Archived: Dr Falak Naz Also known as Dr F Naz

This practice is rated as Inadequate overall. The previous inspection, carried out on 19 January 2016 rated the practice as good overall.

The key questions are rated as:

Are services safe? – Inadequate

Are services effective? – Inadequate

Are services caring? – Good

Are services responsive? – Requires Improvement

Are services well-led? - Inadequate

We carried out an announced comprehensive inspection at Dr Falak Naz on 4 April 2018. We prioritised this inspection in response to concerns raised by Calderdale Clinical Commissioning Group (CCG) and NHS England.

At this inspection we found:

• Patients were at risk of harm because systems and processes were not in place to keep them safe. For example, high risk medicines were being prescribed by the practice without the necessary monitoring; medicines and other patient safety alerts were not actioned and the patient clinical record did not include key information, such as allergies in the appropriate places.
• Recording systems for significant events were not appropriate. Significant events and near misses were not captured in most cases. There was a lack of dissemination of learning to prevent recurrence of incidents.
• Multidisciplinary meetings did not take place. Patients were at risk of harm as information sharing relating to patients at end of life, or patients on the child safeguarding register was not occurring.
• The practice had very limited formal governance arrangements. Staff meetings were held infrequently and staff appraisals were overdue.
• Clinical staff cover for nurses and succession planning arrangements were not effectively established.
• Little or no reference was made to audits or other quality improvement activity within the practice. We saw no evidence that the practice was comparing its performance to others, either locally or nationally. Clinical audit activity was incomplete and did not address key issues of performance and improvement.
• The practice was not complying with up to date clinical guidance in relation to patient care, for example National Institute of Health and Care Excellence (NICE) guidance
• Patient Group Directions (PGDs) used for vaccination and immunisation purposes were being used without the correct authorisation.
• Procedures to monitor temperature sensitive medicines (vaccinations and immunisations) were not appropriate.
• We observed patients being treated with compassion and respect. The national GP patient survey results were consistently high across all areas. Patients told us they received a caring and personalised service. They told us they could access care when they needed it.

The areas where the provider must make improvements as they are in breach of regulations are:

• Care and treatment must be provided in a safe way for service users
• Systems and process must be established and operated effectively to ensure compliance with the requirements of the fundamental standards of care.

I am placing this service in special measures. We are taking action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. The service will be kept under review and if needed could be escalated to urgent enforcement action

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice