Archived: Dr Hara Chakrabarti

Updated 28 May 2015

Dr H Chakrabarti Surgery is situated close to the city centre of Preston in a residential area. There are currently 1850 patients registered with the practice. The practice held a General Medical Service (GMS) contract with NHS England to deliver Primary Care Services to the local community.

The patient population groups are all lower than the Clinical Commissioning Group (CCG) and National averages except for the age groups under 18 years which were higher than both local and national averages. This practice has a minimal annual turnover of patients. Information published by Public Health England rates the level of deprivation within the practice population group as one on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

The practice team comprises of one GP and a locum GP two days per week both male, at present there was no access to a female GP. There was a part time practice nurse with a variety of skills and qualifications. The practice manager was supported by a team of reception and administrative staff. The practice did not at present have an active patient participation group.

Opening hours are 9am-6pm Monday and Wednesday, until 7pm on Tuesday and Friday and the practice closed Thursday afternoon. Surgeries are available mornings, afternoons and evenings. When the practice is closed an out of hours service, Preston Primary Care Centre, meets the care and treatment needs of patients.

The practice informed us their estimate for patients from diverse ethnic population groups registered with the practice was approximately 74% of their practice population.

The practice has imminent plans to move to newly adapted premises which they will share with two other practices, just a short distance from where they are currently situated. We were shown the plans for the new premises and could see the layout was user friendly and more open than current facilities. The move should have taken place at the beginning of April 2015 but had been delayed until June 2015. Patients and staff were fully aware of the planned move.

Updated 28 May 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Chakrabarti Surgery on 22 April 2015.

Overall the practice is rated as good. We found the practice to be good for providing safe, well-led, effective, caring and responsive services.

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 and external incidents were maximised.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Patients told us they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information was provided to help patients understand the care available to them.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and staff.
• The practice had a clear vision which had quality and safety as its top priority. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

We also saw areas of outstanding practice:

• The practice had a nurse who worked across three practices who assisted with the care of the over 75 age group population within the practice. This nurse carried out home visits and dementia assessments in the patient’s own home.
• The practice offered a separate area to nursing mothers to breast feed their babies; mothers could access this area at any time during surgery hours.

In addition the provider should:

• Ensure staff awareness relating to serious adverse incidents is raised and they are empowered to complete the documentation themselves rather than asking the practice manager to do this.
• Ensure re-audit dates are documented on all audits to ensure the full cycle is completed and reported upon.
• Ensure communication with the multi-disciplinary team is formally recorded and strengthen links with this team.
• Ensure there is an auditable system for reviewing and monitoring the recording of serial numbers on blank hand written prescriptions pads held in storage and once allocated to GPs.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 May 2015

The practice is rated as good for the care of people with long-term conditions. There was a high prevalence (47.6%) of patients with long standing conditions, such as cardiovascular disease and Chronic Obstructive Pulmonary Disease (COPD) amongst the patient population. Nursing staff had received appropriate training which enabled them to focus upon specific chronic conditions and appropriately assist in the management of them through a comprehensive schedule of clinics. These patients were recalled annually which ensured they had structured annual reviews to check their health and medication needs were being met.

GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care for those patients with the most complex needs. The practice offered enhanced services to meet the needs of patients with long-term conditions such as avoidance of unplanned admissions to hospital through care planning.

Updated 28 May 2015

The practice is rated as good for the care of families, children and young people. Systems were in place for identifying and following up children who were at risk. For example, children and young people who had a high number of A&E attendances. Immunisation clinics for babies and young children were available on a weekly basis. Appointments both routine and urgent were available outside school hours and the premises were suitable for children and babies. Children needing urgent appointments were seen as soon as possible at the surgery. Children and young people were treated in an age appropriate way and recognised as individuals. Monthly Health Visitor and GP meetings were held to discuss any concerns or safeguarding issues. The population group of under 18 year olds accounted for 53.9% of the practice patient population which is higher than both the Clinical Commissioning Group (CCG) and national average for this age group.

Updated 28 May 2015

The practice is rated as good for the care of older people. Nationally reported data showed that 7.1% of the patient population were aged 65 or over which was below the national average. The practice had good outcomes for conditions commonly found amongst older people. The practice offered proactive, personalised care to meet the needs of the older patients in its population and had a range of enhanced services, for example, avoidance of unplanned admissions to hospital, timely diagnosis and support for people with dementia, and a shingles vaccination programme for those aged 70 and above. The practice was responsive to the needs of older people including offering home visits. The practice had used Clinical Commissioning Group resources to employ a nurse shared between three local practices to create extra session and home visits for this age group, this allowed for dementia screening in the persons own home and familiar environment.

Updated 28 May 2015

The practice is rated as good for the population group of the working-age people (including those recently retired and students). The needs of this group had been identified and the practice had adjusted the services it offered to ensure these were accessible. Patients were able to book appointments and request repeat prescriptions using online facilities. A full range of health promotion and screening services were available which reflects the needs for this age group was available within the practice. Telephone triage services were arranged at a time to suit the patient if patients were working and felt they needed advice from the GP. Late night appointments were available until 7pm on Tuesday and Friday evenings.

Updated 28 May 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Patients within this group received a timely recall for their annual physical health check. The practice took all reasonable measures to ensure high quality of mental health care was available to patients within the limitations of the local service available.

The practice provided an enhanced service with a view to facilitating timely diagnosis and support for people with dementia which they were actively working to improve upon. This included employing a nurse shared between three local practices to create extra session and home visits for the elderly, this allowed for dementia screening in the persons own home as a familiar environment.

Staff told us the practice had sign-posted patients experiencing poor mental health to various support groups, and they were proactive in helping patients address issues to improve all aspects of their health.

Updated 28 May 2015

The practice is rated good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances for example those with learning disabilities. Patients with learning disabilities were offered annual health checks and longer appointments were available if required. The practice effectively supported carers who were sometimes vulnerable themselves alongside the person they were caring for.

The practice worked with multidisciplinary teams in the case management of vulnerable patients. Staff knew how to recognise the 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 and out of hours.