Archived: Dr Yannamani's & Dr John's Surgery

Updated 29 March 2016

Dr Yannamani and Dr John’s surgery is situated in Stonydelph which is a suburb of Tamworth in Staffordshire. Approximately 79% of the practice population are White British. Stonydelph has some deprived areas but has average overall levels of deprivation when compared to other areas in England.

The practice is located within a purpose-built health centre that is shared with two other GP practices, a dental practice and various community nurse services that include a walk in clinic. The practice moved into the current premises in 1986 and the property is owned by NHS Properties.

At the time of our inspection there were 1,965 patients on the patient list. The practice has two GP partners, one male and one female who combined equated to 0.95 whole time equivalent. In addition, there is a practice nurse employed. The administrative staff consists of a practice manager, senior receptionist and three administration staff. The practice is open from 8.30am until 1pm and 2pm to 6pm Monday to Friday. The phone lines remain open between 1pm and 2pm for urgent calls. There are extended hours offered until 7.15pm on alternate Tuesdays and Thursdays. Patients requiring a GP outside of normal working hours are signposted to the out-of-hours provider and telephone calls are diverted. The practice has a General Medical Services (GMS) contract and also offers enhanced services for example: various immunisation schemes, extended hours and remote care monitoring.

Updated 29 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Yannamani’s and Dr John’s Surgery on 1 December 2015. Overall the practice is rated as Requires Improvement.

Our key findings were as follows:

• Risks to patients were assessed and monitored although resultant outcomes were not always implemented.
• Patients’ needs were assessed and care was planned. A patient recall system was in place and all unplanned admissions were reviewed.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients said they were treated with dignity and respect and found the receptionists helpful.
• Patients told us they were happy with the appointment system and urgent appointments were available the same day and normally given when requested.
• The practice had good facilities and was well equipped to treat patients and meet their needs.

Importantly, the provider must:

• Maximise the functionality of the computer system in order that the practice can run clinical searches, provide assurance around patient recall systems, consistently code patient groups and produce accurate performance data.

• Ensure that clinical audits in relation to patients’ care and treatment complete two cycles to demonstrate improvements in the safety and quality of services provided.

• Operate a system to seek and review patient feedback on the services provided.

In addition the provider should:

• Update the practice business continuity plan to ensure it contains up to date information.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 29 March 2016

The provider was rated as requires improvement for effective and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group.

We found that the nurse had the knowledge, skills and competency to respond to the needs of patients with a long term condition (LTC) such as diabetes and asthma. The practice nurse had introduced structured reviews in July 2015 for a number of LTCs, for example, diabetes and heart failure. Longer appointments and home visits were available when needed. All of these patients were offered a review to check that their health and medication needs were being met. Written management plans had been developed for patients with LTCs and those at risk of hospital admissions. For those people with the most complex needs, the GPs worked with relevant health and social care professionals to deliver a multidisciplinary package of care.

Updated 29 March 2016

The provider was rated as requires improvement for effective and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group.

There were systems in place to identify and follow up children who were at risk. Appointments were available outside of school hours and the premises were suitable for children and babies. Same day emergency appointments were available for children. There were screening and vaccination programmes in place and the immunisation rates were in line with the local Clinical Commissioning Group averages. New mothers and babies were offered post-natal checks.

Updated 29 March 2016

The provider was rated as requires improvement for effective and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group.

Every patient over the age of 75 years had a named GP. The practice offered proactive, personalised care to meet the needs of the older people in its population and care plans were in place for vulnerable patients. For example, there was a register kept of patients who had been identified as being of high risk of admission. Patients who were palliative had end of life care plans completed and the practice had a lead for palliative care. Regular reviews were held with the community team, district nurses and social services. It was responsive to the needs of older people and offered home visits and longer appointments as required. The practice identified if patients were also carers and offered additional health checks and advice, and information about carer support groups was available in the waiting room.

Updated 29 March 2016

The provider was rated as requires improvement for effective and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group.

The needs of the working age population, those recently retired and students had been identified and the practice had recently adjusted the appointment system to provide consultations outside core working hours. A range of on-line services were available, including medication requests and booking appointments. Pre-bookable telephone consultations were available. The practice offered all patients aged 40 to 75 years old a health check with the nursing team. The practice offered a full range of health promotion and screening that reflects the needs for this age group.

Updated 29 March 2016

The provider was rated as requires improvement for effective and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group.

People experiencing poor mental health were offered an annual physical health check. Dementia screening was offered to patients identified in the at risk groups. Advance care planning for patients with dementia was carried out. The practice worked with multi-disciplinary teams in the case management of patients with mental health needs. The practice also worked with the health visiting team to support mothers experiencing post-natal depression. It had told patients about how to access various support groups and voluntary organisations, for example Addiction and Alcoholics Anonymous.

Updated 29 March 2016

The provider was rated as requires improvement for effective and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group.

An interpretation service was in place for non-English speakers. The practice held a register of patients with a learning disability and had developed individual care plans for each patient. The practice carried out annual health checks and offered longer appointments for patients with a learning disability. The practice worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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.