Archived: Dr Mohua Chowdhury

Updated 15 September 2016

Dr Mohua Chowdhury (also known as The Chowdhury Practice) is located on the first floor of a health centre in Oldham Town Centre. There are other GP practices located in the same building. The practice is fully accessible to those with mobility difficulties. There is a car park next to the building.

There is one female GP and a team of locum GPs working at the practice. There are four regular locum GPs, all male, and a male advanced nurse practitioner. There are also two practice nurses, two healthcare assistants, a practice manager and administrative and reception staff.

The practice and the telephone lines are open:

Monday and Wednesday 8am – 7.30pm

Tuesday, Thursday and Friday 8am – 6.30pm.

GP surgery times are:

Monday 9am – 7.30pm

Tuesday 9am – 5pm

Wednesday 9am – 1.30pm and 2pm – 7.30pm

Thursday 9am – 1pm and 2.30pm – 6pm

Friday 9am – 12 noon and 2pm – 6pm.

The practice has a General Medical Service (GMS) contract with NHS England. At the time of our inspection 6635 patients were registered.

The practice has a high level of patients who do not speak English as a first language; 88% of patients are Bangladeshi. The GP, locum GPs and some reception staff speak second languages, mostly Bengali. The practice is an in an area of high deprivation. They have a young practice population and they have a high number of larger young families.

Average life expectancy is below the local and national averages. There is a slightly lower than average number of people with long term health conditions, and a higher number of unemployed people.

The practice has opted out of providing out-of-hours services to their patients. This service is provided by a registered out of hours provider, Go to Doc Ltd.

Updated 15 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Mohua Chowdhury (also known as The Chowdhury Practice) on 5 August 2016. Overall the practice is rated as requires improvement.

The practice had previously been inspected on 19 November 2015. Following this inspection the practice was rated as inadequate with the following domain ratings:

Safe – Inadequate

Effective – Inadequate

Caring – Requires improvement

Responsive – Requires improvement

Well-led – Inadequate.

The practice was placed in special measures.

Following this inspection on 5 August 2016 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.
• Risks to patients were assessed and well managed.
• 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.
• Not all staff received adequate supervision and action was not always taken in a timely manner when staff performance issues were identified.
• Patients commented they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Feedback from the GP patient survey was less positive.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Most 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. The practice proactively sought feedback from staff and patients, which it acted on.

The areas where the provider must make improvements are:

• The provider must ensure appropriate recruitment checks are carried out for all new staff.

• The provider must ensure all staff receive appropriate support to carry out their role.

• When performance issues are identified the provider must ensure appropriate action is taken.

In addition the provider should:

• The provider should calibrate equipment in doctors’ bags.
• The provider should monitor patient outcomes and health screening data and have plans to improve these. The provider should also improve quality improvement activity as a way to drive improvement.
• The provider should explore ways of engaging with their patients in order for them to contribute to improvement
• The provider should improve their system for identifying carers so appropriate support can be offered.
• The provider should monitor the patient survey results and have plans in place to make improvments.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by this service. The practice will be inspected again in the next 12 months.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 September 2016

The practice is rated as requires improvement for the care of people with long-term conditions. The provider was rated as requires improvement for the safe, effective and caring domains. The issues identified as requiring improvement overall affected all patients including this population group.

• 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 62%.This was worse that the CCG average of 82% and the national average of 89%.

• Longer appointments and home visits were available when needed.

• All these 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.

Updated 15 September 2016

The practice is rated as requires improvement for the care of families, children and young people. The provider was rated as requires improvement for the safe, effective and caring domains. The issues identified as requiring improvement overall affected all patients including this population group.

• 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.

• Staff told us that children and young people were treated in an age-appropriate way and were recognised as individuals.

• 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.

• The practice’s uptake for the cervical screening programme was 75%, which was slightly below to the CCG average of 82% and the national average of 82%.

Updated 15 September 2016

The practice is rated as requires improvement for the care of older people. The provider was rated as requires improvement for the safe, effective and caring domains. The issues identified as requiring improvement overall affected all patients including this population group. 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 carried out over 75s health checks and most patients over the age of 75 had received a check.

• 82% of patients over the age of 65 had received a flu vaccination.

Updated 15 September 2016

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 the safe, effective and caring domains. The issues identified as requiring improvement overall affected all patients including this population group.

• 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.

• The practice had late appointments twice a week.

Updated 15 September 2016

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 the safe, effective and caring domains. The issues identified as requiring improvement overall affected all patients including this population group.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those 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.

• Performance for mental health related indicators was 87%.This was worse that the CCG average of 92% and the national average of 93%.

Updated 15 September 2016

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 the safe, effective and caring domains. The issues identified as requiring improvement overall affected all patients including this population group.

• 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.