Tanworth-in-Arden Medical Practice

Updated 12 April 2017

Tanworth-in-Arden Medical Practice is a semi-rural practice located just outside of Tanworth-in-Arden. They moved in to the purpose built premises in 2001 and became known as The Birches. Tanworth-In-Arden Medical Practice is a dispensing practice. The practice offers a wide range of services to their patients and offer additional NHS services the opportunity to use their building such as:

• Abdominal Aortic Aneurysm (AAA screening)
• Psychological therapy,
• Improving Access to Psychological Therapies (IAPT) which is an NHS programme rolling out services across England offering interventions approved by the National Institute of Health and Clinical Excellence (NICE) for treating people with depression and anxiety disorders.
• Digital retinopathy clinics.

The practice is a training practice offering places to trainee GPs. Trainee GPs are fully qualified doctors who are undergoing their final training to become a GP. The practice is also a teaching practice and provides placements for medical students from Warwick University.

The practice has two GP partners and two salaried GPs. Two of the GPs are female and two are male offering a choice to patients. The practice has two nurses, a healthcare assistant, a phlebotomist (a person trained to take blood), a head dispenser and four dispensers.

The clinical team are supported by a practice manager, an assistant practice manager, a head receptionist and a team of reception staff and medical secretaries. The practice has a General Medical Services(GMS) contract with NHS England. The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

The practice is open between 8.30am and 6pm Monday to Friday. Appointments are from 8.30am to 12.30pm every morning and 2.30pm to 5.30pm every afternoon.

The practice does not provide out of hours services to their own patients but provided information about the telephone numbers to use for out of hours GP arrangements (NHS 111). Alternatively patients are provided with the details of Solihull walk-in centre located at Solihull Hospital which is open from 8am to 8pm seven days a week.

Updated 12 April 2017

Letter from the Chief Inspector of General Practice

We had carried out an announced comprehensive inspection of Tanworth-in-Arden Medical Practice on 18 September 2015. As a result of our inspection the practice was rated as good overall but required improvement for providing safe services.

During the last inspection we identified a breach of regulation around safe care and treatment. The area we identified the provider must improve:

• The provider must ensure that supplies of equipment and medicines for use in an emergency are appropriately maintained.

We also identified further areas the provider should improve:

• Review the checking process for monitored dosage packs to mitigate the risk of medicine dispensing errors.
• Review the documentation of risk assessments.

Following the inspection the practice sent us an action plan detailing the actions they were going to take to improve.

We carried out a focused desk-based review of Tanworth-in-Arden Medical Practice on 15 February 2017 to check that the provider had made improvements in line with our recommendations and to ensure regulations were now being met. This report only covers our findings in relation to those requirements. The full comprehensive report for the November 2015 inspection can be found by selecting the ‘all reports’ link for Tanworth-in-Arden Medical Practice on our website at www.cqc.org.uk.

The practice is now rated as good for the provision of safe services.

As part of our focused desk-based review the management team provided evidence to demonstrate that:

• The provider had revised their system and ensured that supplies of equipment and medicines for use in an emergency were appropriately maintained.

• The checking process for monitored dosage packs had been reviewed and updated to mitigate the risk of medicine dispensing errors.
• The documentation of risk assessments had been reviewed and processes updated to ensure that records were managed more effectively.

We were satisfied that the practice had made the required improvements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 February 2016

The practice is rated as good for the care of people with long term conditions. Chronic disease management was central to the practice’s role. The practice had robust recall systems for patients, arranging individual reviews at the patient’s convenience. During reviews the practice tried to empower and educate patients through the services they provided such as heart clinics, and made additional advice available online. All the practice’s respiratory disease patients had written management plans and as appropriate carried stand-by medicine for early intervention with exacerbations.

The practice reviewed all diabetic patients at least six monthly. Patients in other chronic disease categories were reviewed at least annually. Patients with complicated or difficult issues were seen more frequently than this.

The practice had a system for reviewing test results and an auditable process of patient recall.

Many of these patients were on multiple medicines and a medicines review was standard practice during each patient contact and at least annually. The practice achieved near maximum points on the Quality and Outcomes Framework (QOF) in this category. QOF is a system intended to improve the quality of general practice and reward good practice.

Updated 18 February 2016

The practice is rated as good for the care of families, children and young people. The practice had family friendly facilities and worked closely with health visitor and midwifery colleagues who had rooms at the practice. The practice had a policy that all sick children under five were seen on the same day if parents were worried.

The practice was committed to providing a confidential and comprehensive contraceptive and sexual health service with special regard for young people and this was advertised on their website and in the practice leaflet. Two of the GPs had additional training in contraceptive implants.

Updated 18 February 2016

The practice is rated as good for the care of older people. In 2015 the practice employed a care co-ordinator with responsibility for proactive review of the elderly. This involved co-ordinating with Age Concern colleagues and the wider team to discover and anticipate problems in the hope of addressing issues early and preventing morbidity and mortality. At the time of the inspection 84 face-to-face interviews had taken place. The practice had received positive comments about this from patients.

As part of the practices’ weekly medicines delivery service they employed two regular drivers who knew the patients well. They reported back if a patient seemed unwell or had any issues enabling early intervention from an appropriate team member particularly amongst older patients. This allowed the practice to set up services to support the patient in continuing independent living. The practice delivered monthly to 180 patients. An additional 47 patients had weekly deliveries of daily dose systems.

Updated 18 February 2016

The practice is rated as good for the care of working age people, recently retired people and students. The practice kept specific early and late appointments for working people and would often arrange to see patients with urgent problems and take blood samples before surgery started for this population group. All the clinicians at the practice took blood samples during their consultations saving time and a repeat attendance for the patient. We did, however, note that the practice did not offer extended hours.

Updated 18 February 2016

The practice is rated as good for the care of people who experienced poor mental health. Clinicians would pre-book patients who experienced poor mental health to avoid having to negotiate the appointments system. Patients could ring and leave a message for their clinician which would be answered that day.

The practice had an in-house clinic from an Improving Access to Psychological Therapies (IAPT) counsellor and had shared clinical meetings allowing a joint approach.

In 2015 the practice tried to identify potential patients with memory issues using in-house searches and national audits. The practice diagnosis rate based on prevalence of dementia rose from 24.2% in Sept 2014 to 49.3% in March 2015. The practice reviewed, referred and treated all patients identified in this way. The lead clinicians had attended dementia awareness training and the practice was in the process of being registered as ‘dementia friendly’.

Updated 18 February 2016

The practice is rated as good for the care of people living in vulnerable circumstances. As a small, rural practice the practice knew their patients well. They would see vulnerable patients at short notice and they maintained a special considerations board to ensure prompt and appropriate response to any request from these patients.