practice, Heathfield Family Centre. Emergency appointments are available daily and telephone consultations are also available for those who need advice. Home visits are available to those patients who are unable to attend the practice.

Appointments were available when the practice was closed, through the local commissioning group federation Improved Access Scheme (ICOF). Patients could access appointments between 6.30pm to 8pm Monday to Friday and during the weekend from 9am to 1pm Saturday and 10am to 1pm Sunday. These appointments can be booked in advance by the surgery or directly by the patients. When the practice is closed, primary medical services are provided by Primecare, an out of hours service provider and the NHS 111 service.

Updated 20 July 2018

This practice is rated as Good overall. (Previous inspection March 2017 – Good overall, with requires improvement rating for providing Responsive services)

The key questions are rated as:

Are services responsive? – Good

We carried out an announced focused inspection at Dr Uday Abhyankar's practice (also known as Holly Road Surgery) on 1 June 2018. This inspection was in response to our previous comprehensive inspection at the practice in March 2017, where breaches of the Health and Social Care Act 2008 were identified. You can read the report from our last comprehensive inspection on 15 March 2017; be selecting the 'all reports' link for Dr Uday Abhyankar on our website at www.cqc.org.uk.

During this inspection in June 2018, we found the provider was in breach of the Care Quality Commission (Registrations) Regulation 2009 – Regulation 15 Notice of Changes due to the provider not having advised the CQC that their registration status had changed from a single-handed GP to a partnership as of October 2017.

Our key findings were as follows:

• We saw the provider had acted to improve on the areas we had identified during our previous inspection. For example, the new partnership had increased face to face consultations and nursing staff hours to manage patient demand and at peak times the number of appointments were increased to reduce patients’ waiting times.
• The management team told us they were currently in the process of changing the telephones with a new system being introduced in June 2018 to further improve access.
• The practice now provided extended hours appointments through the local commissioning group federation Improved Access Scheme (ICOF). This included appointments outside of the practice opening hours and weekend appointments.
• The practice had achieved higher than average results for several aspects of care from the 2017 National GP Patient survey.
• The practice had continued to review their carers register and encouraged patients to identify themselves if they had caring responsibilities. We saw the number of patients on the practice's carers register had increased from 1% to 2%.
• At our previous inspection, the practice's uptake for the cervical screening programme was lower than the national average. The practice had increased the availability of the practice nurse and patients could also access appointments at other practices the provider was working with locally. The practice had seen an increase in the number of patients attending appointments and had a system in place to follow up on patients who had not attended their appointments, however results remained lower than the national average.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 15 September 2016

The provider was rated as requires improvement for safety and for well-led. The issues identified as requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

The nurse worked one morning a week but told us they would be available on alternative days if there was a need.

The practice achievement for most long term conditions was generally above local and national averages. Longer appointments and home visits were available when needed. There was one GP at the practice (GP provider). However, when they were away there was a regular locum cover. Records we looked at showed that those patients with long term conditions had regular structured annual reviews to check their health and medicines needs were being met. For those patients with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. The practice offered a model of integrated care in the community for patients suffering symptoms affecting the ear, nose or throat (ENT). This service was accessible for all patients registered with the provider as well as other patients within the community. This was convenient for patients as they did not need to go to the hospital to access the same service.

Updated 15 September 2016

The provider was rated as requires improvement for safety and for well-led. The issues identified as requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk. Immunisation rates were relatively high for all standard childhood immunisations. However, the practice achievement for cervical screening was below local and national averages. The practice did not offer extended hours appointments but a GP could be seen 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 15 September 2016

The provider was rated as requires improvement for safety and for well-led. The issues identified as requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

The practice offered proactive, personalised care to meet the needs of the older people in its population. The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. The practice was accessible to patients with mobility difficulties and vaccinations appropriate for this age group were available. 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 15 September 2016

The provider was rated as requires improvement for safety and for well-led. The issues identified as requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

Most needs of the working age population, those recently retired and students had been identified. The practice offered online services as well as a full range of health promotion and screening that reflected the needs of this age group. The practice did not offer flexibility in regards to expended opening but was actively looking to work at locality level in collaboration with other local practices to offer this.

Updated 15 September 2016

The provider was rated as requires improvement for safety and for well-led. The issues identified as requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

All (100%) patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is higher than the local and national average s of 84%. The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. The practice was aware of support groups and voluntary organisations these patients could access. Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 15 September 2016

The provider was rated as requires improvement for safety and for well-led. The issues identified as requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

The practice held a register of patients living in vulnerable circumstances including mental health, depression and those with a learning disability. The practice was responsive to the needs of these patients and offered home visits. A care home manager of a learning disability home told us that they received a home visit when required and the GP was responsive to the needs of these patients when reviewing them. 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.