Archived: Dr AH Tak, Dr EG Stryjakiewicz & Dr M Sadik

Letter from the Chief Inspector of General Practice

We carried out an unannounced inspection of Dr AH Tak, Dr EG Stryjakiewicz & Dr M Sadik.on the 2 December 2014 following concerns raised by the NHS England (North Yorkshire and Humber) Area Team. Overall the practice is rated as inadequate.

Specifically, we found the practice inadequate for providing safe, effective and responsive services and for being well led. It was also inadequate for providing services for the six population groups. Improvements were also required for providing caring services.

Our key findings are as follows:

• Lessons learned from significant events were not shared with staff so improvements could be made.
• Risk assessments had not been completed to identify any significant risks and the measures required to reduce harm occurring. The practice did not regularly monitor risks to patients, staff and visitors to the practice.
• Urgent appointments were usually available on the day they were requested. However, we found that the routine appointment system was not working, as patients experienced difficulty getting through on the telephone and were often waiting a long time for non urgent appointments.
• There was no evidence of completed audit cycles.
• Patients with long term conditions had not received annual reviews and medication reviews.
• Most patients were positive about their interactions with staff and said they were treated with compassion.
• Leadership within the practice was not effective.

The areas where the provider must make improvements are:

• Improve systems to so all staff receive appropriate training and are appraised annually.
• Put systems in place to ensure all clinicians are kept up to date with national guidance and guidelines.
• Put systems in place so patients with long term conditions and those taking medication have annual reviews.
• Ensure there are formal governance arrangements in place, including systems for assessing and monitoring risks and the quality of the service provision.
• Ensure audits of practice are undertaken, including completed clinical audit cycles.
• Clarify the leadership structure and ensure there is leadership capacity to deliver all improvements
• Ensure staff have appropriate up to date policies and guidance to carry out their roles in a safe and effective manner which is reflective of the requirements of the practice.

On the basis of the ratings given to this practice at this inspection, I am placing the provider into special measures. This will be for a period of six months. We will inspect the practice again in six months to consider whether sufficient improvements have been made. If we find that the provider is still providing inadequate care we will take steps to cancel its registration with CQC.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice