Archived: Sycamore House Medical Centre Also known as Drs. Dugas and Dhaliwal

Updated 31 January 2017

Sycamore House Medical Centre is located in Walsall, West Midlands situated in a multipurpose NHS building, providing NHS services to the local community.

Based on data available from Public Health England, the levels of deprivation in the area served by Sycamore House Medical Centre are above the national average, ranked at seven out of 10, with 10 being the least deprived. Deprivation covers a broad range of issues and refers to unmet needs caused by a lack of resources of all kinds, not just financial. The practice serves a higher than average patient population aged 65 and above.

The patient list is approximately 4,320 of various ages registered and cared for at the practice. Services to patients are provided under a General Medical Services (GMS) contract with the Clinical Commissioning Group (CCG). GMS is a contract between general practices and the CCG for delivering primary care services to local communities.

The surgery 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 surgery is situated on the ground floor of a multipurpose building. Parking is available for cyclists and patients who display a disabled blue badge. The surgery has automatic entrance doors and is accessible to patients using a wheelchair.

The practice merged with Umbrella Medical Group in August 2016. Umbrella Medical Group is a Walsall based super-partnership which comprises of four GP practices providing GMS and Alternative Provider Medical Services (APMS) contract with the Clinical Commissioning Group (CCG) for approximately 21,000 patients. The partnership comprises of seven GP partners; five male and two female. As a result of the merger the practice management were in the process of adding Sycamore House under the provider name of Umbrella Medical.

Sycamore House Medical Centre staffing comprises of one male GP, one male long term sessional locum GP; as part of the merger with Umbrella Medical Group the practice were discussing the option of accessing female GPs located at other practices within the group. There are two practice nurses, one advanced nurse practitioner, one nurse practitioner and a health care assistant. There is a practice manager; a locality practice manager and a team of administrative staff. The practice is also an approved training practice and provides training to medical students from the University of Birmingham. There are two Foundation Year two Doctors (FY2s).

The practice is open between 8am and 6.30pm on Mondays, Tuesdays, Wednesdays and Fridays. Thursday opening times are between 8am and 1pm. Extended opening hours are available from 7.30am to 8am on Mondays, Thursdays and Fridays.

GP consulting hours are from 8am to 6.30pm on Mondays, Tuesdays, Wednesdays and Fridays. Thursday opening times are between 8am and 1pm. Extended opening hours are available from 7.30am to 8am on Mondays, Thursdays and Fridays. A telephone consultation service is also available for those who need urgent advice. Home visits are available to those patients who are unable to attend the surgery.

The practice has opted out of providing cover to patients in their out of hours period. During this time services are provided by NHS 111. During in service closure times services are provided by WALDOC (Walsall doctors on call).  

Updated 31 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Sycamore House Surgery on 1 March 2016. Overall the practice is rated as good.

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

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Staff understood and fulfilled their responsibilities to raise safety concerns and to report incidents and near misses
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Risks to patients were assessed, but there were no failsafe systems in place to assure risks were minimised.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had proactively sought feedback from patients and had a small patient participation group.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour and the practice encouraged a culture of openness and honesty.
• Confidentiality was an issue in reception as the telephones were situated on the front desk; however the staff were aware and endeavoured to keep patient identifiable information to a minimum.
• Staff were carrying out chaperoning duties, but had not received training or had received the necessary checks.

The areas where the provider must make improvements are:

• Ensure that appropriate risk assessments and training have been done for staff who carry out chaperoning duties.

The areas where the provider should make improvements are:

• The practice should consider the benefits to proactively identifying carers in order to ensure appropriate support and care.
• The practice should consider how they could further promote membership of the patient participation group.
• The practice should risk assess emergency systems to identify the impact on care of patients. Since the inspection the practice has reviewed their systems and now have emergency oxygen available at the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 May 2016

The practice is rated as good for the care of people with long-term conditions. Nursing staff had lead roles in chronic disease management and they were supported by the advanced nurse practitioner and the GPs. Longer appointments and home visits were available when needed. All patients with a long-term condition had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. The practice had 240 patients on the diabetic register and 172 (88%) had received their flu vaccination.

Updated 20 May 2016

The practice is rated as good for the care of families, children and young people. There were policies, procedures and contact numbers to support and guide staff should they have any safeguarding concerns about children. The nurse offered immunisations to children in line with the national immunisation programme. Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this. Appointments were available outside of school hours on the day appointments were available to facilitate rapid access. The premises were suitable for children and babies with easy access for pushchairs and prams. The practice provides care to the children and families at Acorns Hospice and we saw positive examples of joint working with midwives and health visitors and antenatal care was provided by the midwife who held a clinic once a week at the practice and the health visitor had a clinic for child immunisation and review once a week.

Updated 20 May 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, this included enhanced services for dementia and end of life care. The practice was responsive to the needs of older people, and offered home visits and urgent appointments. 70% of patients aged 65 years and over had received their flu vaccination. The practice pharmacist carried out over 75 reviews and medication checks and held regular meetings with the GPs to discuss patient’s needs. The practice offered proactive, personalised care to meet the needs of the older people in its population.

Updated 20 May 2016

The practice is rated as good for the care of working-age people. 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. It provided a health check to all new patients and carried out routine NHS health checks for patients aged 40-74 years. The practice was proactive in offering online services such as appointment booking, telephone consultations and repeat prescriptions services and offered early morning surgery on a Wednesday and Friday morning from 7am to 8am. There was a full range of health promotion and screening that reflected the needs for this age group.

Updated 20 May 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice had 24 patients diagnosed with dementia on their register and 20 (87%) had had their care reviewed in a face to face meeting in the last 12 months. Patients on the dementia and mental health register received annual reviews and patients unable to attend the practice were seen at home. Patients experiencing poor mental health were advised how to access various support groups and voluntary organisations. The practice had 26 patients on their mental health register and 23 (88%) had had their care plans reviewed in the last 12 months. The community psychiatric nurse held one clinic a week at the practice to review and monitor patients experiencing poor mental health. Staff had a good understanding of how to support patients with mental health needs and dementia and the practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

Updated 20 May 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. It offered longer appointments and annual health checks for people with a learning disability. Home visits were carried out to patients who were housebound and to other patients on the day that had a need. There were nine patients on the learning disability register and one had received their annual health checks and the other eight patients had confirmed appointments for their annual reviews. No hearing loop was available, but the practice had a system in place which identified patients who required assistance or sign language interpreters to be booked. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people and held monthly meetings with the district nurses and community teams. There was a system in place to identify patients who required additional support and extra time during appointments. The safeguarding lead and staff had received safeguarding training and 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.