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Dr Anuj Handa Good Also known as Dr Handa

Inspection Summary


Overall summary & rating

Good

Updated 27 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Anuj Handa's practice on 3 February 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • Patients’ comments we received were extremely positive about the practice and identified how caring the staff were.
  • Patients said they found it easy to make an appointment, there was continuity of care and urgent appointments were available on the same day as requested.
  • Patients told us they were seen within 48 hours, irrespective of need.
  • Longer appointments were given to those patients who needed them.
  • Information regarding the services provided by the practice was readily available for patients.
  • The practice had good facilities and was well equipped to treat and meet the needs of patients.
  • There was a complaints policy and clear information available for patients who wished to make a complaint.
  • The practice sought patient views how improvements could be made to the service, through the use of patient surveys, the NHS Friends and Family Test and the patient participation group.
  • The needs of patients were assessed and care was planned and delivered following best practice guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • Risks to patients were assessed and well managed. There were good governance arrangements and appropriate policies in place.
  • The practice was aware of and complied with the requirements of the duty of candour. (The duty of candour is a set of specific legal requirements that providers of services must follow when things go wrong with the care and treatment of patients.)
  • There was a culture of openness and honesty, which was reflected in the approach to safety. All staff were encouraged and supported to record any incidents using the electronic reporting system. There was evidence of good investigation, learning and sharing mechanisms in place.
  • There was a clear leadership structure, staff were aware of their roles and responsibilities and told us the GPs were accessible and supportive

However, we saw an area where the provider should make improvements:

  • Ensure the cleaning and refurbishment up of the old ‘minor surgery’ room is carried out before usage (this was an unused room in the practice).

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 27 May 2016

The practice is rated as good for providing safe services.

  • There was an effective system in place for reporting and recording significant events.
  • Lessons were shared to ensure action was taken to improve safety in the practice.
  • Risks to patients were assessed and well managed.
  • The practice had clearly defined and embedded systems, processes and practices in place to keep people safe and safeguarded from abuse.
  • There was a comprehensive chaperone policy and procedures in place to meet the cultural needs of patients.
  • There were effective processes in place for safe medicines management.
  • The practice had cleaning schedules in place, however, some high level areas such as ceilings, window blinds and notice boards were dusty and required cleaning. We have since seen evidence the practice have resolved this issue and have a comprehensive cleaning schedule in place.
  • We saw the old ‘minor surgery’ room required cleaning and tidying. We were informed this room was not used. We have since received written confirmation of this and also of the plans to have the room cleaned and refurbished prior to usage.

Effective

Good

Updated 27 May 2016

The practice is rated as good for providing effective services.

  • Data from the Quality and Outcomes Framework showed patient outcomes were comparable to both local and national figures.
  • Staff assessed needs and delivered care in line with current evidence based guidance.
  • Clinical audits demonstrated quality improvement.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • There was evidence of appraisals and personal development plans for all staff.
  • Staff worked with multidisciplinary teams to understand and meet the range and complexity of people’s needs. For example, the district nursing team and community matron.

Caring

Good

Updated 27 May 2016

The practice is rated as good for providing caring services.

  • National GP patient survey data showed that patients rated the practice as being comparable to others for several aspects of care.
  • The practice had a patient-centred culture and we observed that staff treated patients with kindness, dignity, respect and compassion.
  • Patients’ comments we received were extremely positive about the practice and identified how caring the staff were.
  • Information for patients about the services available was easy to understand and accessible.
  • We saw staff treated patients with kindness, respect and maintained confidentiality.
  • The practice had a carers’ champion in post to provide support for carers and signpost to other areas of support as needed.

Responsive

Good

Updated 27 May 2016

The practice is rated as good for providing responsive services.

  • It reviewed the needs of its local population and engaged with the NHS England Area Team and Greater Huddersfield Clinical Commissioning Group (CCG) to secure improvements to services where these were identified.
  • Patients said they found it easy to make an appointment and often saw the GP of their choice. Urgent appointments were available for the same day as requested.
  • Patients told us they were seen within 48 hours, irrespective of need.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was an accessible complaints system. Evidence showed the practice responded quickly to issues raised and learning was shared with staff. Learning from complaints was shared with staff and other stakeholders.

Well-led

Good

Updated 27 May 2016

The practice is rated as good for being well-led.

