Archived: Dr Shabir Bhatti Also known as Bermondsey Spa Medical Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Shabir Bhatti on 15 October 2015. Overall the practice is rated as inadequate.

We previously inspected Dr Shabir Bhatti in February 2014 and it was found to be non-compliant with safeguarding people from abuse, care and welfare of people using the service, cleanliness and infection control and management of medicines. We found it to be compliant in all areas at a subsequent inspection in September 2014. They had practice managers in post at both of these inspections.

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

• Patients were at risk of harm because systems and processes were not in place to keep them safe. Appropriate recruitment checks on staff had not been undertaken prior to their employment, there were insufficient arrangements to safeguard people from abuse and medicines management arrangements needed improvement

• Staff were not clear about reporting incidents, near misses and concerns and there was no evidence of learning and communication with staff.

• There was insufficient assurance to demonstrate people received effective care and treatment. For example, the practice did not engage in regular clinical and multi-disciplinary meetings to discuss and make decisions about the care of their patients with complex needs. The practice did not routinely monitor their quality performance and make plans to improve.

• Whilst some patients were positive about their interactions with staff, some patients did raise concerns about a lack of care and concern and rude attitude shown by reception staff and clinical staff at times.

• Patients said that they sometimes had to wait a long time for non-urgent appointments and that it was very difficult to get through the practice when phoning to make an appointment. Patients also told us they experienced long delays waiting for their booked appointments

• The practice had insufficient leadership capacity and lacked formal governance arrangements.

The areas where the provider must make improvements are:

• Introduce robust processes for reporting, recording, acting on and monitoring significant events, incidents and near misses.

• Take action to address identified concerns with infection prevention and control practice.

• Ensure recruitment arrangements include all necessary employment checks for all staff.

• Ensure there are formal governance arrangements in place including systems for assessing and monitoring risks and the quality of the service provision.

• Ensure staff have appropriate policies and guidance to carry out their roles in a safe and effective manner which are reflective of the requirements of the practice.

• Ensure staff have appropriate training and appraisals for their roles

• Ensure complaints are dealt with in line with the practice policy

The areas where the provider should make improvement are:

• Improve processes for making appointments.
• Actively seek to involve patients in developing and improving the service through the development of a patient participation group
• Ensure online services are available for patients in line with their service contract obligations
• Ensure there is a system for the management of prescription pads so they are properly accounted for
• Develop systems to provide information and support to patients who are also carers.

I am placing this practice in special measures. Practices placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The practice will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice