Dr Azim and Partners

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We assessed all quality statements for this key question and rated the practice as requires improvement for providing responsive services. At our last comprehensive inspection in November 2022, we rated this key question as requires improvement.

We received positive and negative feedback in the previous 12 months regarding the provision of services. Patient feedback received in the national GP patient survey fell below, sometimes well below, the local GP average and national average scores regarding patient satisfaction with services (see below for detail). The practice had conducted its own patient survey and feedback received was mixed. The practice was yet to conduct an analysis of the national GP patient survey and create an action plan to address areas of concern.

The practice and staff told us they offered reasonable adjustments and took people’s individual preferences into consideration during appointments and when providing information. For example, the practice provided information in formats to help patients understand their care, treatment and conditions, provided access to interpreters, provided longer appointments to patients with complex needs and conducted home visits where required.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

As part of this assessment, we considered feedback from patients sent to us about the practice over the previous 12 months. We also asked the practice to display a poster for patients in the lead up to this assessment to ask them to contribute their views. Overall, patient feedback we received show a mixed picture of care received by patients, with recurring themes of lack of access to care, particularly in relation to problems and delays with contacting the practice by telephone, delays and issues with patients receiving prescriptions, lack of response to complaints and a delay in receiving care and treatment. We received positive comments in relation to the service being improved, the quality of staff at the practice and accessible appointments.

Patient feedback we received from the GP patient survey indicated 64% of patients who responded felt that the health professional they saw or spoke to was good at treating them with care and concern during their last GP appointment. This was lower than the local average GP score of 83% and lower that the national average score of 85%. 52% of patients who responded found the reception and administrative team at the practice helpful. This was lower than the local average GP score of 79% and lower than the national average score of 83%. A total of 123 surveys were completed by patients which was a completion rate of 21%.

The practice told us it reviewed the results of the GP patient survey and devised an action plan but had not analysed the most recent results. For the previous GP patient survey, the practice had analysed the 3 lowest domains and had created an action plan to address these. The practice gave an example of where it had made changes to address issues with contacting the practice by telephone. The practice had reconfigured where staff sat and had amended job descriptions to make tasks role specific. The practice had reviewed the phone lines system in January 2024 and the current system was that reception exclusively managed appointments and general enquiries, with a focus on appointments. There was a separate line for prescriptions and test results which was monitored by the administrative team and another line which was for referrals and was monitored by the practice secretaries. Each telephone line had a call back service for patients to use. The practice told us the new system was working well, with fewer calls being missed, and that it planned to review this and put in place changes if required. The practice used an online consultation platform which allowed patients to access service and contact the practice during surgery hours. The practice told us it had seen a high uptake of patient registrations, approximately 7000 patients, for this service.

The practice delivered services to a local care home, which included weekly ward rounds for residents and additional visits for acutely unwell patients. However, we were made aware of concerns about the practice’s responsiveness to the care home, delays in processing referrals and ensuring timely care for residents.

The practice told us it worked to ensure that people were at the centre of their care and treatment choices. We saw evidence of a population needs assessment for Barnet PCNs which reviewed the impact of religion on service delivery, as well as the impact of ethnicity on service delivery, disease prevalence and social deprivation.

The practice and staff told us they offered reasonable adjustments to allow patients to participate in their care and treatment and that it took people’s individual preferences into consideration during appointments and when providing information. The practice provided information in a variety of formats to help patients understand their care, treatment and conditions as well as having access to interpreters, the provision of longer appointments for patients with complex needs and conducting home visits where required. The practice had a care navigator who was able to assist with organising home visits, signpost patients to appropriate services and escalate queries to clinicians during the triage process. The surgery also supported a nearby care home and undertook weekly GP site visits and urgent visits where a resident was acutely unwell.

The practice had an understanding of the health and social care needs of the local community and ensured that services were coordinated and responsive to them. For example, the practice signposted patients to services such as mental health practitioners, wellbeing coaches and social prescribers and would book appointments for patients with their consent. The practice also signposted patients to PCN services, for example, food banks, exercise classes and dieticians. Patients had a choice of booking appointments online, by telephone and in person. During our site visit, we saw several patients who had attended the practice who were able to make a same day appointment with a clinician.

People in vulnerable circumstances were able to register with the surgery, including those with no fixed abode such as homeless people and travellers. The practice told us staff were alert to look for signs that people may need assistance and would attempt to set up an appointment for a patient whilst they were on the premises for their convenience. The practice adjusted the provision of service to meet the needs of people by booking longer appointments where required, for example, if a resident in the care home was not mobile, a clinician would go to see them there. The practice also ensured appointments for carers were flexible to their routines. The practice told us there was a large population of refugees and people seeking asylum in the local area and it supported them with care and treatment, including mental health services.

The practice ensured the patient population had access to information that was beneficial to their health. The practice provided access to interpreters (including British Sign Language interpreters), a hearing loop, and documents in accessible formats. The practice listened to patients and signposted them to the right services where necessary. The practice complied with the Accessible Information Standard, but we did not see that staff had undertaken any training in relation to this. The surgery website was available to as wide an audience as possible and had accessible online tools such as translation, altering text size and a dyslexia friendly format.

The practice had identified ways for people to share feedback and raise complaints about their care, treatment and support. The practice told us it also conducted its own patient feedback questionnaire and analysis, which looked at feedback in response to surveys sent to patients by text message and after appointments. The practice also reviewed the results of the Friends and Family feedback it received. The practice received 31 responses to the survey sent by text message, a response rate of 12% and a further 24 responses to the survey given to patients after appointments. The surveys collected some positive and negative feedback regarding patient satisfaction with reception staff, communication, call wait times, ease of getting through on the telephone and care received. The Friends and Family feedback and feedback gathered by the practice in its own surveys were predominantly positive.