  • There was a clear leadership structure and a vision and strategy to deliver high quality care and promote good outcomes for patients.
  • There were governance arrangements which included monitoring and improving quality, identification of risk, policies and procedures to minimise risk and support delivery of quality care.
  • The provider was aware of and complied with the requirements of the duty of candour.
  • The partners encouraged a culture of openness and honesty.
  • There were systems in place for reporting notifiable safety incidents and the practice shared this information with staff to ensure appropriate action was taken
  • Staff were encouraged to raise concerns, provide feedback or suggest ideas regarding the delivery of services. The practice proactively sought feedback from patients through the use of patient surveys, the NHS Friends and Family Test and the patient participation group.
  • Staff informed us they felt very supported by the GPs and practice management.
  • The ethos of the practice was to provide good quality services and care for their patients.
Checks on specific services

People with long term conditions

Good

Updated 27 May 2016

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

  • All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. 
  • Patients who were identified most at risk of hospital admission were identified as a priority.

  • 100% of newly diagnosed diabetic patients had been referred to a structured education programme in the last 12 months, compared to 90% locally and nationally.
  • 93% of patients diagnosed with asthma had received a review in the last 12 months, compared to 78% locally and 75% nationally.
  • 96% of patients diagnosed with chronic obstructive pulmonary disease (COPD) had received a review in the last 12 months, compared to 92% locally and 90% nationally.
  • Longer appointments and home visits were available when needed.
  • Health trainers supported people with long term conditions; particularly regarding managing lifestyle, stress or anxiety related issues.
  • The practice had diabetic diet leaflets which identified Asian food groups, to support those patients in making the right dietary choices.

Families, children and young people

Good

Updated 27 May 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 accident and emergency (A&E) attendances.
  • Patients and staff told us 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. All children who required an urgent appointment were seen on the same day as requested.

  • The practice worked with midwives, health visitors and school nurses to support the needs of this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.
  • Immunisation uptake rates were high for all standard childhood immunisations, with an achievement of 100% for many vaccinations.
  • Sexual health, contraceptive and cervical screening services were provided at the practice.
  • 90% of eligible patients had received cervical screening, compared to 86% locally and 82% nationally.

Older people

Good

Updated 27 May 2016

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

  • The practice provided proactive, responsive and person-centred care to meet the needs of the older people in its population. Home visits and urgent appointments were available for those patients in need.
  • The practice worked closely with other health and social care professionals, such as the district nursing team, to ensure housebound patients received the care and support they needed.
  • Care plans were in place for those patients who were considered to have a high risk of an unplanned hospital admission.

  • Patients who were lonely or isolated were signposted to other services, such as the health trainers.

Working age people (including those recently retired and students)

Good

Updated 27 May 2016

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

  • The needs of these patients had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

  • Telephone consultations were available as needed.
  • 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.
  • Health checks were offered to patients aged between 40 and 74 who had not seen a GP in the last three years.
  • NHS vaccinations were available for students as part of the government immunisation programme.

People experiencing poor mental health (including people with dementia)

Good

Updated 27 May 2016

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

  • The practice regularly worked with multidisciplinary teams in the case management of people in this population group, for example the local mental health team. Patients and/or their carers were given information on 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.
  • The practice was working towards becoming dementia friendly. Staff had received training and had a good understanding of how to support patients with dementia or mental health needs.
  • Advance care planning was undertaken with patients who had dementia, 100% of whom had received a face to face review of their care in the last 12 months, which was higher than the local and national averages.
  • 96% of patients who had a complex mental health problem, such as schizophrenia, bipolar affective disorder and other psychoses had received an annual review in the past 12 months and had a comprehensive, agreed care plan documented in their record. This was higher than the local and national averages (local 90%, nationally 88%).
  • The practice identified patients who were carers and offered support and signposted to other services as needed.

People whose circumstances may make them vulnerable

Good

Updated 27 May 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 and regularly worked with multidisciplinary teams in the case management of this population group.
  • Staff 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.
  • The practice could evidence children who were on a child protection plan (this is a plan which identifies how health and social care professionals will help to keep a child safe).
  • Information on how to access various local support groups and voluntary organisations was available and patients were signposted to these services as needed.
  • Longer appointments were available for patients as needed.