Archived: Drs Passi and Handa

Updated 18 June 2015

Drs Passi & Handa is a registered provider of primary medical services with the Care Quality Commission (CQC) and has one registered location (practice).This is Leicester Street Medical Centre, Whitmore Reans, Wolverhampton, WV6 0PS. The practice also has a branch surgery which is Owen Road Medical Centre, 130 Owen Rd, WolverhamptonWV3 0AJ. This inspection focused on the main surgery Leicester Street Medical Centre. However, the data we reviewed before the inspection visit represented both surgeries.

The registered patient list size is approximately 6700 patients. The practice is open Monday to Friday 8am to 6:30pm. The consulting hours were from 8:30am to 10:30am and 3:30pm to 5:30pm. The practice provided extended hours on Saturdays from 9am to 12.30pm. The practice has opted out of providing out-of-hours services to their own patients. This service is provided by an external out of hours service contracted by the CCG. CCGs are groups of GP practices that commission most of the hospital and community NHS services in the local area for which they are responsible.

There are two GPs (one male and one female) and a salaried GP who works six sessions a week. All the GPs worked at both the main and branch surgery sites. The practice employs one nurse practitioner (a nurse who is qualified to treat certain medical conditions without the direct supervision of a doctor), a practice nurse and three health care assistants one of whom was a trainee. There is also a team of six administrative staff and a deputy practice manager who was acting in the role of the practice manager.

The practice has a General Medical Service contract (GMS) with NHS England. A GMS contract ensures practices provide essential services for people who are sick as well as for example, chronic disease management and end of life care. The practice also provides some enhanced services such as minor surgery. An enhanced service is a service that is provided above the standard GMS contract.

We reviewed the most recent data available to us which showed that the practice is located in a deprived area in Wolverhampton. The patient population comprised a large group of Asian people as well as recent immigrants and asylum seekers. The practice has a lower than average patient population who are aged 45 years and over and a higher than average patient population aged between 20 and 34 years in comparison to the practice average across England.

Updated 18 June 2015

Letter from the Chief Inspector of General Practice

We undertook a comprehensive inspection of Drs Passi and Handa (Leicester Street Medical Centre) on 9 December 2014. The providers also have a branch surgery which is Owen Road Medical Centre but we did not inspect the branch surgery as part of our visit. We found the practice was good in providing care that was effective, caring and responsive but required improvement for effective and well-led. The overall rating for the practice is requires improvement.

Our key findings were as follows:

• The practice had some arrangements in place to ensure patients received a safe service.

• Patient care was provided by staff who had received appropriate training. The practice worked with other health and care providers to deliver co-ordinated care.

• Feedback from patients told us that they were treated with dignity and respect and that staff were friendly and helpful.

• Action had been taken to improve access to appointments. Information and feedback from patients was used to deliver service improvement

• We found the practice was organised operationally and staff understood their roles to deliver a satisfactory service.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Ensure that robust systems and governance arrangements are put in place to protect patients from unsafe care and deliver service improvement.

The provider should:

• Implement a consistent system for ensuring appropriate clinical accountability around repeat prescribing.

• The practice should ensure staff have appropriate working knowledge of the Mental Capacity Act (2005).

• The practice should ensure audits complete their full audit cycle in order to check any changes have led to improvements in patient care.

• The practice should ensure patients that are unable to produce documentation have access to a GP and staff are aware of the process to follow in that event.

• Establish clear lines of accountability so that staff are aware of whom they should approach if there any issues or concerns in the practice.

• Ensure vision and values for the practice are developed and shared with staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 June 2015

The practice held registers of patients with long term conditions and offered structured reviews for these patients to check their health and medication needs were being met. Patients with long term conditions were reviewed by the GPs and the nurses to assess and monitor their health condition so that any changes could be made. For those with the most complex care needs, we saw the GPs worked with a range of health and care professionals to deliver a multidisciplinary package of care. We saw evidence of care plans that were in place to help manage and better co-ordinate patients care. Patients were able to see a GP in an emergency if their health was deteriorating.

Updated 18 June 2015

There was evidence of multidisciplinary working including the health visiting team. Safeguarding procedures were in place for identifying and responding to concerns about children who were at risk of harm. The childhood vaccination programme was undertaken by the practice nurse. The most recent data available to us showed immunisation rates were mostly in line with the average for the Clinical Commissioning Group area.

Updated 18 June 2015

Patients over the age of 75 years were offered health checks at dedicated clinics that took place. There were arrangements to review patients in their own home if they were unable to attend the practice. Telephone consultations were available so patients could call and speak with a GP if they did not wish to or were unable to attend the practice. Care plans were in place to monitor and review their health needs. Patients over 75 years of age had a named GP to help co-ordinate their care. Those with complex care needs and at high risk of admission had been identified so that they could be appropriately supported to live at home and avoid admission to hospital.

The practice worked with the palliative care team through quarterly meetings to provide support to patients receiving end of life care.

Updated 18 June 2015

A number of clinics and services to promote good health and wellbeing were available for all patients. Emergency appointments, telephone consultations and extended hours of surgery with the nurse were available on Saturday mornings. A GP partner we spoke with told us they were also available for if needed by the nurse. This enabled patients who worked to attend in the surgery for routine check-ups. Patients were able to order repeat prescriptions around their working day by telephone or on line if they registered for the facility. The practice carried out NHS health checks for patients between the ages of 40 and 74. The NHS Health Checks examine patients vascular or circulatory health and works out the risk of developing some of the most disabling but preventable illnesses.

Updated 18 June 2015

Patients with mental health needs were reviewed annually and the practice made available a room for Healthy Minds which could be accessed by patients on a weekly basis Healthy Minds is an NHS primary care psychological therapies service that works closely with GPs. It offers advice, information and brief psychological talking therapies. Dementia screening for all patients over 65 was available at the practice. This enabled patients to receive appropriate treatment and support if they were developing symptoms of dementia.

Updated 18 June 2015

We were told that the practice population comprised vulnerable groups such asylum seekers. One of the GPs told us that they found that this group of patients often moved on before follow-up care could be offered. They often did not stay in the area long. We saw that staff did not discriminate in regards to race or gender. However, the practice staff we spoke with were unclear what they would do to enable patient groups such as those without a permanent address to register at the practice. The practice provided an enhanced service to avoid unplanned hospital admissions .This service focused on co-ordinated care for the most vulnerable patients and included emergency health care plans. The aim was to avoid admission to hospital by managing their health needs at home. An enhanced service is a service that is provided above the standard general medical service (GMS) contract. The practice had a translation service available and many staff at the practice were multi-lingual.