Garretts Green Lane Surgery

Updated 28 September 2016

• Dr Raksha Chopra’s practice also known as Garretts Green Lane Surgery is located in Sheldon, Birmingham and has approximately 2400 patients registered with the practice.
• The practice is led by one full-time female GP. There is also a female practice nurse, a practice manager, an assistant practice manager, a business manager and three reception staff, one of whom had also been trained as an healthcare assistant (HCA).
• The practice has a General Medical Services (GMS) contract. A GMS contract is a contract between NHS England and general practices for delivering general medical services.
• The practice is open between 8.45am and 7pm Monday to Friday except for Thursday afternoons when the practice closes at 1pm. Appointments take place from 9.30am to 12pm and 4.30pm to 6.30pm daily (except on Thursdays). The practice offers extended hours on Tuesdays from 7pm to 8pm. In addition to pre-bookable appointments that can be booked for any time in advance, urgent appointments are also available for people that need them.
• The practice has opted out of providing out-of-hours services to their own patients and this service is provided by Birmingham and District General Practitioner Emergency Rooms (BADGER) medical service. Patients are directed to this service on the practice answer phone message. The practice also has an arrangement in place with BADGER to provide cover between 8am and 9.30am.
• The practice population demographics are similar to the national average.
• The practice is in an area that is nearer to the higher levels of social and economic deprivation.

Updated 28 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Raksha Chopra’s practice on 31 August 2016. Overall the practice is rated as good.

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

• Staff we spoke with understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. We saw evidence to demonstrate that learning was shared amongst staff.
• 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.
• The practice worked closely with other organisations in planning how services were provided to ensure that they meet patients’ needs.
• We saw evidence to demonstrate that the practice had carried out an analysis of its patient population profile and developed targeted services and made changes to the way it delivered services as a consequence. For example by offering more in-house services such as diabetes care or 24 blood pressure monitoring.
• Risks to patients were assessed and well managed.
• Feedback from patients about their care was consistently positive. Patients we spoke with told us they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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 and there was continuity of care, with urgent appointments available the same day.
• 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 September 2016

• Performance for diabetes related indicators for the practice in 2014/15 was 78% which was lower than the CCG average of 83% and national average of 84%. Exception reporting for the practice was lower at 6% compared with 11% for the CCG and 12% nationally. Data available from the practice showed that there had been a significant improvement for the year 2015/16 with the practice performance now at 95%. However, this was not published and verified data.
• The practice had set up a pre-diabetic register and identified patients at higher risk of developing diabetes in order to support and advise patients on changes to prevent diabetes developing.
• The percentage of patients on the asthma register, who had an asthma review for 2014/15, was below average at 56% for the practice compared to 74% for the CCG and 75% nationally. However, exception reporting was lower for the practice (3%, compared with 7% CCG & 8% nationally). Data available from the practice showed that there were had been a significant improvement for the year 2015/16 with the practice performance now at 100%. However, this was not published and verified data.
• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. 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.

Updated 28 September 2016

• Same day appointments were available for children and those with serious medical conditions.
• Immunisation rates for childhood vaccinations were in line CCG averages.
• The practice’s uptake for the cervical screening programme was 80%, which was above the CCG average of 78% and same as the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies and baby changing facilities were available.
• We saw positive examples of joint working with district nurses and health visitors.

Updated 28 September 2016

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• A facility for online repeat prescriptions and appointments bookings was available.
• Patients were also able to book telephone consultations with the GP.
• A phlebotomy service was available at the practice for the convenience of patients requiring blood tests.
• An electrocardiogram (ECG) service (equipment to record electrical activity of the heart to detect abnormal rhythms and the cause of chest pain) was available onsite at the practice.
• There were longer appointments available for older patients and those over 75 were allocated a named GP.
• There were disabled facilities available and the practice had a level access entrance to the premises.

Updated 28 September 2016

• 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 offered extended hours on Tuesdays from 7pm to 8pm for working patients who could not attend during normal opening hours.
• Patients could book appointments or order repeat prescriptions online.
• Patients were able to book telephone consultations with the GP.
• The practice offered a full range of health promotion and screening that reflected the needs for this age group.
• The healthcare assistant conducted the health checks and gave advice on health promotion.

Updated 28 September 2016

• Performance for mental health related indicators was 85% which was comparable to the CCG and national averages of 87%.
• However, the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption has been recorded in 2014/15 was 79% for the practice compared to 90% for both the CCG and nationally. However, exception reporting was lower for the practice (0%, compared with 8% CCG and 10% nationally). Data available from the practice showed that there had been a significant improvement for the year 2015/2016 with the practice performance now at 88%. However, this was not published and verified data.
• The practice maintained a mental health register on the clinical system.
• Staff had received training on how to care for people with mental health needs.
• The practice had informed patients experiencing poor mental health about how to access various support groups.
• The GP we spoke with had knowledge of the relevant consent and decision-making requirements of legislation and guidance, including the Mental Capacity Act 2005.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 28 September 2016

• The practice held a register of patients living in vulnerable circumstances and alerts were in place on the clinical patient record system.
• Translation services were available.
• There were longer appointments available for patients with complex needs such as those with dementia or a learning disability.
• There was a lead staff member for safeguarding and we saw evidence to show that staff had received the relevant training.
• The practice had policies that were accessible to all staff which outlined who to contact for further guidance if they had concerns about a patient’s welfare.
• Staff members we spoke with were able to demonstrate that they understood their responsibilities with regards to safeguarding.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.