Archived: Dr NK Agrawal and Partner

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr NK Agrawal and Partner on 26 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 a system in place for reporting and recording significant events. However, all significant events were not recorded and shared appropriately.
• Most risks to patients were assessed and well managed. However, we found that the practice did not have a defibrillator so that it could adequately respond to a medical emergency. A risk assessment had not completed to provide a rationale for this.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Most patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had the facilities and had most equipment to treat patients and meet their needs. However, there was no Automatic External Defibrillator (AED) and no risk assessment was in place to determine if one was needed.
• There was a leadership structure and staff felt supported by management. A new GP partner was joining the current partnership and they assuming some leadership responsibilities. However, due to this transition of responsibilities governance processes in respect to recruitment of some staff were not as robust.
• The practice was looking to establish a Patient Participation Group (PPG) so that it could seek feedback from patients.
• The provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider must make improvement are:

• All Patient Group Directions (PGDs) must be available and appropriately signed.

• Appropriate recruitment checks must be in place before staff begin working at the practice.

• The practice must determine if an Automatic External Defibrillator (AED) is required.

The areas where the provider should make improvement are:

• Ensure method for recording all incidents and significant events is consistent.

• Ensure risk assessments such as control of substances hazardous to health (COSHH) are carried out.

• All risk assessment to protect patients, staff and visitor should be in place and reviewed regularly.

• The practice should ensure staff appraisals are carried out regularly.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice