Archived: Dr Ramnikgiri Gonsai Also known as Dr R B Gonsai

Updated 2 November 2016

Dr Ramnikgiri’s practice, also known as the Cumberland Medical centre, is situated in a two storey building which is owned by the practice. They provide NHS primary medical services to approximately 2900 patients in Plaistow, London Borough of Newham, through a Personal Medical Services contract (a locally agreed alternative to the standard GMS contract used when services are agreed locally with a practice which may include additional services beyond the standard contract).

The premises have step free access and a disabled toilet and parking. It is located on a residential road a short walking distance from several underground stations including Plaistow and West Ham.

The practice staff includes a principal male GP working four sessions, three regular locum GPs (one female working five sessions and two male both working two sessions per week), a regular locum female practice nurse working two sessions and a female health practitioner working seven sessions per week. The practice manager works full time and there are six administration and reception staff working a mixture of full and part time hours.

The practice is open from 7.30am to 7.10pm on Monday and Tuesday, 7.30am to 7.00pm Wednesday, 7.30am to 3.00pm Thursday and 8.20am to 6.30pm on Fridays. The practice provides telephone consultations and home visits, the home visits are carried out before morning surgery, between morning and evening surgery and after evening surgery. Out of hours services and weekends are covered by the Newham GP Cooperative.

The practice’s patient population has an above average number of working age adults aged from 20 to 64 years (60%). The 2011 census shows that the largest ethnic group is white (50%) and 58% of the practice’s patient group have English as their first language. Information published by Public Health England rates the level of deprivation within the practice population group as two on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

Updated 2 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Ramnikgiri Gonsai (Cumberland Medical Centre) on 19 July 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; however, the practice did not carry out annual Infection Control audits.
• 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:

• The provider should take steps to make meeting minutes readily accessible to appropriate people.

• Review how patients are made aware of the chaperone system.

• Review their procedure for IPC audits in line with national guidelines.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 2 November 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.

• The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) is 140/80 mmHg or less was 85% which is comparable to the CCG percentage of 82% and higher than the national average of 78%.

• Longer appointments and home visits were available when needed.

• 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 online appointment booking and prescription requests.

Updated 2 November 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.

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

• 78% of women aged 25-64 had received a cervical screening test which was comparable to the CCG and national averages of 81% and 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies. Children and babies were prioritised for same day appointments.

• We saw positive examples of joint working with midwives and health visitors

Updated 2 November 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.

• The practice had multidisciplinary meetings every six weeks for older patients

• All patients over 75 had a named GP.

Updated 2 November 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 reflects the needs for this age group.

• Same day appointments were available.

• The practice offered extended hours on Monday’s and Tuesdays to accommodate working people.

• Telephone consultations were available.

• Online appointment booking and prescription requests were available.

Updated 2 November 2016

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

• 93% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record, in the preceding 12 months (01/04/2014 to 31/03/2015). This was higher than the CCG average of 84% and the national average of 88%.

• The Practice ran a monthly session with the Newham Primary Care Liaison Service where a Primary Care Liaison Nurse saw patients who had mental health issues and offered them assistance once they had been seen by the Community Mental Health Team.

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

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

Updated 2 November 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 those with a learning disability. There was also an alert on the patient records where a patient was identified as vulnerable.

• 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.