Dr Ajith Azad, Dr Sajith Azad and Dr NM Mohamed Faiz Also known as The Azad Practice

Updated 12 December 2016

Dr Ajith Azad, Dr Sajith Azad and Dr NM Mohamed Faiz (also known as The Azad Practice) is a GP practice based in Boleyn Medical Centre in East Ham, London. The medical centre is situated on a high street in a residential area. It is a modern purpose built building which is shared with another GP practice. This practice is located on the first floor of the building. The medical centre is well served by public transport services. A disabled parking bay is provided at the rear of the premises. Parking on the surrounding streets is generally for permit holders only, however there are public car parks within walking distance of the practice.

East Ham is a town in the London Borough of Newham which is to the east of London. The practice is part of Newham Clinical Commissioning Group (CCG) and provides services under a General Medical Services contract (GMS) to around 8956 patients. Results from the 2011 census for the London Borough of Newham show a majority white British population as (49.46%) followed by those of black African ethnicity in (15.43%). Newham residents have lower life expectancy and higher rates of premature mortality than other Boroughs in London and the average for England as a whole. The main causes of death in Newham are cardiovascular disease, cancer and respiratory disease and the levels of diabetes are among the highest in the country. Newham is the third most deprived local authority area in England. The area has a higher percentage than national average of people whose working status is unemployed (13% compared to 5% nationally) and a lower percentage of people over 65 years of age (7% compared to 17% nationally).

Clinical services are provided by three full time GP partners (all male, 9 sessions each per week) and three part time practice nurses (all female, six sessions in total). There were also two healthcare assistants (HCAs), a fulltime practice manager and six reception/administrative staff. Patients who wished to be seen by a female GP were able to book appointments at other local practices through the out of hours arrangements.

The practice is open from 9am to 6.30pm every day except weekends when it is closed and Thursday afternoon when it closes at 1pm. Appointments are available from 9am to 11am and then 4pm to 5pm except Thursday when there are no afternoon clinics. When the practice is closed patients are directed to the extended hours GP service which operates from 6.30pm to 9pm Monday to Friday and Saturday from 9am to 1pm. The practice also operates a daily emergency walk-in clinic for which patients have to be booked in by 11am for morning appointments and 5pm for evening appointments.

The practice is registered to provide the regulated activities services of treatment of disease, disorder or injury; diagnostic and screening procedures; maternity and midwifery from Boleyn Medical Centre 1st floor, East Ham, London, E6 3BD.

Dr Ajith Azad, Dr Sajith Azad and Dr NM Mohamed Faiz was not inspected under the previous inspection regime.

Updated 12 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Ajith Azad, Dr Sajith Azad and Dr NM Mohamed Faiz on 24 October 2016. Overall the practice is rated as good.

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.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients 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 provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Carry out a regular review of all significant events to identify any repetitions or trends.

• Review processes for recording discussions and agreements at meetings to ensure such information is shared effectively within the practice.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 12 December 2016

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

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

• Quality and Outcomes Framework (QOF) performance in 2015/16 for diabetes related indicators was 84% which was in line with the CCG average of 86% and the national average of 90%. Longer appointments and home visits were available when needed.

• All these 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 a dedicated call and recall system for patients with long term conditions, whose management involves all members of the practice team.

Updated 12 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. Immunisation rates were relatively high for all standard childhood immunisations.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The practice’s uptake for the cervical screening programme was 78%, which was comparable to the CCG average of 81% and the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice offered services aimed specifically at young people including confidential family planning advice.

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

• Children on the child protection list were discussed at monthly meetings with the health visitor and were also discussed with the social worker.

Updated 12 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.

• Over 65s were prioritised for the flu vaccine.

• Patients identified as being at risk of unplanned admissions were closely monitored and reviewed following discharge to ensure any changes to their needs were implemented.

Updated 12 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 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 offered a dedicated clinic for health checks to those aged 40-75 in Newham who were not diagnosed with a chronic disease.

• Meningitis vaccinations were offered to university students.

• The practice provided information about self-referral to services such as Newham Talking Therapies for psychotherapy, physiotherapy, alcohol counselling, sexual health and family planning clinics.

Updated 12 December 2016

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

• 83% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the CCG average of 76% and the national average of 78%.

• Quality and Outcomes Framework (QOF) performance in 2015/16 for mental health related indicators was 96% which was in line with the CCG average of 87% and the national average of 93%.

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

• Regular meetings with the community psychiatric liaison nurse were hosted at the practice to review patients with mental health problems.

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

• Patients were signposted to various relevant 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.

Updated 12 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 homeless people, travellers and 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.