Archived: Malling Health @ Parsonage Street

Updated 17 December 2015

Malling Health @ Parsonnage Street is part of the Sandwell and West Birmingham Cross City 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.

Malling Health @ Parsonnage Street is registered with the Care Quality Commission to provide primary medical services. The service has a personal medical service (PMS) contract with NHS England. Under this contract it is required to provide essential services to patients who are ill and includes chronic disease management and end of life care. The service is both a general practice and walk in centre.

The service is located in a porta cabin style premises built for the purpose of a health centre. Based on data available from Public Health England, deprivation in the area served is among the highest nationally. The practice side of the service has a registered list size of approximately 4,500 patients. Both registered and non-registered patients can attend the walk in centre. The practice sees approximately 100 patients per day as a walk in.

The practice is open 8am to 8pm seven days a week including bank holidays. When the practice is closed patients receive primary medical services through another provider (Primecare).

The service is part of Malling Health (UK) Limited which provides services across the country. The service is staffed with four salaried GPs, three advanced nurse practitioners, a practice nurse and health care assistant. There is also a team of administrative staff led by a practice manager.

The practice has not previously been inspected by CQC.

Updated 17 December 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Malling Health @ Parsonage Street on 19 June 2015. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed. However follow up of actions was not always clearly reported.
• Risks to patients were assessed and generally well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles.

• Patients said they were treated with dignity and respect and they were involved in their care and decisions about their treatment. However, published data from the latest GP national patient survey showed scores that were lower than other practices in the locality and nationally.
• Information about services and how to complain was available and easy to understand.
• There was mixed feedback from patients about access to appointments and satisfaction with consultations. Results from the national GP patient survey were below local and national averages for many indicators. Our feedback from patients during the inspection was more positive.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure. There were opportunities for staff to provide feedback and staff felt listened to and supported by management.

We saw one area of outstanding practice:

• The practice had worked with local businesses and the Big Issue to provide support to some of the most vulnerable people on public holidays such as Christmas Day, providing food and somewhere for them to go. Approximately 100 people had turned up to the last event.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Improve record keeping for recording follow up of actions from significant events and complaints.
• Ensure audits complete their full audit cycle in order to demonstrate improvements made to practice.
• Ensure systems are in place for updating patient records following multi-disciplinary team meetings.
• Review patient survey information to identify how patient satisfaction could be improved.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 December 2015

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 received appropriate training to support these patients. Patients with long term conditions received at the minimum annual reviews and had access to a named GP. The practice held multi-disciplinary team meetings with other health professionals to discuss care needs of those with the most complex needs. Care plans were also in place to help minimise the risk of hospital admission. Home visits were available for those whose health needs prevented them from attending the practice.

Updated 17 December 2015

The practice is rated as good for the care of families, children and young people. The practice had a higher proportion of younger patients registered with them than the national average. There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk. Childhood immunisation rates were comparable with other practices locally. Those that did not attend for immunisations were followed up and the practice worked closely with the health visitors. Appointments were available outside of school hours and urgent appointments for children under five were offered within four hours. The premises were accessible for pushchairs and baby changing facilities were available. The practice offered six to eight week baby health checks.

Updated 17 December 2015

The practice is rated as good for the care of older people. The practice had a lower proportion of older patients registered with them than the national average. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. Patients over 75 had an allocated named GP. The uptake of seasonal flu vaccinations for this age group was comparable to other practices. The practice had a range of enhanced services, for example, in dementia and end of life care to support the needs of the older people in its population. Care plans were in place for those with increased risk of hospital admission and multidisciplinary team meetings regularly took place to discuss those with enhance needs including end of life care needs. Home visits were available for those whose health needs made it difficult for them to attend the practice.

Updated 17 December 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). The practice had a higher proportion of working age patients registered with them than the national average The needs of the working age population, those recently retired and students were recognised. The practice provided accessible and flexible services for those with working commitments who were unable to attend during the day. This included on-line services for appointments and prescriptions, the availability of telephone appointments and a walk in service. Text messaging was used to remind patients of their appointments. The practice offered a range of health promotion and screening that reflected the needs for this age group.

Updated 17 December 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Nationally reported data showed that outcomes for patients experiencing poor mental health were better than those for other practices locally and nationally. Those on the mental health register received annual reviews. The practice regularly worked with multi-disciplinary teams in the case management of this population group. The practice shared a building with the mental health team. The practice participated in the enhanced service to support the early diagnosis and treatment of patients with dementia.

Updated 17 December 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice held registers of patients living in vulnerable circumstances including those with a learning disability, poor mental health and palliative care needs and had carried out an annual health check for the majority of their vulnerable patients. The practice had signed up for the learning disability enhanced service and had a trained member of staff in this area. It offered longer appointments for people who needed them and walk in appointments. The practice had worked with local organisations to provide a drop in service during public holidays.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. 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.