Archived: Dr Erode Ganapathi Also known as Dr EN Ganapathi

Updated 12 October 2016

Dr Erode Ganapathi (known locally as Chapel End Surgery) is located in the Chapel End district of Nuneaton. It is an urban area with a significant number of patients from various ethnic minorities and fewer elderly patients than other local practices.

The practice is run by a single-handed GP and has 2520 patients registered. The practice’s origins go back over 100 years and it moved to its present building, a converted house in 1981. Facilities are shared with another GP practice which is also known as Chapel End Surgery. It has a General Medical Services (GMS) contract with NHS England. The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

The practice has one GP (male) who is supported by a locum GP (also male) who is permanently based at the practice. There is also a practice nurse and a healthcare assistant. They are supported by a practice manager and administrative and reception staff. The practice manager is due to retire later in 2016 and will be replaced by the practice manager of the other practice located within the building. This will mean both practices will be managed by the same person.

The practice is open from 8.00am to 6.30pm during the week, but closes at 2pm on Fridays. Appointments are available from 9.30am to 11.30am and from 5pm to 6.30pm, with the exception of Fridays when there is no afternoon session. Outside of these times, a duty GP is available, apart from Friday afternoons when a duty GP rota is in place with other local practices. On Friday afternoons, patients needing an urgent medical appointment are seen at the practice, or another local practice, or are visited at home. This is managed by West Midlands Ambulance Service who answer patient telephone calls and route the calls to the relevant GP. Extended hours appointments are available on Mondays from 6.30pm to 7.30pm.

At other times when the practice is closed, patients can access out of hours care provided by Care UK through NHS 111. The practice has a recorded message on its telephone system to advise patients. This information is also available on the practice’s website and in the patient practice leaflet.

Home visits are available for patients who are unable to attend the practice for appointments. There is also an online service which allows patients to order repeat prescriptions and book new appointments without having to telephone the practice. Telephone appointments are available for patients who are unable to reach the practice during normal working hours.

The practice treats patients of all ages and provides a range of medical services. This includes minor surgery and disease management such as asthma, diabetes and heart disease. Other appointments are available for blood tests, family planning and smoking cessation. The practice also cares for patients who live in some of the local nursing homes.

Updated 12 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Erode Ganapathi (known locally as Chapel End Surgery) on 16 August 2016. Overall the practice is rated as good.

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

• Patients told us they said they were treated with dignity, respect and compassion. Patients were involved decisions about their care and treatment.
• Patients’ needs were assessed and care delivered in line with current guidelines. Staff had the appropriate skills, knowledge and experience to deliver effective care and treatment.
• Urgent same day patient appointments were available when needed. Patients we spoke with and those who completed comment cards before our inspection said they were always able to obtain same day appointments.
• The practice had a number of policies and procedures to govern activity, but some needed more detail. For example, outlining responsibilities regarding sharing resources with the other GP practice located in the building and succession planning for the GP.
• Information about how to complain was available and easy to understand. The practice received very few complaints from patients and reviewed complaints to ensure lessons were learned and mistakes not repeated.
• Risks to patients were assessed and well managed.
• The practice carried out clinical audits to measure performance and improve outcomes for patients; however a more detailed plan for future clinical audits was needed.

• The practice had little evidence of any participation in local audits and local benchmarking.

• There were clearly defined processes and procedures to ensure patients were safe and an effective system in place for reporting and recording significant events. They were fully reviewed at staff meetings.

The areas where the provider should make improvements are:

• Document responsibilities regarding sharing resources with the other GP practice located in the building. This should include which resources will be shared, times they will be shared (for example permanently or during staff absence) and define line management responsibility and accountability.

• Consider the provision of female GP sessions when recruitment or future locum cover is needed.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 12 October 2016

The practice is rated as good for the care of people with long-term conditions.

• The practice had a register of patients with long term conditions to enable their health to be effectively monitored and managed.

• Patients had a named GP and a review every six to 12 months to monitor their condition and ensure they received correct medicines. The frequency of the review depended on the severity of the patient’s condition.

• Nursing staff had received appropriate training in chronic disease management, for example asthma and diabetes.

• The practice achieved a 100% vaccination record for diabetes patients during 2015-2016. This was above the Clinical Commissioning Group (CCG) average of 96% and the national average of 94%.

• Longer appointments and home visits were available when needed.

Updated 12 October 2016

The practice is rated as good for the care of families, children and young people.

• Systems were in place to identify children and young people who might be at risk, for example, those who had a high number of A&E attendances.

• A total of 81% of eligible patients had received cervical screening in the last 12 months. This was slightly below the Clinical Commissioning Group (CCG) average of 83% and the national average of 81%.

• There were appointments outside of school hours and the practice building was suitable for children and babies.

• Outcomes for areas such as child vaccinations were in line with or above average for the CCG.

• We saw positive examples of joint working with midwives. Weekly appointments were available at the practice.

• A full range of family planning services were available.

Updated 12 October 2016

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

• Older patients were given personalised care which reflected their needs.

• Care plans were in place with the most vulnerable older patients (2% of the patient list) and used with multi-disciplinary teams to reduce unplanned hospital admissions.

• Over the last 12 months all patients aged 75 and over had been invited for a health check. This included blood tests, fracture assessment, frailty assessment, and checks for depression and dementia. From those checks, the practice identified patients who needed further investigation and referred them appropriately.
• The practice carried out frailty assessments.

• Home visits were offered to patients who could not reach the practice.

• Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people.

Updated 12 October 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The practice ensured it provided services to meet the needs of the working age population, For example, extended hours appointments were available during the week and Saturday morning flu clinics were available during the flu vaccination season.

• Telephone consultations were available for patients who were unable to reach the practice during the day.

• A full range of services appropriate to this age group was offered, including travel vaccinations.

Updated 12 October 2016

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

• The practice had a register of patients with poor mental health to enable their health to be effectively monitored and managed.

• The practice worked with multi-disciplinary teams to provide appropriate care for patients with poor mental health. This included patients with dementia.

• Patients who were diagnosed with depression received a follow up from a GP within eight weeks of diagnosis.

• Patients were signposted to appropriate local and national support groups.

• Staff demonstrated a good working knowledge of how to support patients with mental health needs and dementia.

Updated 12 October 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• Longer appointments were available for patients with a learning disability.

• The practice had a register of patients who were vulnerable to enable their health to be effectively monitored and managed. This included patients with a learning disability.

• The practice supported vulnerable patients to access various support groups and voluntary organisations.

• The practice worked with other health care professionals to provide care to vulnerable patients, for example, the district nursing team.

• Staff could recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities to share appropriate information, record safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.