Dr Rashpal Dosanj Also known as Bredon Avenue Surgery

Updated 18 February 2016

Dr Rashpal Dosanj (known locally as Bredon Avenue Surgery) is located in the Binley district of Coventry. The practice is run as a partnership comprising of the lead GP and the practice manager. They took over the management of the practice from the previous owner in 2012. The area served by the practice is urban and tending to be of a higher social economic status. Primary medical services are provided under a General Medical Services (GMS) contract with NHS England. The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

The practice is housed in a purpose built facility which has been extensively refurbished over the last two years. This has included newly equipped consultation rooms and new office accommodation within the existing building. There were 3,600 patients registered with the practice at the time of the inspection. This included a large Polish speaking population, primarily served by a Polish speaking GP employed by the practice. There is a small number of patients in a local care home, although the practice does not have an exclusive contract with this home.

In addition to the lead GP (male), there is a salaried GP (female), a practice nurse and a healthcare assistant. They are supported by the practice manager and administrative and reception staff.

The practice is open from 8am to 6.30pm during the week. Appointments are available between 8.30am to 12pm and from 3pm to 6pm, except on Thursday afternoons when a GP provides an ‘on-call’ service. There is extended opening from 7am on Wednesdays and Thursdays and an open clinic on Thursday mornings until 10am for which no appointments is needed. When the practice is closed, patients can access out of hours care through NHS 111. The practice has a recorded message on its telephone system to advise patients. This information is also available on the practice’s website and in the patient practice leaflet.

A wide range of NHS services is available at the practice, including NHS health checks, minor surgery, family planning and travel vaccinations.

Home visits are available for patients who are unable to attend the practice for appointments. There is also an online service which allows patients to order repeat prescriptions and book new appointments without having to telephone the practice.

The practice treats patients of all ages and provides a range of medical services. This includes disease management such as asthma, diabetes and heart disease. Other appointments are available for maternity care, family planning and smoking cessation.

Updated 18 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Rashpal Dosanj (known locally as Bredon Avenue Surgery) on 19 October 2015. Overall the practice is rated as good for providing safe, effective, caring, responsive and well led services.

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

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned. The practice had a particular interest in helping patients who were vulnerable or had poor mental health.

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.

• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day. The practice had addressed patient concerns about availability of appointments.

• Information about services and how to complain was available and easy to understand.

• The practice had good facilities and was well equipped to treat patients and meet their needs. There had been extensive refurbishment to a high standard over the last three years and new equipment had been purchased.

• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 18 February 2016

The practice is rated as good for the care of people with long-term conditions. The practice used a management system to monitor patients with chronic diseases and care of these patients was monitored by the practice nurse. Patients at risk of hospital admission were closely monitored. Longer appointments and home visits were available when needed. All patients diagnosed with a long term condition had a named GP and a structured six-monthly review to check that their health and medicine needs were being met. For those patients with the most complex needs, the GPs and practice nurse worked with relevant health and care professionals to deliver a multidisciplinary package of care. The practice also offered dietary, weight management and smoking cessation advice.

Updated 18 February 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 of abuse. For example, children and young people who had a high number of accident and emergency (A&E) attendances.

New patients who registered with the practice were offered an initial assessment with the practice nurse, who would check the immunisation history of children. The practice ran weekly baby clinics and shared the care of patients who were pregnant between the GPs and midwife who came to the practice every Monday. The practice had a policy for providing same day appointments for children and appointments were also available outside of school hours. The premises was suitable and accessible for children, with changing facilities for babies. We saw good examples of joint working with midwives, health visitors, school nurses and district nurses.

Updated 18 February 2016

The practice is rated as good for the care of older people. 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. It was responsive to the needs of older people, and offered home visits for those unable to reach the practice, this included patients who lived within a local care home. Health checks were carried out for all patients over the age of 75 years. At the time of our inspection, the practice had commenced its 2015-2016 flu vaccination programme. Care plans were in place for the most vulnerable older patients to prevent unplanned hospital admission.

Updated 18 February 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. Extended hours opening was available from 7am on Wednesday and Thursday mornings to provide suitable appointment times for patients who worked. Telephone consultations were also available for patients who were unable to reach the practice during the day. The practice was proactive in offering online services as well as a full range of health promotion and screening services that reflected the needs for this age group. The practice nurse had oversight for the management of a number of clinical areas, including immunisations.

The practice offered a number of online services including booking appointments and requesting repeat medicines.

New patients who registered with the practice were offered an initial assessment with the practice nurse, who would check their blood pressure, alcohol consumption, and smoking and drug use. Appropriate support was offered to patients at this stage if needed.

Updated 18 February 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multidisciplinary teams to plan care and treatment with patients who experienced poor mental health, including those with dementia. This included a number of patients who lived in a local care home. The most vulnerable patients had care plans in place and the practice carried out advanced care planning and annual health checks for patients with dementia and poor mental health. The GP and practice nurse understood the importance of considering patients’ ability to consent to care and treatment and dealt with this in accordance with the requirements of the Mental Capacity Act 2005.

The practice had advised patients experiencing poor mental health how to access various support groups and voluntary organisations. Patients with poor mental health and their carers were given information about the local crisis team and a local Improving Access to Psychological Therapies (IAPT) counsellor for a psychological assessment if this was needed. An independent in-house counsellor was also employed to whom patients could self-refer.

There was a system in place to follow up patients who had attended accident and emergency (A&E). Staff had received training on how to care for people with mental health needs and dementia.

Updated 18 February 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. Any potentially vulnerable patient had their records noted accordingly and were added to the relevant practice register if appropriate, e.g. learning disability. Vulnerable patients received an annual health check and were offered longer appointments when necessary.

The practice regularly worked with multidisciplinary teams in the case management of vulnerable patients, this included the local crisis team. It had advised vulnerable patients on how to access various support groups and voluntary organisations. The practice identified and closely monitored vulnerable patients who frequently attended accident and emergency (A&E).

Staff had received training and knew how to recognise signs of abuse in adults whose circumstances made them vulnerable and children who were considered to be at risk of harm. 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.