Dr Vipul Masharani

Updated 19 December 2016

The Lutterworth Medical Centre comprises of two GP surgeries - Dr Vipul Masharani (The Masharani Practice) and The Wycliffe Medical Practice. The building also houses the local ambulance station and a private pharmacy.

At Dr Vipul Masharani (The Masharani Practice) the service is provided by the senior GP and a combination of five salaried or regular locum GPs, providing a total of 26 sessions per week. They are supported by one practice manager, an associate manager, one advanced nurse practitioner/prescriber, one practice nurse, two health care assistants and a team of administration and reception staff.

The practice has 5700 patients and the practice’s services are commissioned by East Leicestershire and Rutland Clinical Commissioning Group (CCG). The practice has a General Medical Services Contract (GMS). The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

Local community health teams support the GPs in provision of maternity and health visitor services.

The practice had a website which was easy to navigate and provided information about the healthcare services provided by the practice.

The practice is open between 8.00am and 6.30pm Monday to Friday. Appointments were from 08.30am to 11.30am every morning and in the afternoon from 3.00pm to 6.00pm daily. The practice offered an open surgery every day between 08.30am and 11.30am. Telephone consultations and home visits are also available on the day. There was also a nurse practitioner led minor illness clinic available on a daily basis.

The practice has opted out of the requirement to provide GP consultations when the surgery is closed. The out-of-hours service is provided to Leicester City, Leicestershire and Rutland by Derbyshire Health United. There were arrangements in place for services to be provided when the practice is closed and these are displayed on their practice website.

Updated 19 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced focused inspection at Dr Vipul Masharani on 22 November 2016. Overall the practice is rated as good.

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

• Various audits had been implemented to ensure the practice met all aspects of the the Health and Social Care Act 2008: Code of Practice on the Prevention and Control of Infections.

• Relevant fire safety training had been undertaken as well as a fire risk assessment.

• Appropriate recruitment checks were carried out before staff were employed.

• Policies and protocols had been reviewed to ensure adequate systems and processes were in place to assess, monitor and mitigate against risk.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 December 2016

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

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

• Longer appointments and home visits were available when needed.

• 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.

• The practice had equipment enabling them to carry out ambulatory ECG and blood pressure monitoring.

• The practice had access to a visiting cardiologist at the adjacent cottage hospital. This considerably reduced travel distance and time for patients.

• The practice used a direct access service to talk to a consultant on their mobile phone regarding the conditions; diabetes, endocrinology and haematology (general and malignant).

Updated 19 December 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. Children’s immunisation rates were lower than average in some areas and the practice told us this was due to difficulties in getting travellers on their register to attend immunisation appointments. They liaised with a support worker to address this.

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

• There was a daily minor illness clinic led by the nurse practitioner who was able to prescribe medicines for specific conditions. Children could access fast track appointments if necessary.

• The practice offered chlamydia testing.

• The practice had access to a community paediatrician who attended the local cottage hospital which ensured that parents could access specialist opinions closer to home.

• The practice were in the process of developing a scheme whereby parents of under-fives could attend a training course to learn about resuscitation and management of emergencies in the home at a subsidised cost.

Updated 19 December 2016

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.

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

• The practice had increased the numbers of health checks offered to older patients by actively searching for patients not being seen and accordingly increased the number of appointments available for health checks.

• The lead GP had particularly focused on cardiovascular outcomes and primary prevention so those patients identified at a high risk of cardiovascular disease were sent information outlining suggested lifestyle changes and invited back three months later for a review.

• Around 3% of patients had care plans in place. For patient who were too frail to come to the practice, a practice nurse visited the patient at home to discss their care plan. They would also review long term conditions at the same time.

• The practice held regular multi-disciplinary palliative care meetings to discuss co-ordinated patient care.

• The practice participated in the local integrated care scheme and one of the GPs was the clinical lead. The service provided a multi-disciplinary co-ordinated approach to health and social care. This meant that patients’ needs were addressed holistically to include support for emotional issues such as provision of mobility items, assessment of risks, falls and the strain of being a carer.

• Local services were provided wherever possible in order to reduce the need for patients to travel further afield.

• The practice offered in house hearing screening tests.

Updated 19 December 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.

• The practice provided an open access consulting scheme each weekday morning which starts at 8.30am to enable working people to attend the surgery before going to work. They also encouraged telephone consultations if patients were unable to attend the early morning surgery.

• 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 19 December 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 multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.

• The practice carried out advance care planning for patients with dementia.

• Onsite counselling was available and there was weekly clinics provided by the community psychiatric nurse.

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

• Staff had a good understanding of how to support patients with mental health needs and dementia.

• The practice has developed a self assessment questionnaire based on the General Practitioner Assessment of Cognition dementia screening tool to enable patients and relatives to self assess whether they may be developing memory problems. Patients were encouraged to attend the morning open surgery without notice if they felt the need to talk to a clinician.

Updated 19 December 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 travellers. Within the practice catchment area were two approved residential/parking sites for travellers. The practice held a learning event for some staff and PPG members to increase understanding regarding specific issues travellers faces and how this impacted on their aiility to access medical care.

• The practice held a register of patients with a learning disability and offered longer appointments and annual health checks for these patients. They liaised with the CCG learning disability support worker.

• 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.

• Patients were encouraged to attend the morning open surgery without notice or having to make an appointment if they felt the need to talk to a clinician.