Archived: Dr Pratim Chaudhury

Updated 17 October 2017

Dr Pratim Chaudhury is located within a purpose built, primary care centre in the centre of Canvey Island in Essex.

• This purpose built centre offers car parking for patients, facilities for disabled patients, lift access and an on-site pharmacy managed by an external company.

• The practice has a higher than average population of patients aged 15 to 19 years old and aged 55 years and over. The practice has a smaller than average population of patients aged 0 to 9 years old and aged 25 to 39 years old. The practice is located in an area with a higher than average population score.

• At the time of our inspection, Dr Pratim Chaudhury had a list size of 2057 patients. Dr Pratim Chaudhury is registered with the Care Quality Commission as a sole provider; there are no permanent nursing staff so locum nurses are used to cover nursing duties.

• There is a practice manager, a medical secretary and a team of five receptionists. The practice had a pharmacist that was employed through the CCG that worked for the practice one day per week.

• The practice is open from 8am to 6.30pm Monday to Friday. Appointments are offered between 8.30am and 10.30am (11.30am on Thursday), and between 4pm and 6pm Monday to Friday, except Thursday afternoons when there are only emergency appointments available.

• The practice were part of an Alliance were patients could book appointments at a local practice on a weekend and bank holiday.

• When the practice is closed, patients are directed to out of hours services by calling 111. These services are provided by Integrated Care 24.

Updated 17 October 2017

Letter from the Chief Inspector of General Practice

On 6 January 2016 we carried out a comprehensive inspection at Dr Pratim Chaudhury. Overall the practice was rated as requires improvement. The practice was found to be requires improvement in safe, effective and well-led, good in caring and responsive.

As a result of that inspection we issued the practice with requirement notices in relation to risks to patient safety not being assessed and managed appropriately, the governance at the practice, delivery of person centred care and continuity of care from nursing staff.

We then carried out an announced comprehensive inspection Dr Pratim Chaudhury on 27 September 2017. Overall the practice is rated as good.

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

• Risks to patients who used the service were assessed. There were numerous risk assessments in place, including fire and health and safety.

• Medicine and patient safety alerts had been actioned.We saw that the practice held records of all safety alerts that had been received and a log that documented the date received and any action taken if applicable to the practice. The practice produced evidence of searches already conducted in response to the alerts received.

• Practice specific policies were implemented and were available to all staff. These were updated and reviewed regularly.

• The practice had implemented clinical audits and we saw evidence of quality improvement.

• The practice had locum packs and checklists in place for locum recruitment. The medical indemnity for two of the locum nurses was not available on the day of the inspection. However, this was forwarded as evidence on the day of our inspection.

• The practice had identified areas for improvement from the last inspection. Nursing staff were involved in recalling patients and ensuring a holistic approach to reviews.

• All patients had a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• A pharmacist worked in the practice for one day per week and completed medication reviews for patients.

• The practice had launched a practice website to increase the use of online services. Patients were able to book appointments on line.

• The practice had a comprehensive business continuity plan for major incidents such as power failure or building damage. The plan included arrangements for cover from local practices in the area should there be the need. For example, an outbreak of flu virus. Patients would be able to access services locally.

In addition the provider should:

• Implement the procedure to ensure prescriptions are tracked throughout the practice.

• Review the procedure to ensure that fridge temperatures are checked daily in line with the practice protocol.

• Continue to review recruitment checks to ensure that the provider can assure themselves that staff have appropriate indemnity in place.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 October 2017

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

• The nursing staff had lead roles in chronic disease management. Although the nursing team were locums, they were part of the practice team and one of the nurses had worked at the practice for over two years.

• Longer appointments and home visits were available when needed.

• The practice had identified areas for improvement from the last inspection. Nursing staff were involved in recalling patients and ensuring a holistic approach to reviews.

• All patients had a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• A pharmacist worked in the practice for one day per week and completed medication reviews for patients.

Updated 17 October 2017

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 comparable to Clinical Commissioning Group (CCG) and national targets for all standard childhood immunisations.

• The practice’s uptake for the cervical screening programme was 76%, which was in line with the CCG average 87% and the national average of 81%. This had increased by 2% from the previous year.

• Appointments were available outside of school hours and the premises were suitable for children and babies with baby changing facilities available within the primary care centre.

• We saw positive examples of joint working with midwives and health visitors who were located in the same primary care centre.

Updated 17 October 2017

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

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

• Longer appointments were available for older people if required.

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

• The primary care centre in which the practice was located was easily accessible by anyone with limited mobility.

• The practice worked closely with their admission avoidance patients with a multi-disciplinary approach.

Updated 17 October 2017

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

• The practice had actively attempted to identify the needs of the working age population, those recently retired and students on an on-going basis, although the practice population aged between 20 and 49 years was lower than the national average.

• The practice was a member of the local GP alliance which offered patients appointments at weekends; this was particularly useful for working age people.

• The practice had launched a practice website to increase the use of online services. Patients were able to book appointments on line.

• The practice offered online services as well as a full range of health promotion and screening that reflected the needs for this age group.

• Telephone appointments were available with the GP or nursing team.

Updated 17 October 2017

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

• The practice’s dementia indicators from the unverified 2016/17 data were 98%. This was a 10% increase from the 2015/16 data of 88%.

• Mental health indicators from the unverified 2016/17 data were 87%. This was a 7% increase from the 2015/16 data of 81%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. Staff had a good understanding of how to support patients with mental health needs and dementia.

• The practice carried out advance care planning for patients with dementia and provided home visits for those unable to attend.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• Carers were highlighted on their patient record and offered appropriate vaccinations and health checks.

Updated 17 October 2017

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 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.