Archived: Dr Shiba Hameed

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Shiba Hameed/HeathfieldSurgery on 25 October 2016. Overall the practice is rated as requires improvement.

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

• Risks to patients were not always assessed and well managed; the practice had no defibrillator or medical oxygen to respond to medical emergencies and that many staff had not undertaken mandatory training including safeguarding, basic life support, infection control, information governance and fire safety training. Also there were gaps in monitoring of refrigerator temperatures in which vaccines were stored and not all staff who acted as chaperones were trained for the role or had received a Disclosure and Barring Service (DBS check).
• There was an effective system in place for reporting and recording significant events.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. However there was no robust system in place to keep all clinical staff up to date.
• The practice had a low uptake of cervical screening.
• 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 they found it easy to make an appointment with a named GP and that 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 leadership structure and staff felt supported by management.
• The provider was aware of and complied with the requirements of the Duty of Candour.

There were areas of practice where the provider must make improvements:

• Ensure all staff have child protection training, annual basic life support training, safeguarding vulnerable adults training, mental capacity act training, fire safety training, infection control training and information governance training relevant to their role; ensure that temperatures are regularly monitored for refrigerators that store vaccines; ensure that the chaperone processes are in line with guidelines and that staff have been trained and undertake a risk assessment to ascertain if DBS checks are required for all staff who undertake this role.
• Ensure that the Quality and Outcomes Framework results are improved especially for patients with diabetes.
• Ensure that a system to seek and act on feedback from service users is reinstated, including re-establishing a Patient Participation Group (PPG).

There were areas of practice where the provider should make improvements:

• Review practice procedures to ensure that the practice has a defibrillator and medical oxygen available to respond to medical emergencies or to have completed a risk assessment identifying how they would deal with medical emergencies.
• Review practice procedures to ensure that fire and health and safety of the premises risk assessments are undertaken and all the recommendations from the fire, premises and legionella risk assessments are actioned.
• Review systems in place to ensure all patients are monitored and reviewed as required dependent upon their medical condition. For example annual health reviews for all patients with a learning disability.
• Review practice procedures to improve uptake of cervical screening.
• Review how patients with caring responsibilities are identified and recorded on the clinical system to ensure information, advice and support is made available to them.
• Review practice procedures to ensure that GP survey results are reviewed to address low scoring areas to improve patient satisfaction.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice