Archived: Aston Pride Community Health Centre Also known as Raydocs

Updated 9 February 2017

Aston Pride Community Health Centre is part of the NHS Sandwell and West Birmingham Clinical Commissioning Group (CCG). CCGs are groups of general practices that work together to plan and design local health services in England. They do this by 'commissioning' or buying health and care services.

The practice is located in purpose built accommodation. It has a registered list size of approximately 6,700 patients. Based on data available from Public Health England, deprivation in the area served is among the highest 10%nationally. The practice population is younger than the national average. For example, 36% of the practice population is under 18 years compared to the CCG average of 24% and national average of 21 %. The practice has a diverse population with 68% of patients registered as black or minority ethnic (BME) compared to the CCG average of 48% and approximately 15 different languages are spoken by patients at the practice.

Services to patients are provided under a General Medical Services (GMS) contract with NHS England.

The provider for this service also has a second location at Newtown Health Centre, 171 Melbourne Avenue, Birmingham. B19 2JA. The GP partners and some of the staff worked across both locations.

Practice staff consist of two partners (both male), a salaried GP (male) supplemented by locum GPs (male and female), an advanced nurse practitioner (female), three practice nurses, four health care assistants, three managers and a team of administrative staff. The practice provided approximately 30 GP clinical sessions each week.

The practice is open Monday to Friday 8 am to 6.30 pm. Appointments vary between the GPs but were usually from 9am to 12.30pm and 3pm to 6pm. When the practice is closed services are provided by an out of hours provider (BADGER). The practice provides extended opening hours on a Tuesday and Thursday evening between 6.30pm and 7.30pm.

The practice was previously inspected by CQC in June 2015. The practice was rated requires improvement overall and was found to be in breach of regulation 12 (safe care and treatment) and regulation 19 (fit and proper persons employed) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Updated 9 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Aston Pride Community Health Centre on 25 November 2016. The practice had previously been inspected in June 2015 and was found to be in breach of regulation 12 (safe care and treatment) and regulation 19 (fit and proper persons employed). The practice was rated as requires improvement overall.

Following the inspection the practice sent us an action plan detailing the action they were going to take to improve. We returned to the practice on 25 November 2016 to consider whether improvements had been made. At this inspection we found the practice had made sufficient improvements and the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed. We saw improvements made to patient safety since our previous inspection in relation to the management of the premises and staff.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice had identified the impact of loneliness on patients’ health and wellbeing and had funded a project in which monthly coffee group were held and were well attended.
• Patient feedback from CQC comment cards and patients we spoke with was positive about the care received. However, the latest national patient survey showed scores that were lower than other practices locally and nationally. The practice had acted on this feedback with continual review and changes to the appointment systems in order to improve access. Appointments were available on the day of our inspection.
• 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. 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.

The areas where the provider should make improvement are:

• Ensure child play area is specifically included as part of the cleaning schedule and cleaning audit checks.
• Review systems and processes for uncollected prescriptions.
• Review systems for recall of patients with long term conditions to identify how this might be improved.
• Review areas of high exception reporting and identify how this may be improved.
• Review how the use of clinical audits may better support service improvement.
• Review and identify how uptake of national screening might be improved in the practice population.
• Continue to review patient feedback to support continued improvement of the service.
• Recommence online services as soon as possible of the convenience of patients.
• Ensure all patients with a learning disability receive the opportunity for an annual health review.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 February 2017

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

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators (2015/16) was 99% which was above the CCG average of 88% and national average of 89%.
• The practice provided additional diabetic services including virtual consultant clinics and diabetes initiation services for the convenience of patients. Virtual consultant clinics were also provided for patients with chronic kidney disease.
• Two members of the nursing team had undertaken training and diabetes education to better support patients.
• The practice held a register and followed up patients at risk of developing diabetes.
• In conjunction with the provider’s other practice Newtown Health Centre patients could access a range of services to support the diagnosis and monitoring of patients with long term conditions such as ambulatory blood pressure monitoring and spirometry.

Updated 9 February 2017

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk. The practice worked with the health visiting team.
• Immunisation rates were in line with local and national averages for standard childhood immunisations. The practice offered a walk in immunisation clinic to try and increase up take.
• Uptake of cervical screening (2015/16) was at 71% which was below the CCG average 79% and national average 81%. The practice was piloting the sending of a birthday card to patients on their 25th birthday to promote and raise awareness of the cervical screening programme.
• Appointments were available outside of school hours and the premises were suitable for children and babies. Dedicated breast feeding facilities and baby changing facilities were available.

Updated 9 February 2017

The practice is rated as good for the care of older people.

• The practice had a low proportion of patients in this population group. For example, only 2.3% of the practice population was over 75 years of age, compared to the CCG average of 6% and national average of 7.8%.
• The practice offered proactive, personalised care to meet the needs of the older people in its population. The practice was participating in a project to support patients at risk of unplanned admissions and deliver a multi-disciplinary package of care.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice offered flu vaccinations to patients in this population group and carried these out as home visits where patients were unable to attend the practice due to their medical condition.
• Support was available for those who had recently suffered a bereavement.

Updated 9 February 2017

The practice is rated as good for the care of working-age people (including those recently retired and students).

• 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 had offered online services but had recently changed their IT system and needed to reset this again.
• The practice made use of texting to remind patients of their appointment.
• The practice offered extended opening hours on a Tuesday and Thursday evening between 6.30pm and 7.30pm for the convenience of patients who worked.
• Patients were able to access minor surgery at the provider’s other practice (Newtown Health Centre).
• Travel vaccinations were available on the NHS and written information was provided as to where vaccinations only available privately could be obtained.
• The practice had both male and female members of the nursing team.
• Telephone consultations were available for issues that do not require face to face consultations. Feedback from two patients on the CQC comment cards said that as workers they found these helpful.
• The practice offered NHS health checks to patients in this population group and 122 were undertaken in last year.

Updated 9 February 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• Nationally reported data for 2015/16 showed 80% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the CCG and national average 84%. Exception reporting at 9% was similar to the CCG and national average of 7%.
• National reported data for (2015/16) showed 95% of patients with poor mental health had comprehensive, agreed care plan documented, in the preceding 12 months which was slightly higher than the CCG average of 91% and national average 89%. Exception reporting at 51% was significantly higher than the CCG average of 15% and national average of 13%. Although, this may be due to reporting errors.
• In order to improve uptake of dementia screening the practice used bespoke software in multiple languages for memory testing to support earlier diagnosis and referral as appropriate.
• In conjunction with the provider’s other location at Newtown Health Centre the practice offered counselling for those with anxiety and depression through the healthy minds service.

Updated 9 February 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances, for example those with a learning disability and those with caring responsibilities. There were 32 patients on the learning disability register, seven had been reviewed in the last year (22%).
• The practice had identified 121 patients as carers and information was available to signpost them to services locally available. This represented 1.8% of the practice list.
• Staff described a flexible approach to ensure some of their most vulnerable patients could access services, for example those who found it stressful attending or had hearing impairments.
• There were systems for registering vulnerable groups of patients, for example patients with no fixed abode or in temporary accommodation.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice had set up a project to support patients who were lonely or isolated, through monthly coffee events.
• 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.
• Patients could access the citizens advice bureau and support for substance misuse at the providers other location, Newtown Health Centre.