Archived: MGS Medical Practice Also known as Low Hill Medical Practice

Updated 8 October 2015

Three practices Low Hill Medical Centre, Bradley Health Centre and Ruskin Road Surgery have recently merged to form MGS Medical Practice. Low Hill Centre is the main practice and the other two practices are branches, We carried out an announced comprehensive inspection at the Low Hill Medical Centre, the main practice site the other two branches were not inspected. Low Hill Centre and its branches provide services for 7,700 patients living in the area of Wolverhampton. The practice is situated within an area of very high deprivation. The practice is a purpose built single storey building and provides on-site parking.

The team of clinical staff at the practice is made up of one GP partner and two salaried GPs (all male), one practice nurse and two healthcare assistants (all female). A business manager (non-clinical partner), reception and administrative staff provide management and administration support for the practice.

The practice is open between 8am and 6.30pm Monday, Tuesday, Thursday and Friday. On Wednesday the practice is open between 8am and 1pm and extended hours are available on Tuesday evening between the hours of 6.30pm and 8.30pm. Patients can book appointments in person, on-line or by telephone. Appointments are from 9.30am to 12.30pm every morning and afternoon surgery 4pm to 6pm on Monday, Thursday and Friday. Appointments are available with the practice nurse from 9am to 1pm and 2pm to 5.30pm daily with the exception of Wednesday afternoon.

The practice provides services to patients of all ages based on a General Medical Services (GMS) contract with NHS England for delivering primary care services to their local community. Services provided at Low Hill Medical Centre include the following clinics; asthma, family planning, new patient medical health checks, diabetic, baby vaccination and wellbeing screening clinics and drug and alcohol services.

The practice has opted out of providing out of hours services to their own patients. Primecare provides an out of hours service for patients between 8am and 9am Monday to Friday. At all other times when the practice is closed patients are asked to contact the NHS 111 service.

Updated 8 October 2015

Letter from the Chief Inspector of General Practice

MGS Medical Practice comprises of three branches, Low Hill Medical Centre, Bradley Health Centre and Ruskin Road Surgery. We carried out an announced comprehensive inspection at Low Hill Medical Centre, the main branch on 27 May 2015. The other two branches were not inspected as part of this visit. Overall Low Hill Medical Centre is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led services. The practice was rated as good for providing services for older people, people with long term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances make them vulnerable and people experiencing poor mental health (including people with dementia).

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 and addressed.
• Risks to patients were assessed and well managed, with the exception of ensuring the skill mix of staff was appropriate to meet the needs of patients registered at the service.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Patients said 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.
• Patients said it was not always easy to make an appointment with a named GP, that there was a lack of continuity of care and although urgent appointments were available the same day they found it difficult to access these.
• 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.

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

Action the provider should take to improve:

• Ensure that a suitable mix of staff with appropriate levels of skills and competencies are available to meet the needs of patients registered at the practice.
• Implement multidisciplinary meetings to discuss the care of patients at the end stage of their life and those with complex health needs.
• Review the appointment system offered to ensure patients can access the practice, a GP of their choice and appointments in a timely manner.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 8 October 2015

Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care. However we found that formal multidisciplinary meetings to discuss the care of patients at the end stage of their life and those with complex health needs were not in place.

Updated 8 October 2015

There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were high for all standard childhood immunisations. Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 8 October 2015

Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 8 October 2015

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 was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 8 October 2015

Data showed that 82.4% of people experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. We saw that there was a psychologist attached to this practice who provided support for patients who experienced poor mental health.

Updated 8 October 2015

The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability. It had carried out annual health checks for people with a learning disability and 95% of these patients had received a follow-up. It offered longer appointments for people with a learning disability. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations. 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.