Archived: Dr Navaid Alam Also known as TG Medical Centre

Updated 16 November 2016

Dr Navaid Alam is registered with the Care Quality Commission to provide primary care services. The practice provides GP services for approximately 4,100 patients living in Wirral and is situated in a suitably furbished medical centre. The practice has three female GPs, three male GPs, two practice nurses, one healthcare assistant, administration and reception staff and a practice management team. It is a teaching practice and occasionally has medical students working at the practice. Dr Navaid Alam holds an Alternative Provider Medical Services (APMS) contract with NHS England and is part of the NHS Wirral Clinical Commissioning Group (CCG).

Telephone lines are open from 8am – 6.30pm Monday – Friday.

The practice is open Monday – Friday 7.30am – 6.30pm with extended hours until 8pm on Thursdays.

Patients can book appointments in person, via the telephone or online. The practice provides telephone consultations, pre-bookable consultations, urgent consultations and home visits. The practice treats patients of all ages and provides a range of primary medical services.

The practice is part of Wirral Clinical Commissioning Group (CCG). The practice does not provide out of hours services. When the surgery is closed patients are directed to the local out of hours service provider. Information regarding out of hours services is displayed on the website and in the practice information leaflet.

Updated 16 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Navaid Alam (TG Medical Centre) on 17 May 2016 and at this time the practice was rated overall as good. However breaches of legal requirements were also found. After the comprehensive inspection the practice wrote to us and told us that they would take action to meet the following legal requirements set out in the Health and Social Care Act (HSCA) 2008:

Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2010, Safe care and treatment.

Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2010, Safeguarding service users from abuse and improper treatment.

On 5 October 2016 we carried out a focused review of this service under section 60 of the Health and Social care Act 2008 as part of our regulatory functions. The review was carried out to check whether the provider had completed the improvements needed and identified during the comprehensive review in May 2016. This report only covers our findings in relation to those requirements. The report from our last comprehensive inspection can be read by selecting the ‘all reports’ link for Dr Navaid Alam on our website at cqc.org.uk

The findings of this review were as follows:

• The practice had addressed the issues identified during the previous inspection.

• Effective systems were now in place to safeguard people and prevent abuse. Staff had been suitably trained and policies and procedures reflected current guidance and legislation.

• Effective systems were now in place to monitor and mitigate the risks relating to the health, safety and welfare or patients and others. In particular in relation to the risks of general environmental risks, infection, storage of vaccines, medical equipment use and the management of prescription security.

We found that the practice had acted upon other recommendations made at the previous inspection to improve the service and care. For example:

• There was an effective system was in place to monitor clinical staffs professional registration such as with the General Medical Council (GMC) and Nursing and Midwifery Council (MNC).

• An audit policy and plan was in place.

• Patient reviews were undertaken and an effective system was in place to recall patients needing reviews.

• A nurse practitioner had been appointed which will increase capacity to care and treat patients.

• A NICE guidance policy had been implemented to set out the processes for implementing, monitoring and reporting progress in relation to NICE guidance and quality standards.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 22 June 2016

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

The practice maintained and monitored registers of patients with long term conditions for example, cardiovascular disease, diabetes, chronic obstructive pulmonary disease and heart failure. These registers enabled the practice to monitor and review patients with long term conditions effectively.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Some performance indicators for diabetes were lower than the CCG and National average. For example the percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months was 68%. The CCG average was 86% and the national average was 88%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a 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.

• Medical records for vulnerable patients with long term conditions were highlighted so that all staff knew their needs and arranged appointments and care accordingly.

Updated 22 June 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 A&E attendances.

• Immunisation rates were relatively good for all standard childhood immunisations with immunisations uptake for all children aged five and under around 94%.

• 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.

• Unwell children were always offered same day/urgent appointments.

• The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding five years was at the national average at 82%.

• Appointments were available outside of school hours.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 22 June 2016

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

The practice had a higher than national and local clinical commissioning group (CCG) average number of elderly patients with 41% over the age of 65. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in avoiding unplanned hospital admissions, dementia, nursing and residential care home support and end of life care.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• Nationally reported data showed that outcomes for patients for conditions commonly found in older people were mixed. For example the percentage of patients with diabetes in whom the last blood pressure reading is 140/80mmHg or less was lower than the CCG and national average. Whilst the percentage of patients with atrial fibrillation treated with anticoagulation or anti platelet therapy was higher than the CCG and national average.

• All the older patients had a named GP who coordinated their care.

The practice had a GP lead for elderly care.

Updated 22 June 2016

The practice is rated as good 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.

• For example, it offered online bookings of appointments and prescription requests and offered evening appointments, telephone and Skype consultations.

• It offered early morning (from 7.30am) appointments.

• 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 for example NHS health checks for those aged 40 to 75 years old.

Updated 22 June 2016

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

• 74% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months which is comparable to the national average.
• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the preceding 12 months, which is above the national average of 88%.

• The practice regularly worked with multi-disciplinary 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.

Updated 22 June 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, those misusing substances and alcohol 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.

• Improvements were needed to ensure all staff were fully trained in safeguarding and related policies and procedures reflected current guidance and legislation.