Archived: Dr Prabir Das Gupta Also known as SPUR ROAD SURGERY

Updated 10 March 2017

The practice operates at 1 Spur Road, Tottenham, London, N15 4AA. The practice is based across two floors of a converted property although all clinical areas are on the ground floor. It is part of the Haringey clinical commissioning group area. Services are delivered under a General Medical Services (GMS) contract.

The practice has approximately 1,100 patients. The surgery is based in an area with a deprivation score of 2 out of 10 (10 being the least deprived). The practice population’s age demographic is generally in line with the national average. However, the number of patients under the age of 20 is lower than the national average.

The GP team includes a male practice principle and a female salaried doctor, who combine for 1.4 whole time equivalent and 11 clinical sessions. There is one practice nurse (one session per week). The clinical team is supported by a practice manager, a reception manager and five other administrative or reception staff.

The practice is open from 9.00am to 6:30pm Monday to Friday, with extended hours until 7:00pm on Fridays. The practice offers appointments throughout the day when the practice is open. When the surgery is closed urgent GP services are available via NHS 111.

The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury.

The practice had not previously been inspected by the CQC.

Updated 10 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Prabir Das Gupta’s practice on 12 January 2016. Overall the practice is rated as requires improvement.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. However, learning was not consistently implemented or shared with staff.
• Some risks to patients were assessed and well managed. However, the practice had not undertaken regular infection control audits.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Some patients said they were treated with compassion, dignity and respect, but the national patient survey showed that patients considered GP consultations to be worse than the national average.
• Information about services and how to complain was available and easy to understand. However, the practice did not review complaints as a whole to see if there were common themes.
• 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 good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. However, governance systems in the practice were not always formalised.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvements are:

• Ensure that findings of serious untoward events are actioned and that near misses are also recorded as serious events. Learning from events should be shared with all staff.

• Ensure that all policies and protocols are easily accessible to all staff.

• Ensure that annual infection control audits are undertaken.

• Continue to review patient feedback from the national patient survey such that results are improved.

• Ensure that all governance systems in the practice are formalised.

The areas where the provider should make improvements are:

• Consider replacing the flooring in the reception area/waiting room.

• Develop a formalised business continuity plan.

• All staff should complete basic life support annually and that clinical staff are regularly trained in the Mental Capacity Act.

• Consider reviewing how carers are identified, as the number on the practice list is relatively low.

• Consider reviewing complaints for themes and taking actions where consistent problems are highlighted.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 10 March 2017

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

The provider was rated as requires improvement for safety, caring and well led. The issues identified as requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

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

• Performance for diabetes related indicators was similar to the national average. The practice had scored 80% for diabetes related indicators in the last QOF similar to the national average of 89%. The exception reporting rate for diabetes related indicators was 14.6%, slightly higher than the national average of 11.6%.The practice was aware that exception reporting for diabetes was high.

• 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.

Updated 10 March 2017

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

The provider was rated as requires improvement for safety, caring and well led. The issues identified as requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

• 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 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 91%, which was higher than the national average of 81%.

• 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 10 March 2017

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

The provider was rated as requires improvement for safety, caring and well led. The issues identified as requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

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

• All patients over the age of 75 had a named GP.

Updated 10 March 2017

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

The provider was rated as requires improvement for safety, caring and well led. The issues identified as requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

• 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.

Updated 10 March 2017

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

The provider was rated as requires improvement for safety, caring and well led. The issues identified as requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

• 76% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average.

• QOF performance for mental health related indicators was similar to the national average. The practice had scored 100% for mental health related indicators in the last QOF (of a total of nine patients on the register), which was similar to the national average of 93%. The exception reporting rate for mental health related indicators was 5.7%, lower than the national average of 11.3%.

• 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 10 March 2017

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

The provider was rated as requires improvement for safety, caring and well led. The issues identified as requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

• The practice held a register of patients living in vulnerable circumstances including homeless people, travellers 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.