Archived: Midlands Medical Partnership - Birmingham South

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Midlands Medical Practice (MMP) – Birmingham South , Old Priory Surgery on 18 and 19 October 2016. Old Priory Surgery is located in Kingsheath, Birmingham. It has two branches at All Saints Medical Centre and Broadmeadow Health Centre.

Old Priory Surgery is one of four registered providers within the Midlands Medical Partnership (MMP) group of practices. The four registered providers include four locations with an additional six branches.The other registered providers in the group are: Erdington Medical Centre, serving Birmingham north east with four branch surgeries; Mere Green Surgery serving Sutton Coldfield and Dudley Park Medical Centre, covering Birmingham south east. All four registered locations were visited by the inspection team including all six branches.All of the practices share one practice list and have a central management team with shared policies, procedures and governance arrangements. We have produced four reports to reflect the four provider/location registrations; however due to the structure of the practice much of the detail included in the reports will be replicated.

Overall the practice is rated as outstanding.

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

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group (PPG). In response to patient feedback a central telephone hub was created with support from the PPG. This had improved telephone access to all 11 MMP practices with call abandonment rates reduced by up to 90% and demonstrated improved patient satisfaction. Feedback from patients about their care was consistently positive.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The organisation actively reviewed complaints and how they were managed and responded to, and made improvements as a result.
• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.

These are the outstanding features:

• Staff had been trained to identify and support patients at risk of domestic violence. Over a six month period referral rates to services providing specialist support increased six-fold and staff told us patients said they felt supported and listened to.
• An event in August 2016 for all of the practice staff focussed on reporting of significant events. As a result all practice staff were aware of their responsibility in responding to risks. They were discussed weekly at practice meetings and there was a strong emphasis on learning. The events were analysed, actions agreed and learning points shared.
• There was evidence of quality improvement including clinical audits. There had been 25 clinical audits undertaken in the last two years across MMP with the learning shared across all practices. These were completed audits where the improvements made were implemented and monitored. Findings were used by the practice to improve services.
• Staff offered kind and compassionate care. For example a dementia drop in service had been established in conjunction with the Alzheimer’s Society which ran monthly. Patients and their carers were free to drop in without appointment to access support and advice.
• MMP’s ethos was “Taking Care” which was applied at all levels to both patients and staff. The management group had set objectives to achieve consistently exceptional care, to demonstrate leadership in service redesign and promote patient engagement and empowerment.
• A comprehensive understanding of the performance of the practice was maintained through the elected management board. Performance was managed centrally and managers could examine achievement and compliance at each location and cross-organisationally. We saw individual practice dashboards which were discussed with staff to motivate them to seek further improvement.
• Staff said they felt respected, valued and supported. For example,an employee of the month scheme motivated staff to perform well and all members of staff could identify opportunities to improve the service delivered through the staff forum.

The provider should:

• Continue to identify and support carers in order to be responsive to individual needs.

  Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice