Archived: Dr Cliff Khan Also known as Brandon Lane Surgery

Updated 17 March 2016

Brandon Lane Surgery is situated in Brandon. They have a General Medical Services (GMS) contract and also offer enhanced services for example; the childhood vaccination and immunisation scheme. The practice covers the village of Brandon and surrounding areas, in the county of Durham. There are 2400 patients on the practice list and the majority of patients are of white British background. The practice is a purpose built premises. The practice scored four on the deprivation measurement scale, the deprivation scale goes from one to ten, with one being the most deprived. People living in more deprived areas tend to have a greater need for health services.

The practice is a single handed GP practice with one salaried part time GP. There is a Practice Manager, one Practice Nurse, and one Health Care assistant (all female). There are four receptionists/administration staff.

The practice is open between 8.30am and 5.30pm Mondays and Fridays, 8.30am to 3.30pm Tuesdays and Thursdays and 8.30am to 11am on Wednesdays. The practice has an agreement with North Durham CCG that care outside of these hours will be provided by the GP out of hour’s service.

Patients requiring a GP outside of normal working hours are advised to contact the GP out of hour’s service (111) provided by North Durham CCG. 

Updated 17 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Brandon Lane Surgery on 16 February 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, with the exception of those relating to recruitment checks.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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.

• Patients said they found it easy to make an appointment with a named GP and that 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.

We saw some areas of outstanding practice;

• The practice engaged with the local foodbank and clothes bank and had participated in fundraising for local charities. They had a health awareness display in the local supermarket.

• The practice had engaged with the local school and provided flyers to increase awareness in the flu vaccination for young people and children. This had led to an increase in the uptake of flu vaccinations in this group.

The area where the provider should make improvement is:

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

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 March 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. However we were told that nursing staff did not hold qualifications regarding specific chronic diseases and that the care of these patients was overseen by the GP.

• The percentage of patients with diabetes, on the register, in whom the last HbA1c was 64 mmol/mol or less in the preceding 12 months was 77% compared to a national average of 78%

• The percentage of patients with diabetes, on the register, who had the influenza immunisation was 97% compared to a national average of 94%

• Longer appointments and home visits were available when needed. Patients with more than one long term condition were able to be seen in one visit.

• All 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.

Updated 17 March 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.

• Immunisation rates were relatively high for all standard childhood immunisations.

• The percentage of patients with asthma, on the register, who had had an asthma review in the preceding 12 months was 86% compared to a national average of 75%.

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

• The practice had recently completed some work with ‘investors in children’ an organisation that seeks to promote the human rights of children and young people.

• The practice had engaged with the local school and provided information flyers about flu vaccinations for at risk groups. This had helped to increase the uptake of flu vaccinations in children aged 0-4 in 2014/2015 from 41 to 62 in 2015/2016 41. Flu vaccinations in the age range of 5-64 had also increased in this timescale from 219 to 244.

• The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding 5 years was 84% compared to a national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice had implemented a toolkit to be completed if a child presented with an injury – this ensured that the child was referred to the Local Authority if necessary. This toolkit was a practical working guide and covered best practice guidance, clinical governance and legal aspects of child safeguarding.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 17 March 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.

• As part of the Primary Care Outcomes Scheme, in conjunction with the CCG, the practice held a register of patients who were at risk of unplanned emergency admission to hospital. In addition the practice held a register of frail elderly patients and the GPs were in the process of visiting these patients at home to assess their needs.

Updated 17 March 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 that reflected the needs for this age group.

• The practice had recently changed its appointment system in response to feedback from patients.

• The practice offered a contraceptive service that included IUCDs (intrauterine contraceptive devices) and contraceptive implants. This provided care closer to home for patients who required this service.

Updated 17 March 2016

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

• 98% of patients with physical and/or mental health conditions had a smoking status recorded in the preceding 12 months which was above the national average.

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

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

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

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

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

Updated 17 March 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.

• The practice offered longer appointments for patients who needed them.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• The practice informed vulnerable patients 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.