Northwood Medical Centre

Updated 2 February 2017

Northwood Medical Centre is a GP practice which provides primary medical services under a General Medical Services (GMS) contract to a population of approximately 9,100 patients living in Kings Norton, Alvechurch and the surrounding areas of Birmingham. A GMS contract is a standard nationally agreed contract used for general medical services providers. The practice has a branch surgery located in Alvechurch which was not inspected.

The practice operates from a two storey Georgian building where consultations with patients take place on the ground floor. There are disabled parking spaces and whilst space in the waiting areas is limited there is sufficient space to accommodate patients using mobility aids.

The practice population has a higher than average number of patients aged 0 to 4 years, and those aged 60 to 75 years and a significantly higher than average number of patients over 85 years. National data indicates that the area is one that experiences moderate levels of deprivation. The practice population is made up of predominantly white British with pockets of patients from ethnic minority groups.

There are four full time GP partners, one female, three male and one full time salaried male GP. The practice employ three practice nurses, two health care assistants, a practice manager and deputy practice manager, who are supported by a team of administrative and reception staff.

The practice is open on Monday, Tuesday, Wednesday and Friday between 8am and 6.30pm, and opens from 8am until 1.30pm on Thursdays, with cover provided by Southdoc from 1.30pm until 6.30pm. Extended hours appointments are provided on Wednesday from 7am until 7.55am for pre-bookable appointments only. When the surgery is closed services are provided by the out of hours service who can be contacted via NHS 111.

Updated 2 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Northwood Medical Centre on 25 October 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• There were effective systems in place to assess and manage risks to patients.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients from all age groups consistently reported they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. The GPs and staff took additional measures to support patients during acute health problems and times of uncertainty. A caring and compassionate ethos was evident throughout the practice and patients and staff gave examples of caring acts carried out by the GPs and nurses.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day. The National GP Patient Survey 2016 response reflected this. The practice operated effective appointment systems which allowed patients to be seen on the same day if necessary.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• 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.

The areas where the provider should make improvement are:

• Take action to ensure there is a system in place for checking and recording fridge temperatures during times of staff absence.
• Display the procedure for managing emergencies in reception for frontline staff to refer to.
• Ensure photo identity is kept in all staff records.
• Display more information for carers in the waiting area.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 2 February 2017

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 patients at risk of hospital admission were identified as a priority. Each GP also had a specific areas of interest and monitored outcomes for long term conditions.
• The Quality and Outcomes Framework (QOF) achievement for all long term conditions were above the local and national averages, for example in conditions such as diabetes, chronic obstructive pulmonary disease, asthma and mental health.
• Longer appointments and home visits were available when needed.
• The practice used an automated appointment system for flu and QOF recalls and also sent texts to remind patients of their appointments.
• All these patients had a named GP and a structured annual review to check their health and medicine needs were being met. Patients were called during their month of birth and all conditions were reviewed at the same visit.
• 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 health trainers held weekly sessions to encourage healthy lifestyles and choices.

Updated 2 February 2017

The practice is rated as good for the care of families, children and young people.

• 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. Immunisation rates were high for all standard childhood immunisations.
• 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.
• Cervical screening rates were at 77% which was above the CCG average of 70% and national average of 76%.
• Appointments were available 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.
• The practice were using questionnaires to explore ways of gaining the views of young people regarding sexual health services and how they could be better delivered.

Updated 2 February 2017

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.
• The practiced served seven care homes and each had a nominated GP who visited on a weekly basis and as requested in response to patients’ needs.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice participated in the local incentive scheme for patients over 75 who had complex needs. They had robust systems in place to review their condition.
• Housebound patients were visited at home to provide flu vaccinations by the practice nurses.

Updated 2 February 2017

The practice is rated as good for the care of working-age people (including those recently retired and students).

• 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.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.
• The practice actively encouraged patients aged 40-74 years to take NHS health checks and provided in house phlebotomy (taking of blood for tests).
• GPs arranged to telephone patients with their test results to prevent the need for time off work.

Updated 2 February 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• 96% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was above the CCG and national averages of 85% and 84% respectively.
• The overall achievement for mental health indicators were 100% compared with the CCG and national averages of 97% and 94% respectively.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice had access to mental health support organisations such Birmingham Healthy Minds, Forward Thinking Birmingham and single point of access and older patients over 66 years were referred to psycho-geriatricians.
• The practice hosted clinics from the consultant psychiatrist and community psychiatric nurse alternate weeks for patients with ongoing mental health problems to prevent them having to attend the hospital.
• The practice carried out advance care planning for patients with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 2 February 2017

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 and those with a learning disability and reviewed these patients regularly.
• The practice offered longer appointments for patients with a learning disability. When patients were attending with a carer the GP was notified to ensure the patients were seen as soon as possible.
• 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.