Archived: Dr Mohamedtaki Walji

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

At our last assessment, we rated this key question as good. At this assessment, the rating remains the same.
We assessed all the quality statements in this key question and found that staff involved people in decisions about their care and treatment and there were effective methods to ensure people’s need were fully assessed and recorded. Staff made reasonable adjustments where possible and supported people to access personalised care within the limitations of the care environment. Staff maintained up-to-date knowledge and mostly provided evidence-based care that aligned with national guidance. The provider had improved the uptake of childhood immunisations and cervical screening since the last inspection however, further action was required to meet national targets.
 

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Feedback from people using the provider was positive, people felt confident that staff understood their individual and cultural needs. All staff were aware of the needs of the local community and accommodated these wherever possible. Reception staff used digital flags within the care records system to highlight any specific individual needs, such as the requirement for longer appointments or for a translator to be present. Staff checked people’s health, care, and wellbeing needs during health reviews. The provider had effective systems to identify people with previously undiagnosed conditions. Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber.

The service did not always plan and deliver people’s care and treatment in line with legislation and current evidence based good practice and standards. Systems were in place to ensure staff were up to date with evidence-based guidance and legislation. Clinical records we saw demonstrated that mostly care was provided in line with current guidance.
The provider had targeted patients with diabetes as a group which needed more support to manage their condition effectively. They had introduced diabetes management clinics and all patients had been invited to attend a review with the nurse. A virtual follow up was conducted by the GP if any abnormal blood test results were received and the administrative team monitored attendance and outcomes via a spreadsheet.
However, we found some evidence-based guidelines had not been followed regarding the prescribing of medicines which could damage the lining of the stomach and gut. Additional medicines designed to protect the stomach and gut had not been routinely prescribed to a vulnerable group of older patients. Appropriate monitoring of these patients had not been undertaken to ensure they continued to take this additional medicine and that they understood why it was important for them to do so.
We found other areas where evidence-based best practice or legislation had not been followed regarding the availability of emergency equipment and medicines, infection prevention and control and premises safety.
 

The provider worked well across teams and providers to support people. Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. The practice worked with other providers to ensure continuity of care, including where clinical tasks were delegated to other providers.
There was regular engagement with members of the community multidisciplinary team such as health visitors during safeguarding meetings. The practice had a close working relationship with the community palliative care team and involved them in their end-of-life care reviews.
Communication between out-of-hours care providers and 111 was effective, with both being able to access patient records and the practice diary system.
 

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. People were supported to live healthier lives and where possible, reduce their future needs for care and support.
Staff focussed on identifying risks to patients’ health, including those in the last 12 months of their lives, patients at risk of developing a long-term condition and those with caring responsibilities. The practice had completed 110 NHS over-40’s health checks in the previous 12 months and as a result had identified patients not previously diagnosed with pre-diabetes. Staff supported national priorities and initiatives to improve population health, including stopping smoking and tackling obesity.
 

The provider did not always monitor people’s care and treatment to continuously improve it. They mostly ensured that outcomes were positive and consistent and that they met both clinical expectations and the expectations of people themselves.
Feedback from the National GP Patient Survey showed that patient satisfaction with the outcome of their last GP appointment was above the national average.
GP trainees carried out a range of audits and eight had been completed in the last 12 months. These audits had resulted in changes to systems and processes which had meaningfully improved the care of patients with a range of conditions. However, the practice did not carry out prescribing audits for all staff which would provide important information to support monitoring and improving patient outcomes.
From the clinical notes we reviewed, we found that most people who used the provider experienced positive outcomes. However, the practice had not met national targets for screening and some childhood immunisations. For example, 3 of the 5 cohorts of childhood immunisation were below 80% uptake compared with a national target of 95%. The practice was significantly below the national target of 80% for people aged 25 to 49 years old who required cervical screening, 56% of eligible people had been screened. This is the most recent nationally verified data taken from a snapshot on 30/6/24. Unverified data supplied by the practice showed substantial improvements had been made in the uptake of both since 2024 and the practice had an action plan to improve further. This included providing regular clinics to accommodate patients who needed to attend before or after work, quarterly walk-in clinics including during the school holidays and advertising clinics well in advance. Where patients required further information or support before deciding whether to have either cervical screening or have their child vaccinated, they could book an appointment with a GP. The practice could also book appointments at the “Children’s Zone” clinics within the health centre provided by another local practice which allowed parents to access paediatricians. The practice was working with the integrated care board as part of an initiative to improve education around vaccine-hesitancy. Robust procedures were in place to follow up patients who did not respond to invitations for screening, did not attend or where a child was not brought to an appointment.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.
Staff understood and applied legislation relating to consent. Capacity and consent were clearly recorded. Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation.