Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Great Barr Group Practice on 1 September 2016. Overall the practice is rated as Good. There are two surgery locations that form the practice; these consist of the main practice at Walsall Road and the branch practice at Moreton Avenue. Systems and processes are shared across both sites. During the inspection we visited the main site at Walsall Road. The practice will be moving to new premises in October 2016 where both sites will be combined.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.
• The practice used innovative and proactive methods to improve patient outcomes, For example the practice nurse developed a checklist to follow when visiting housebound patients to ensure that both clinical and social needs were being met.
• Feedback from patients about their care was consistently positive.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. The practice had clearly defined and embedded systems, processes and practices in place to keep people safe and safeguarded from abuse.
• Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• We saw that staff were friendly and helpful and treated patients with kindness and respect. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Patients could access appointments and services in a way and at a time that suited them. Patients were given the option of a preferred practice location and they could also access services across the two sites including cervical screening and phlebotomy.
• The practice worked closely with other organisations in planning how services were provided to ensure that they meet patients’ needs. For example the practice had commenced a rheumatology (DMARD) monitoring service for their patients.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• We observed the premises to be visibly clean and tidy. Some areas were showing signs of being worn, but the practice was moving to new premises in October 2016.
• Notices in the patient waiting room told patients how to access a number of support groups and organisations. There was also a language board, this explained how to book appointments in various languages.
• The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result. The provider was aware of and complied with the requirements of the duty of candour.
• There was a clear leadership structure and staff felt they were supported by management and the GPs.
• Staff spoken with demonstrated a commitment to providing a high quality service to patients.

• The practice nurse had achieved the Queen’s award. The Queen's Nurse programme is designed for community nurses who want to develop their professional skills and promote the highest standards of patient care. From this award the nurse had introduced a checklist for housebound patients registered at the practice to review and monitor their care.

However there were areas of practice where the provider should make improvements:

• Continue to encourage patients with learning disabilities to attend their annual reviews.
• Review and strengthen current procedures for the filing of pathology results once actioned.

• Ensure effective communication where all staff groups have the opportunity to formally contribute to the running and development of the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We conducted our inspection over two days as the practice treated patients on the same list in two separate surgeries. On the first day we visited the main surgery located on the Walsall Road, Great Barr. On the second day we visited the branch surgery on Moreton Avenue, Great Barr. During our inspection we spoke with nine patients and eight members of staff.

All patients spoken with were generally positive about the care and treatment they received at the practice. One patient we spoke with said: “The GP is very good; the first time (I attended) I was very impressed”. Patients told us they were treated with dignity and respect. However, all the patients spoken with said they found it difficult to get an appointment to see a GP. Some patients said they had to wait a long while after their appointment time.

All the patients told us they were listened to and felt their care was personalised and met their needs. One patient said: “The doctor is very good; every time I take my (baby) daughter, he’s always checked her thoroughly. He checks her chest and sees how bad her nappy rash is”.

All the patients said that they had no concerns with the practice and staff were supported to deliver care to an appropriate standard.

There were processes in place for monitoring the quality of service provision. There was a system for regularly obtaining opinions from patients about the standard of the service they received.