This practice is rated as Good overall. (Previous rating June 2015 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Birbeck Medical Group on 5 July 2018 as part of our inspection programme.

At this inspection we found:

•Recommendations made during the last CQC inspection had been acted on and improvements had been made.

•The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

•The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.

•Staff involved and treated patients with compassion, kindness, dignity and respect.

•Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

•The practice made good use of social prescribing, and had close links with a number of organisations in the local community that promoted healthy living.

•There was a nurse practitioner who specialised in sexual health. The practice provided sexual health services for their own patients as well as other practices in the area.

•There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw two areas of outstanding practice:

•The practice held weekly learning disability clinics and patients attending these clinics were encouraged to contribute to their own action plan which they were then given to keep and refer to. These were one-to-one sessions to review patient’s health and wellbeing. The practice had a higher than average number of patients reporting a learning disability (3.8% compared to a local average of 2.9% and national average of 3.1%)

•Nurses at the practice had been trained in insulin initiation so that they could begin treatment for patients in low-risk diabetes cases. Nurses did home visits to assess patients’ insulin, and they worked closely with other clinicians, such as podiatrists and secondary care consultants. So far, 14 patients had been initiated on insulin by nurses at the practice, saving them from having to access secondary care for this service.

The areas where the provider should make improvements are:

•Where staff have not had Disclosure and Barring Service (DBS) checks a risk assessment should be carried out detailing why one has not been deemed necessary.

•Continue to request that the fire risk assessment of the premises is updated.

•Continue to request that improvements are carried out to the premises to help patients who may require additional assistance.

•Continue to maintain an up-to-date staff training matrix to assist in ensuring staff have completed all mandatory training requirements and updates.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Birbeck Medical Group on 12 May 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, well-led, effective, caring and responsive services. It was also good for providing services for the following population groups: Older people; People with long-term conditions; Families, children and young people; Working age people (including those recently retired and students); People whose circumstances may make them vulnerable; 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 report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• The practice used proactive methods to improve patient outcomes, working with other local providers to share best practice. For example the practice had developed comprehensive care plans which included relevant socio-economic details as well as medical information.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG).

• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.
• The practice had a clear vision which had quality and safety as its top priority. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

We saw one area of outstanding practice:

• The practice held weekly learning disability clinics and patients attending these clinics were encourage to contribute to their own action plan which they were then given to keep and refer to.

However, there were also areas of practice where the provider needs to make improvements. The provider should:

• Ensure there is a standard process in operation regarding the monitoring and recording of drugs held in GP bags.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice