Engleton House Surgery

Updated 9 January 2017

Engleton House Surgery is a purpose built premises located in the Radford area of Coventry within the Coventry and Rugby Clinical Commissioning Group (CCG) which serves patients in the local area. The practice is served by the local bus network and there is accessible car parking. The practice and facilities are fully accessible to wheelchair users.

In addition to the main location the practice also provides GP services at a branch surgery which forms part of the purpose-built Coventry University Medical Centre. This premises is used to provide GP services to Coventry University students who are registered with the practice during term time only. When the branch surgery is closed outside of term time patients who are students can visit the main location.

The branch surgery is fully computerised and linked to the main location and shares the same telephone system. We visited the main location as part of this inspection and spoke with staff who worked at both sites. There are currently no staff who work at the branch surgery only and there is a rota system in place to provide staff coverage at both sites.

The practice and branch surgery provide primary medical services to approximately 21,800 patients. Approximately 60% of these patients form the student population. The local practice population is mostly White British with significant numbers of Asian and Asian British patients. The student population includes a significant number of students from overseas. Due to the student population patients aged 18 to 30 are overrepresented compared with regional and national averages.

The clinical staff team consists of three female and two male GP partners, three female and two male salaried GPs and eight nurses. The clinical team is supported by a practice manager, a patient services manager and a team of 17 secretarial, administrative and reception staff. Additionally there is one female and one male locum doctor working at the practice.

The practice conducts GP training with qualified doctors (known as GP registrars) undergoing a period of further training in order to become GPs and offers experience to medical students. There is currently one GP registrar working at the practice.

The main location and telephone lines are open from 7am to 7pm on weekdays and are closed at weekends. Appointments are available from 8am to 1pm and 2pm to 6.30pm on weekdays. Early morning (from 7am) and late evening (up to 7.30pm) appointments are available on request at the Engleton House site for those patients who cannot attend during normal surgery hours.

The branch surgery is open for GP and nurse appointments for Coventry University students registered with the practice on weekdays during term time only. These appointments are from 8.30am to 11.30am and 2.30pm to 5.30pm. Patients who are students can also visit the Engleton House site outside of these hours and outside of term time.

When the practice is closed services are provided by the local out of hours service which is accessible by telephoning the practice or 111. Patients are also directed to the local Coventry NHS Walk-In Centre which is open from 8am to 10pm, and is situated less than two miles away from the practice and branch sites.

Updated 9 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Engleton House Surgery on 11 October 2016. Overall 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, recording, discussing and learning from incidents and significant events.

• Risks to patients were assessed and well managed.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had received training which provided 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.

• 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.

• Patients said they could make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.

• 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.

We saw an area of outstanding practice:

• The practice had adopted innovative approaches to engaging with and identifying the specific health issues for the student population. The practice had implemented an online patient registrations system for students to use their mobile telephones to register online with the practice quickly and efficiently, resulting in significant reductions in registration errors and delays. The practice had developed a protocol for recognising and treating sickle cell anaemia due to the significant number of registered patients who were African students studying at the University.

However, there was an area of practice where the provider should make improvements:

• The practice should continue to monitor, review and improve patient satisfaction with access to appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 January 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 was in line with the Clinical Commissioning Group (CCG) and national averages. For example 84% of patients registered with diabetes had a total cholesterol rate under the recommended level compared with CCG and national averages of 82% and 81% respectively.

• Longer appointments and home visits were available when needed.

• All patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver an appropriate multidisciplinary package of care.

Updated 9 January 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, for example, children and young people who had a high number of accident and emergency 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. We saw evidence to confirm this.

• Performance for cervical screening indicators was in line with Clinical Commissioning Group (CCG) and national averages. For example the percentage of women aged 25-64 who attended for a cervical screening test in the last five years was 77% compared with CCG and national averages of 81% and 82% respectively.

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

• The practice provided combined parent and baby clinics carrying out post-natal and early child development checks.

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

Updated 9 January 2017

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice had completed 478 medicines reviews for patients over 75 during the last 12 months which represented the majority (81%) of the eligible population.

• The practice directed older people to appropriate support services.

Updated 9 January 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 provided specific services for its student population which took into account overseas students and their country of origin. For example the practice had developed a protocol for recognising and treating sickle cell anaemia due to the significant number of registered patients who were African students studying at the University.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs of this age group.

• The practice offered online appointment booking and the facility to request repeat prescriptions online.

• The practice had implemented an online patient registrations system for students to use their mobile telephones to register online with the practice quickly and efficiently. This had led to significant reductions in registration errors and delays.

• Appointments were offered to accommodate those unable to attend during normal working hours.

Updated 9 January 2017

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

• Performance for mental health (including dementia) related indicators was similar to the CCG and national averages. For example the percentage of patients diagnosed with dementia whose care had been reviewed in a face-to-face review in the preceding 12 months was 90% compared with CCG and national averages of 82% and 84% respectively. The practice’s exception reporting rate for this indicator was 9% compared with the CCG average of 7% and the national average of 8%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice 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.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

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

Updated 9 January 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 including homeless people and those with a learning disability.

• The practice had 42 patients registered as having a learning disability and had offered annual health checks to all of these patients. 25 of these health checks had been completed in the last 12 months. The practice offered longer appointments for patients with a learning disability.

• The practice’s computer system alerted GPs if a patient was also a carer. The practice had identified 88 patients as carers, which represented 1% of the non-student practice population. Staff told us they found that their student patient population who were away from home in term-time were unlikely to having caring responsibilities.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed 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.