Archived: Yew Tree Healthy Living Centre

Updated 30 August 2016

Yew Tree Health Living Centre is a long established practice located in Sandwell, and are part of the Sandwell and West Birmingham Clinical Commissioning Group (CCG). There are approximately 4,500 patients of various ages registered and cared for at the practice.

Services to patients are provided under a General Medical Services (GMS) contract. The practice has expanded its contracted obligations to provide enhanced services to patients. An enhanced service is above the contractual requirement of the practice and is commissioned to improve the range of services available to patients.

Yew Tree Health Living Centre is overseen by two directors who are based at another nearby location. The clinical team includes three GPs and a practice nurse. The team are supported by a practice manager, a trainee practice manager, a receptionist and a healthcare assistant/receptionist. The practice also has a full time receptionist/admininstrative apprentice.

The practice is open between 8.30am and 6.30pm on Monday, Tuesday, Wednesday and Friday. It is also open on Thursday until lunchtime. Appointments are available from 8.30am to 12.30pm and 2.30pm to 6pm. Cordley Street Surgery which is also managed by Great Bridge Partnership for Health Limited, provides telephone triage and home visits until 6.30pm.

Extended hours are available on Tuesdays with appointments available until 7.30pm. The practice is closed on Thursday afternoon, although patients are able to access a full service at Cordley Street Surgery. Extended appointment times are also available on a Saturday from 9.30am to 1pm and 2pm to 5pm at Cordley Street Surgery.

When the practice is closed during the out of hours period patients are directed to the ‘walk in centre’ or 111 out of hours service.

Updated 30 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Yew Tree Healthy Living Centre on 4 May 2016. Overall the practice is rated as requires improvement.

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

• There was a system in place for recording significant events and staff understood their responsibility to raise concerns.
• The practice was not operating an effective system for the management of incoming clinical correspondence and the management of pathology results.
• During the inspection we found that there were inconsistencies in the frequency of reviews for high risk medicines.
• A programme of clinical audits was undertaken across the three practices the provider managed, to improve patient care and outcomes.
• The majority of patients said they were treated with compassion, dignity and respect. However, not all felt cared for, supported and listened to.
• We observed that the receptionist was courteous and helpful to patients attending both at reception and on the telephone.
• The national GP survey data was low compared to the national average for access to appointments, and the ability to get through to the practice via the telephone. The practice manager had recently accessed the national GP patient survey, but had yet to take any action to address the issues identified.
• The friends and family survey undertaken by the practice only ascertained if patients were aware of this survey.

The areas where the provider must make improvement are:

• The provider must actively seek and act on views of people who use the service, about their experience and quality of the care and treatment delivered.
• The provider must review their governance arrangements to ensure effective systems and processes are operated with regards to pathology results and high risk medicine reviews.

The areas where the provider should make improvement are:

• The provider should promote attendance of GPs at key meetings.
• The provider should consider how they identify carers in order to offer support.
• The provider should continue to monitor the numbers of staff, to ensure that they are able to meet the needs of the people using the service
• The provider should ensure that GPs maintain a comprehensive understanding of the performance of the practice and outcomes for patients.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice

Updated 30 August 2016

The practice is rated as inadequate for the care of people with long term conditions.

• Longer appointments for patients with long term conditions were available to patients when needed

• A practice nurse had received appropriate training to manage long-term conditions and patient reviews. Although there was no designated lead for diabetes.

• The practice worked alongside a specialist diabetes service. As a result of patient outcomes t he practice planned to re-establish monthly in-house specialist nurse led clinics, in addition to the above service.

• The practice was performing below the national average  for diabetes related indicators. 61% patients had received reviews compared to the national average of 78%. 

• The practice was not operating an effective system for the management of incoming clinical correspondence and the management of pathology results.

Updated 30 August 2016

The practice is rated as requires improvement for the care of families, children and young people. This is because the practice is rated as requires improvement for providing safe, effective, caring and responsive services. The practice is rated inadequate for well-led services. These ratings affect all population groups.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

• The practice’s uptake for the cervical screening programme was 84%, compared to the national average of 82%, the exception reporting rate was 13%, this was 7% above the national average. However exception rates had been reviewed and had improved.

• Childhood immunisation rates for the vaccinations given were comparable to CCG and national averages. For example, childhood immunisation rates for the vaccinations given to under two year olds ranged from 88% to 90% and five year olds from 89% to 98%.

Updated 30 August 2016

The practice is rated as requires improvement for the care of older people. This is because the practice is rated as requires improvement for providing safe, effective, caring and responsive services. The practice is rated inadequate for well-led services. These ratings affect all population groups.

• The practice and offered urgent appointments for those with enhanced needs.

• Nationally reported data showed that outcomes for patients for conditions commonly found in older people were mixed. Performance for patients identified with Dementia were 100%, with an exception rate of 11%, compared to the national average of 95%.

• The practice offered health checks for patients over the age of 75 years.

• The practice had a separate telephone number issued to the elderly to support admission avoidance.

Updated 30 August 2016

The practice is rated as requires improvement for the care of working aged people, including those recently retired. This is because the practice is rated as requires improvement for providing safe, effective, caring and responsive services. The practice is rated inadequate for well-led services. These ratings affect all population groups.

• The practice offered a range of health promotion and screening that reflected the needs for this age group.

• The national GP patient survey published in January 2016 showed results were below local and national average with regards to accessing the service. For example, 50% of patients were satisfied with the practice’s opening hours compared to CCG average of 71% and the national average of 78%. 52% of patients said they could get through easily to the practice by phone compared to the CCG average of 62% and the national average of 73%.
• The practice offered online appointment booking and electronic prescription ordering.

Updated 30 August 2016

The practice is rated as requires improvement for the care of people experiencing poor mental health. This is because the practice is rated as requires improvement for providing safe, effective, caring and responsive services. The practice is rated inadequate for well-led services. These ratings affect all population groups.

• 75% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is below the national average of 84%. The practice exception rate was 11% compared to the CCG and national average of 8%.

• Performance for mental health related indicators was 97% compared to the CCG average of 87% and national average of 89%.

• The practice provided information about how to access various support groups and voluntary organisations

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 30 August 2016

The practice is rated as requires improvement for the care of people whose circumstances may make them vulnerable. This is because the practice is rated as requires improvement for providing safe, effective, caring and responsive services. The practice is rated inadequate for well-led services. These ratings affect all population groups.

• There were 12 patients on the practice learning disability register, nine of the patients had care plans and the remainder had been contacted so that care plans could be commenced.

• The practice offered longer appointments for patients with a learning disability.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations and worked with other healthcare professional in providing care.

• 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.