Dr PM Patel/Dr R Kumar Also known as Suttons Avenue Surgery

Updated 29 September 2017

Dr PM Patel and Dr R Kumar Practice is located in a residential area of Hornchurch and is a part of Havering Clinical Commissioning Group. The practice is based in a converted house. There are 4572 patients registered with the practice.

The practice has two male GP partners carrying out 18 sessions per week, one female nurse working seven sessions per week, one practice manager and eight administration/reception staff members. The practice is a teaching practice for third year medical students and operates under a General Medical Services (GMS) Contract (a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract).

The practice is open Monday to Friday from 8:00am to 6:30pm; the phone lines were open from 8:00am. Appointment times were as follows:

• Monday 8:30am to 12:20pm and 4:00pm to 5:50pm.

• Tuesday 8:30am to 12:20pm and 4:00pm to 5:50pm.

• Wednesday 8:30am to 12:20pm however the practice doors remained open until 6.30pm.

• Thursday 8:30am to 12:20pm and 4:00pm to 5:50pm.

• Friday 08:30am to 12:20pm and 4:00pm to 5:50pm.

The out of hours provider covers telephone calls made whilst the practice is closed.

Dr PM Patel and Dr R Kumar Practice operates regulated activities from one location and is registered with the Care Quality Commission to provide family planning, treatment of disease disorder and injury, maternity and midwifery services and diagnostic and screening procedures.

Updated 29 September 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr PM Patel/Dr R Kumar on 3 May 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the May 2016 inspection can be found by selecting the ‘all reports’ link for Dr PM Patel/Dr R Kumar on our website at www.cqc.org.uk.

This inspection was an announced comprehensive inspection on 31 July 2017. Overall the practice is now rated as good.

Our key findings were as follows:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with said they generally 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

However, there were also areas of practice where the provider should make improvements.

The provider should:

• Improve systems and processes to improve the identification of patients who are also carers.

• Ensure the business continuity plan is updated to include contact details for all staff.

• Review childhood immunisation achievement rates against local and national averages.

• Review measures to support access for patients who have a hearing impairment.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 29 September 2017

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.

• At 98% performance for diabetes related indicators was higher than the CCG and national averages of 80% and 90%.

• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.
• All these patients had a named GP and there was a system to recall patients for 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.

Updated 29 September 2017

The practice is rated as good for the care of families, children and young people.

• From the sample of documented examples we reviewed we found there were systems to identify and follow up children living in disadvantaged circumstances and who were at risk.
• Immunisation rates were below target for standard childhood immunisations.
• Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice worked with midwives, health visitors and school nurses to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.
• The practice had emergency processes for acutely ill children and young people.

Updated 29 September 2017

The practice is rated as good for the care of older people.

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice offered proactive, personalised care to meet the needs of the older patients in its population.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.
• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible.

Updated 29 September 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations 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 did not offer extended hours but extra clinics were available during the flu season including Saturday morning.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 29 September 2017

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

• The practice carried out advance care planning for patients living with dementia.

• 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was above the CCG average of 82% and the national average of 84%.

• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.

• At 100% performance for mental health related indicators was higher than the CCG and national averages of 82% and 83%.

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

• Patients at risk of dementia were identified and offered an assessment.

• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 29 September 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them 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 had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.