Patient feedback we received from the GP patient survey indicated 59% of patients who responded felt the healthcare professional they saw or spoke to was good at listening to them during their last GP appointment. This was lower than the local average GP score of 84% and lower that the national average score of 87%. 73% of patients who responded were involved as much as they wanted to be in decisions about their care and treatment during their last GP appointment. This was lower than the local average GP score of 90% and lower than the national average score of 91%. A total of 123 surveys were completed by patients which was a completion rate of 21%.

The practice told us it was in the process of reintroducing a patient participation group (PPG) as the previous group had not been representative of the local population. The practice held a meeting in the previous year remotely and gave a presentation to patients who attended about the aims and objectives of a PPG. The practice had experienced difficulties in recruiting members of the PPG since this meeting and were exploring the idea of using patient champions as an alternative to the PPG.

The practice promoted a learning culture and lessons learned from complaints and significant events were discussed at practice meetings. Complaints were managed in line with practice policy. Information was available to patients about how to make a complaint at the surgery, with posters and leaflets on display, and on the practice’s website. We saw evidence the practice had completed an annual review of complaints received in 2023. The total number of complaints received was 29, with 20 upheld and 5 partially upheld. The key themes identified in this review were: slow response time on online appointment system; lack of communication via online system; difficulty in contacting the practice; long waiting times on the telephone; lengthy wait for appointments; lost documentation; and dissatisfaction with the reception and administrative team. The review details actions that had been taken as a result of complaints received, including keeping the online system open during practice hours, additional training for staff, and sending patients a text message with a link to book their own appointments.

Patient feedback we received from the GP patient survey indicated 26% of patients found it easy to get through to the practice by phone. This was lower than the local average GP score of 52% and lower than the national average score of 50%. 29% of patients who responded found it easy to contact the practice using their website. This was lower than the local average GP score of 46% and lower than the national average score of 48%. 32% of patients who responded found it easy to contact the practice using the NHS App. This was lower than the local average GP score of 42% and lower than the national average score of 45%. 34% of patients who responded described their experience of contacting their GP practice as good. This was lower than the local average GP average and national average scores of 67%. 33% of patients who responded were offered a choice of time or day when they last tried to make a GP appointment. This was lower than both the local average and national GP average scores of 54% and 53% respectively. 40% of patients who responded described their overall experience of the practice as good. This was lower than the local average GP score of 72% and lower than the national average score of 74%.

The practice provided us with details of the number of GP appointments available for patients in the two months before our assessment. We noted that on 6 Fridays during this period, a total of 16 appointments were available and on 1 Friday, 13 appointments were available. We further noted that on 5 Tuesdays during this period, a total of 24 appointments were available. We asked the practice why available appointments were lower on these days and it was explained that the demand was less on Fridays due to large Jewish and Muslim populations at the practice and a lesser need for appointments on this day. The practice told us that this data related to face to face appointments and not appointments delivered by other methods. The practice provided us with a population needs assessment within Barnet PCNs which identified the impact of religion on service delivery, specifically that the analysis had been used to improve services by reducing the amount of extended access capacity delivered during the Jewish Sabbath and increasing capacity elsewhere and coordinating flu and covid vaccination clinics to take place outside of religious celebrations that might mean that patients are unable to access non-urgent care.

The practice told us that it operated a total triage model, in line with NHS England guidance on modern general practice access, which promoted triage as a means of ensuring patients were seen by the right person, in the right way, at the right time. The practice’s appointment system included a blend of face to face, telephone and online consultations. The mixed method approach was designed to maximise access, improve efficiency and ensure patient safety by enabling clinicians to prioritise care based on clinical need and support continuity of care. The practice told us that a duty doctor would triage all incoming requests throughout the day. If a patient required a face to face consultation and no pre-booked slots were available, the duty doctor was able to offer additional face to face appointments as required. The practice told us that this ensured that urgent or complex cases were seen promptly and appropriately, even during periods of high demand.

The practice told us of its challenges with recruitment and it had recruited 3 salaried GPs which would increase capacity. The practice told us it had GP partners available on a daily basis for staff to be contacted, either on site or remotely. Staff we spoke with told us there were enough appointments to meet the needs of the local population.

The complaints log kept by the practice detailed that in 2024, out of 26 complaints received, 8 were upheld and 4 were partially upheld. Complaints upheld included concerns raised regarding appointment booking, delay in prescription, telephone wait times, and communication issues. The practice told us it had not yet undertaken an analysis of the current GP patient survey but it had addressed the previous survey and had devised an action plan. To improve access to the surgery, the practice had recently changed its telephone system and reported patients feedback had improved.

Overall, feedback that we received from patients in the past 12 months indicated that people found staff caring and helpful. Staff members had received training in equality and diversity and provided people with the right information and support to meet their needs. The practice was working to address its issues with access, with the use of a new telephone system and by recruiting more GP staff. The practice offered longer appointments for patients with complex needs and older people and supported a local nursing home.

The practice worked collaboratively with other healthcare providers to support patients with end-of-life care. As part of our assessment, we reviewed 5 patient records where there was a DNACPR decision in place. We saw the decisions had been recorded in line with national guidance and according to the Mental Capacity Act. Care plans were updated according to the changing needs of the patients. The wishes of the patients were respected. Advanced care planning discussions were held about long term care with patients and their relatives where appropriate. The practice provided patients with a copy of the DNACPR form and added it to its clinical records system, which was accessible by other services, for example, the ambulance service and palliative care team.