Archived: Dr Mohammed Aurangzeb Khan Also known as The Phoenix Medical Practice

Updated 4 July 2016

Dr Mohammed Aurangzeb Khan, or the Phoenix Medical Practice as it is known locally, is located in Doncaster town centre. The practice provides services for 1,947 patients under the terms of the NHS General Medical Services contract. The practice catchment area  is classed as within the group of the third more deprived areas in England. The age profile of the practice population is similar to other GP practices in the Doncaster Clinical Commissioning Group (CCG) area other than having less patients registered at the practice between the ages of 15 years to 19 years old and more male patients registered between the ages of 59 years to 69 years old.

The practice a GP, a first contact advanced nurse practitioner and three practice nurses. They are supported by  a team of administration staff and receive practice management support from the Frances Medical Centre Practice who also provide cover when the GP is on leave.

The practice is open between 8am and 6pm Monday to Friday. Early morning appointments with the GP Monday mornings and with the first contact advanced nurse practitioner on Friday mornings from 7.30am. Appointments with staff are available at various times throughout the day. Patients requesting same day appointments are triaged over the telephone by the practice nurse and offered a face to face appointment if required.

When the practice is closed calls were answered by the out-of-hours service which is accessed via the surgery telephone number or by calling the NHS 111 service.

Updated 4 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Mohammed Aurangzeb Khan on 5 April 2016. Overall the practice is rated as good.

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 innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example, the GP offered acupuncture to patients and people from the surrounding area to keep them mobile and manage their condition.
• Feedback from patients about their care was consistently positive. ​We received comments from patients whose relatives had come to stay with them in times of need who complimented the service and support offered to them by the practice. They described staff were supportive and responsive to their relatives needs and their own which in turn supported them to care for their loved ones. For example, by visiting their relatives whilst staying with them and ensuring medicines were prescribed and a package of care was in place to support both patient and carer.
• 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. For example, it had reviewed its opening times and offered early morning appointments on Friday mornings for those patient's who could not attend during the normal opening hours.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.
• The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw four areas of outstanding practice:

• The GP was qualified to offer acupuncture with musculoskeletal and other related problems to patients registered at this practice and to those nearby. Patients told us they valued this service as it helped keep them active which in turn assisted them managing their pain. During the last year 179 patients received acupuncture at the practice rather than at the local hospital. Benefits to patients included quicker access to treatment offered closer to home and a reduction in the amount of medicines taken for pain. The practice was one of the lowest prescribers of pregabalin, a medicine sometimes used to treat pain which can become addictive, in comparison to other practices in the area.
• It had developed a case management early warning system where those patients whose circumstances changed were highlighted to the GP for review. The GP would make contact with the patient and a personal care plan developed with the patient and carers, if relevant, to best support the patient. For example, if a patient presented at the practice in a confused state or had experienced recent bereavement.
• ​T he practice had a mobile telephone number which was given to both those patients at risk of admission to hospital and those with palliative care needs. The GP and the first contact advanced nurse practitioner had a rota to answer the telephone during the out-of-hours period to offer advice. Any consultations with patients were documented in the electronic patient record via the practice lap top. Patient's told us this provided continuity of care during the out-of-hours period.
• The role of the first contact advanced nurse practitioner was developed within the practice to provide patients with access to a female clinician who could prescribe medicines.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 4 July 2016

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

• Practice nursing staff had lead roles in long term condition management and patients at risk of hospital admission were identified as a priority.  Patient's told us they were offered three or six monthly condition reviews which they described helped to keep 'them well'.
• Of those patients with diabetes, 87% last HbA1c was 64 mmol/mol or less in the preceding 12 months.  The national average is 78%.
• Longer appointments and home visits were available when needed.
• All these patients had structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• The practice had a mobile telephone number which was given to both those patients at risk of admission to hospital and those with palliative care needs. The GP and the first contact advanced nurse practitioner had a rota to answer the telephone during the out-of-hours period to offer advice. Any consultations with patients were documented in the electronic patient record via the practice lap top. Patient's told us this provided continuity of care during the out-of-hours period.

Updated 4 July 2016

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

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of accident and emergency attendances. Immunisation rates were relatively high for all standard childhood immunisations.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• The practice’s uptake for the cervical screening programme was 84%, which was just above the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 4 July 2016

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

• All patients had a named GP.
• The practice offered proactive, personalised care to meet the needs of the older people in its population.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 4 July 2016

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

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.
• The GP was qualified to offer acupuncture to patients registered at this practice and to those nearby. Patients told us they valued this service as it helped keep them active which in turn assisted them managing their pain. During the last year 179 patients received acupuncture at the practice rather than at the local hospital. Benefits to patients included quicker access to treatment offered closer to home and a reduction in the amount of medicines taken for pain. The practice was one of the lowest prescribers of pregabalin, a medicine sometimes used to treat pain which can become addictive, in comparison to other practices in the area.

Updated 4 July 2016

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

• All patients diagnosed living with dementia  who had their care reviewed in a face to face meeting in the last 12 months, which is above the national average of 84%.
• All patients with complex mental health illness had a comprehensive agreed care plan in their record in the last 12 months, which is above the national average of 90%.
• The practice regularly worked with multidisciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff had a good understanding of how to support patients with mental health needs and dementia. Staff had received dementia awareness training.

Updated 4 July 2016

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

• The practice held a register of patients living in vulnerable circumstances including homeless people and those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.
• It had developed a case management early warning system where those patients whose circumstances changed were highlighted to the GP for review. The GP would make contact with the patient and a personal care plan developed with the patient and carers, if relevant, to best support the patient. For example, if a patient presented at the practice in a confused state or had experienced recent bereavement.