Archived: Dr Doran and Dr Navaratnam

Updated 16 April 2015

Dr Doran and Dr Navaratnam’s practice is located in Crosby, Liverpool. There were approximately 3179 patients registered at the practice at the time of our inspection, the practice treated all age groups.

The practice has two GP partners (one female and one male), a part time practice nurse, a part time healthcare assistant a reception manager and four administration staff. The practice is open 8.00am to 6.30pm Monday to Friday The practice runs a triage system for emergency appointments every morning whereby a GP calls patients back first to ascertain whether clinical advice can be offered or that an appointment is needed. Patients requiring a GP outside of normal working hours are advised to contact an external out of hours service provider, Go to Doc. The practice has a GMS contract and also offers enhanced services for example; various immunisation and health check schemes.

One of the GP partners is a supervisor for medical students. The practice provides education and training to 5th year medical students throughout the year. 

The CQC intelligent monitoring placed the practice in band six. The intelligent monitoring tool draws on existing national data sources and includes indicators covering a range of GP practice activity and patient experience including the Quality Outcomes Framework (QOF) and the National Patient Survey. Based on the indicators, each GP practice has been categorised into one of six priority bands, with band six representing the best performance band. This banding is not a judgement on the quality of care being given by the GP practice; this only comes after a CQC inspection has taken place.

Updated 16 April 2015

Letter from the Chief Inspector of General Practice

This is the report from our inspection of Dr Doran and Dr Navaratnam’s Surgery is registered with the Care Quality Commission to provide primary care services.

We undertook a planned, comprehensive inspection on the 18 November 2014 at Drs Doran and Navaratnam’s Surgery. We reviewed information we held about the service and spoke with patients, GPs, and staff.

The practice was rated as Good overall.

Our key findings were as follows:

• There were systems in place to mitigate safety risks. The premises were clean and tidy. Systems were in place to ensure medication including vaccines were appropriately stored and in date.

• Patients had their needs assessed in line with current guidance and the practice had a holistic approach to patient care. The practice promoted health education to empower patients to live healthier lives.

• Feedback from patients and observations throughout our inspection highlighted the staff were kind, caring and helpful.

• The practice was responsive and acted on patient complaints and feedback.

• The practice was well led. The staff worked well together as a team and had regular staff meetings and training.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 April 2015

There were registers of patients with long term conditions which enabled the practice to monitor and arrange appropriate medication reviews. The practice nurse looked after patients with long term conditions such as diabetes and liaised with the GPs to ensure where necessary appropriate reviews of care and risk were carried out.

The practice used the Quality and Outcomes Framework to monitor patient outcomes and worked on local initiatives such as the locally managed CCG area referral pilot scheme to determine the effectiveness of referrals for vulnerable patients.

The practice sent the out of hours service a weekly report of priority patients, for example, those that had a serious long term condition or terminal illness that may need to contact the out of hours service.

Updated 16 April 2015

The practice had a community midwife who attended the practice every other week. The practice had a system in place for flagging up those children who had not received their vaccinations and the practice encouraged follow up visits.

The practice had child safeguarding policies and procedures in place and all staff had received updated training. There were systems in place to ensure that those children at greater risk were monitored appropriately.

Comments from patients demonstrated that the practice had systems in place to ensure that children requiring urgent consultations were seen. There were appointments available for children and young people outside of schools and colleges core operating times.

Updated 16 April 2015

Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. The practice kept a register of those patients 75 and over which was regularly updated and the practice offered a named GP for these patients in line with the new GP regulations. The practice was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

The practice held Gold Standard Framework meetings to discuss patients who required palliative care with other health care professionals to ensure patients received ‘joined up’ care appropriate to their needs.

Immunisations such as the flu and shingles vaccinations were offered to older patients and the Quality and Outcomes Framework (QOF) information indicated the percentage of patients aged 65 and older who had received these vaccinations was higher than the national average.

Updated 16 April 2015

All patients were offered referrals to the hospital of their choice.

Appointments at the practice are available from 8am to 6:30pm Monday to Friday. The practice had recently introduced an on line booking system for appointments and ordering repeat prescriptions. In addition the practice used a text service to remind patients of their appointments.

The practice also offered NHS health checks for patients between 40-74 years of age.

Updated 16 April 2015

The practice maintained a register of patients who experienced mental health problems. The register was used by clinical staff to offer patients an annual health check and medication review.

The practice kept a separate registers for long term conditions including patients with dementia and depression. The practice liaised with other health and social care services to ensure patients received appropriate care and support. The practice supported patients to access local support services to enable patients to manage their mental health.

Updated 16 April 2015

The practice held a register of patients living in vulnerable circumstances including homeless people and those with a learning disability. It had carried out annual health checks for people with a learning disability. It offered longer appointments for people with a learning disability to enable more time to discuss treatment options.

The practice regularly worked with multi-disciplinary teams to support the case management of vulnerable people. It supported patients 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.