Dr Esmail Esmailji

Background to this inspection

Updated 22 June 2017

Dr Esmail Esmailji is located within Stonehouse Health Clinic in Stonehouse, Gloucestershire and is a long established family orientated small GP practice. The practice is situated in a two storey purpose built health centre building and is wheelchair accessible.

The practice provides general medical services to approximately 2,700 patients. Services to patients are provided under a General Medical Services (GMS) contract with NHS England. (A GMS contract is a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract).

The practice has one GP (male) who is supported by a regular locum GP (female), which is equivalent to approximately one and a half full time equivalent GPs. The clinical team includes a practice nurse and a health care assistant (both female). The clinical team are supported by an administrator and two receptionists.

The practice population has a higher proportion of patients aged over 75 compared to local and national averages. For example, 12% of practice patients are aged over 75 compared to the local clinical commissioning group (CCG) average of 9% and the national average of 8%. The practice has relatively low numbers of patients from different cultural backgrounds with approximately 97.5% of patients being white British.

The practice is located in an area with low social deprivation and is placed in the third least deprived decile by public health England. The prevalence of patients with a long standing health condition is 61% compared to the local CCG average of 55% and the national average of 54%. People living in more deprived areas and with long-standing health conditions tend to have greater need for health services.

The practice is open between 8am and 6.30pm on Monday to Friday. Appointments are available between 8am and 12pm every morning and 4pm to 6pm every afternoon. Extended surgery hours are offered Tuesday and Thursday mornings between 7.30am and 8.30am.

Out of hours cover is provided by South Western Ambulance Service NHS Foundation Trust and can be accessed via NHS 111.

The practice provided its services from the following address:

High Street

Stonehouse

Gloucestershire

GL10 2NG

Overall inspection

Good

Updated 22 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Dr Esmail Esmailji on 19 July 2016. Overall the practice was rated as requires improvement because breaches of regulation relating to the safe and effective provision of services were identified. The full comprehensive report on the 19 July 2016 inspection can be found by selecting the ‘all reports’ link for Dr Esmail Esmailji on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 24 May 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection in July 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

The practice had undertaken and implemented an infection control audit for assessing and monitoring risks associated with infection control, and undertaken relevant actions as required.
The practice had reviewed and established a programme of clinical audits against defined criteria (with re-audit to demonstrate improvement and effective monitoring).
The practice had implemented an appraisal schedule and undertaken full written appraisals for all staff.
The practice had assessed, monitored and improved the quality and safety of the services provided in relation to legionella. Legionella is a term for particular bacteria which can contaminate water systems in buildings.
The practice was working with the clinical commissioning group to establish a patient participation engagement within the practice to ensure feedback is proactively sought.

Additionally, the practice had reviewed how they identified carers in order to provide additional support to patients who are also carers. At the last inspection, the practice had identified 19 patients who were also carers, which was equivalent to 0.7%. At this inspection, the practice had increased their number of carers to 55 patients which was equivalent to 2% of the practice list.

However, there was an area of practice where the provider needs to make improvements.

The provider should:

Ensure actions taken as a result of infection control audits are clearly recorded when these have been completed.

We have changed the rating for this practice to reflect these changes. The practice is now rated good for the provision of safe, effective, caring, responsive and well led services.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice