Archived: Dr Abul Kalam Mohammed Raziur Rahman Also known as Marshall Street Surgery

This practice is rated as Inadequate. (The practice was previously inspected in 9 June 2015 and rated Good overall).

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Inadequate

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Inadequate

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Inadequate

People with long-term conditions – Inadequate

Families, children and young people – Inadequate

Working age people (including those recently retired and students – Inadequate

People whose circumstances may make them vulnerable – Inadequate

People experiencing poor mental health (including people with dementia) - Inadequate

We carried out an announced comprehensive inspection at Dr Abul Kalam Mohammed Raziur Rahman also known as Marshall Street Surgery as part of our inspection programme.

At this inspection we found:

• The practice had a system to record safety incidents. However, we were unable to confirm if learning had been shared and discussed as all data on the computer system had been erased following a temporary takeover of the service by another provider in December 2017.
• There were some systems in place to maintain health and safety. However, at times this was not always effective. The practice was unable to show that a health and safety risk assessment was in place and that risks had been assessed for blind cord loops at the time of the inspection.
• There was some evidence that care and treatment was delivered according to evidence- based guidelines. However, the practice’s QOF achievement was below local and national averages and we did not see any evidence of monitoring to improve achievement.
• Patient’s feedback on the day of the inspection demonstrated that they were treated with compassion, kindness, dignity and respect. Results from the national GP patient survey showed that the practice achievement was mixed in comparison to local CCG and national averages.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• The practice had been taken over by another local provider in December 2017; however, the current provider had retaken the practice after four days. This was a challenge for the current provider, as the brief takeover had exacerbated existing issues such as IT and staffing. This did not demonstrate effective leadership capability to maximise positive outcomes for patients.
• The practice’s governance framework to support the delivery of the strategy and good quality care was not effective. The practice had recruited two local practice managers to help support the practice manager to build on its governance capabilities and this was work in progress.

The areas where the provider must make improvements as they are in breach of regulations are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development and appraisal necessary to enable them to carry out the duties.

The areas where the provider should make improvements are:

• Provide appropriate information for carers to access other services locally.
• Facilitate improvement in the uptake of cancer screening including breast and bowel cancer screening.
• Take appropriate action to protect patient confidentiality during all consultations.
• Explore ways patient feedback could be used to make improvements to service.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice