The Care Quality Commission
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  • GP practice

Archived: Hall Green Health

Overall: Good read more about inspection ratings

979 Stratford Road, Hall Green, Birmingham, West Midlands, B28 8BG (0121) 777 3500

Provided and run by:
Hall Green Health

Important: The provider of this service changed. See new profile

All Inspections

16 December 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Hall Green Health on 18 January 2016. During that inspection we found that although patients were able to obtain urgent same day appointments, they found it difficult to book routine appointments or to see or speak with their preferred GP. The practice had high levels of patients who did not attend their appointments. Whilst t he practice had put measures in place to try and improve access, this was not reflected in patient satisfaction.

In view of the above the practice was rated as requires improvement for providing responsive services.

We undertook this desk based review on 16 December 2016 to check that the provider had completed the required improvements. We did not visit the practice as part of this inspection.

This report only covers our findings in relation to the above area. You can read the report from our last comprehensive inspection, by selecting the 'all reports'link for Hall Green Health  on our website at www.cqc.org.uk.

Our finding across the area we inspected was as follows:

  • The practice had responded to patients concerns and had made significant changes to improve access to appointments. For example, in response to the increase in online registration, the number and variety of available online appointments had significantly increased. The extended hours at the practice had also increased in response to feedback.
  • The practice continued to review and adapt the appointment system to meet the demands on the service.
  • The practice were adopting new ways of working to ensure the services are responsive to people's needs. The practice had employed three clinical pharmacists whose duties included carrying out patient medication reviews.
  • To meet the demand for nurse-led services the practice had expanded the nursing team by 28%, which had increased access to various services.
  • Members of the Patient Participation Group were completing an in-house satisfaction survey to obtain patients views as to the recent improvements made. 
  • Information received from the provider showed a commitment to improving satisfaction results with continuous action plans, that are regularly reviewed.  Whilst the latest national patient satisfaction results relating to access to the service and appointments remained low in areas, there had not been enough time since the above improvements had been made to impact on the results. 

​ Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

18 January 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hall Green Health on 18 January 2016. The practice had previously been inspected in May 2015 and was rated as requires improvement overall. This included an inadequate rating for safe and requires improvement for well led. We returned to reinspect to consider whether sufficient improvement had been made. We found the practice had made significant improvements and now has an overall rating of good.

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Opportunities for learning from incidents were maximised to improve and develop the service.
  • The practice was proactive in its approach to improving patient outcomes, patients with long term conditions were seen according to need. Those with the potential to develop long term conditions were also screened and monitored to facilitate early intervention and improved outcomes.
  • Risks to patients were assessed and well managed.
  • 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.
  • Patients told us that they were satisfied with the care and treatment received once they got to see a clinician but found access to routine appointments difficult. The practice had high levels of patients who did not attend their appointments. The practice was actively responding to issues relating to access.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • Information about services and how to complain was available and easy to understand.
  • The practice demonstrated strong leadership which through self-refection and prompt action had transformed the organisation. There was an open culture in which staff felt valued and involved, a sense of learning and improvement was evident. The practice had openly shared their experience following our previous inspection so that others may learn too.
  • There was a clear vision shared by staff to promote positive patients outcomes and service improvement and a desire to continue the momentum to review and improve all aspects of the service.

We saw areas of outstanding practice:

  • The practice had robust systems for the management of patients with long term conditions and complex needs. There was a dedicated team of staff responsible for recalling patients. Timing of recalls was based on need with appropriate management of all associated risk factors and disease control as assessed through, for example, test results and medicines prescribed rather than a set annual review. Staff were appropriately trained to provide this care. Daily discharge meetings enabled care to be reviewed promptly for the most vulnerable patients.
  • As well as maintaining a register for patients diagnosed with diabetes the practice maintained a pre-diabetes registerof 1535 patients who also received regular reviews. As a result of early intervention the practice reported that 326 patients (21%) had reverted to normal and 4% had been diagnosed as having diabetes enabling early intervention and management.
  • The practice was proactive in providing screening for atrial fibrillation (heart condition) and had exceeded CCG targets of 40% screening. During 2014/15 the practice screened 3266 or 70% of eligible patients. Of these patients
  • Since our previous inspection in May 2015, the response from the practice had been exceptional. The strength of leadership was demonstrated through the maturity in which the practice had learnt from and responded to adverse feedback. The cultural change in the organisation was tremendous. Learning was shared openly with others and staff felt valued and positive. Through self-reflection the governance structures had been reviewed and the way in which services were delivered was under internal scrutiny and review. For example, the way in which a cold chain incident had been managed was exemplary and had motivated the practice to self reflect and explore more widely how they could improve services.

The areas where the provider should make improvement are:

  • The practice should review access to routine appointments and identify how this may be improved.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

19 May 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hall Green Health on 19 May 2015. Overall the practice is rated as requires improvement.

Specifically, we found the practice inadequate for providing safe services and requiring improvement for being well led. It also required improvement for providing services for the six population groups (older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia). This is because the concerns that have led to the overall provider rating apply to everyone using the practice, including these population groups. The practice was good for providing an effective, caring and responsive service.

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

  • Most staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed. However it was not always clear that learning was shared consistently to all relevant staff.
  • Risks to patients were assessed and managed but systems were not always robust and we identified weaknesses in the management of risks relating to medicines and vaccinations.
  • Data showed patient outcomes were in line with other practices and sometimes higher than other practices in the locality. Audits undertaken helped to further drive improvement in the performance and patient outcomes.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. There were robust systems in place for the management of patients with long term conditions.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. However, they raised concerns in relation to access to appointments which the practice was endeavouring to address.
  • Information about how to complain was not easily visible to patients to enable them to make a complaint, although complaints seen had been appropriately managed.
  • A triage system was in place so that patients who needed to be seen the same day received a consultation on the day and if necessary were seen in person.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure. However, it was not clear that the arrangements in place supported an open and transparent service with proactive feedback from all staff groups and the sharing of learning to all relevant staff.

The areas where the provider must make improvements are:

  • Ensure appropriate systems are in place to manage the cold chain for vaccinations.
  • Maintain robust systems for checking medicines and single use equipment are within date and fit for use.
  • Ensure appropriate criminal checks are in place for relevant staff and where these are not deemed necessary roles should be risk assessed to ascertain why and mitigate any potential risks to patients.

In addition the provider should:

  • Develop a culture in which all staff are aware and confident in the reporting of incidents (clinical and non-clinical) and where relevant staff are involved in the learning and feedback from these.
  • Develop systems for maintaining staff training records so that the practice can be assured that training relevant to staff roles has been completed and any identified development needs are met.
  • Ensure policies included in the staff induction handbook are kept up to date to ensure staff are using the latest information and guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice