Archived: Dr. Muktar and Partners

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Muktar and Partners on 2 February 2016. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal incidents were maximised.

• 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 thoroughly assessed and well managed.

• 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.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example the practice had invited a number of support organisations to provide a range of educational and advisory events for practice patients.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• Patients said they were able to get appointments when they needed them, with urgent appointments available the same day.

• Patients did not find it easy to contact the practice via telephone.

• 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 practice had a robust governance system in place to ensure that risks were identified and monitored and improvements to the service were made.

• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw three areas of outstanding practice:

• The practice benefited from a pharmacy co-located next to the health centre and they maintained close links with this service. We were given many examples where GPs were able to take prescriptions and medicines on urgent home visits pre-emptively, so patients received their medicines immediately. Where the medicines were not required by patients, the practice and pharmacy had an arrangement whereby they could be returned to the pharmacy with the prescription. Reception and administrative staff also worked closely with the pharmacy and ensured that those patients’ prescriptions requested at the end of the day were all received by the pharmacy prior to the practice closing to avoid delays in processing of prescriptions.

• The practice had arranged for a number of educational and support events for practice patients, in conjunction with the Patient Participation Group (PPG). For example, a diabetes information evening was held in October 2015 where an external speaker from a national diabetic charity offered advice on diet and exercises and provided information leaflets for patients. A practice nurse and a representative from the health lifestyle advisory service were also present to provide information to patients. The practice nurses also used this evening as an opportunity to provide flu immunisations to their diabetic patients and the PPG encouraged patient feedback by promoting the NHS Friends and Family Test. Of those 37 who attended the event across the three practices, 21 patients received the flu immunisation.

• The practice had robust governance arrangements in place, which included the use of work plans to address key areas of quality improvement; a comprehensive policy schedule outlining all policies and procedures, all review dates and the named staff member for updating the policy; and a comprehensive programme of continuous internal audits to monitor performance which were discussed in monthly management meetings. All management meetings were between the business manager and the partners of the three practices co-located in the shared premises which encouraged a culture of shared leaning and development.

The areas where the provider should make improvements are:

• Implement a clear system for tracking and monitoring the use of prescription pads across the practice.

• Ensure that care plans used are personalised and patient-centred in order to ensure that patients’ needs are effectively assessed.

• Ensure that vulnerable patients with a learning disability are monitored effectively via annual physical health checks.

• Ensure that consent for minor surgical procedures is adequately recorded on the electronic patient record system.

• Ensure that comprehensive minutes are kept of practice weekly clinical meetings.

• Consider providing extended hours surgeries to improve appointment availability for patients of working-age and provide an online appointment booking facility.

• Improve telephone access for patients.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice