Archived: Dr Sarman Bapodra

Updated 28 January 2016

Dr Sampora Bapodra – Belgrave Surgery is located close to Leicester City centre. It provides primary medical services to approximately 2,600 patients. At the time of our inspection the practice had one GP, two associate GP’s, one business manager, one assistant manager, one nurse, one health care assistant and two reception and administrative staff.

The practice has a General Medical Services contract (GMS). The GMS contract is the contract between general practices and NHS England for delivering primary care services to local authorities.

The practice benefits from access to a number of services such as health visitors, district nurses, a practice therapist and midwives.

The practice website provides patients with information about online services such as ordering repeat prescriptions, booking appointments and access to medical records. The website also provides patients with information on a range of clinics such as travel vaccinations, childhood immunisations, phlebotomy, health promotion (diabetes, coronary heart disease, asthma & respiratory conditions).

The practice is open from 8am until 6.30pm Monday to Friday and offers a walk-in service for appointments on a Monday, Tuesday and Wednesday from 10am until 11.30am. The practice does not offer extended hours appointments however they are part of a scheme within Leicester City which offers patients an evening and weekend appointment with either a GP or advanced nurse practitioner at one of four healthcare hub centres. Appointments are available between 6.30pm until 10pm Monday to Friday and between 9am until 10pm on weekends and bank holidays. Appointments are available by walk in, telephone booking or direct referral from NHS 111.

The practice opted out of providing out-of-hours services (OOH) to their own patients.  The OOH service is provided to Leicester City, Leicestershire and Rutland by Central Nottinghamshire Clinical Services.

Updated 28 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 20 January 2015. Overall the practice was rated as requires improvement. Breaches of legal requirements were found. After the comprehensive inspection, the practice wrote to us to say what they would do to meet the legal requirements in relation to the effectiveness and leadership of the practice.

We undertook this focussed inspection to check that they had followed their improvement plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Dr Sampora Bapodra – Belgrave Surgery on our website at www.cqc.org.uk.

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

• Risks to patients were assessed and well managed. Since our last inspection the practice had carried out various risk assessments including general health and safety, legionella and fire. Policies had been implemented for chaperone procedures, cold chain, infection control and medicines management.

• The practice had implemented a clear audit programme with full cycle audits to improve the quality of patient outcomes.

• The practice had implemented regular multi-disciplinary meetings to discuss the needs of complex patients, for example those with end of life care.

• 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.

• 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. Staff were invited to attend regular meetings such as practice, clinical, team and patient participation group (PPG) meetings.

• The provider was aware of and complied with the requirements of the Duty of Candour.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 April 2015

The practice is rated as requires improvement 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. Longer appointments and home visits were available when needed. However, not all these patients had a personalised care plan or structured annual review to check that their health and care needs were being met.

The practice had used the Human and Environmental (HERA) Tool to identify the patients ‘at risk’ of being admitted to hospital as a result of a chronic long term condition. 125 patients had been identified and 40.8% had personalised care plans which had been discussed with the patient. The patients received routine assessments by care navigators to monitor their long term condition. The care navigators supported patients to maintain their independence. Deterioration in health can be picked up earlier to avoid a hospital admission. Care navigators were employed by Leicestershire County Council and support patients who are identified at risk. They support the patient to maintain their independence and stay in their own home when it is appropriate and safe to do so.

The provider was rated as good for safe, caring and responsive overall and this includes for this population group. The provider was rated as requires improvement for effective and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group.

Updated 23 April 2015

The practice is rated as requires improvement 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 for the standard childhood immunisations were mixed. Appointments were available outside of school hours. We saw examples of joint working with the community midwives. The practice provided a room for parents who wished to breast feed.

The provider was rated as good for safe, caring and responsive overall and this includes for this population group. The provider was rated as requires improvement for effective and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group.

Updated 23 April 2015

The practice is rated as requires improvement for the care of older people. Care and treatment of older people did not always reflect current evidence-based practice, and 60% of older people did not have care plans where necessary.

All patients over 75 had a named GP. The practice has 229 patients registered over the age of 66.

They had a register of ‘Better Care’ patients who were patients who had accessed services such as A&E, Urgent care centre or walk in centre. Patients who were in the care of a consultant or seen more than four times by the GP in the last 12-18 months were also on the register. The practice offered an annual influenza vaccination programme. The shingles vaccine was offered to patients in line with national guidance for patients aged 70, 78 and 79. The practice also had a local agreement for patients aged 71 to have the vaccination.

The practice referred patients to the Clinical Response Team who visit patients over 75 who need a home visit, The team consisted of GP’s working with East Midlands Ambulance Service who assessed and treat patients to avoid them being admitted to hospital.

Longer appointments and home visits were available for older people when needed, and this was acknowledged positively in feedback from patients.

The provider was rated as good for safe, caring and responsive overall and this includes for this population group. The provider was rated as requires improvement for effective and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group.

Updated 23 April 2015

The practice is rated as requires improvement 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, for example, extended hours until 8pm and Saturday morning appointments to see the GP.

The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group, for example, NHS Health checks.

The provider was rated as good for safe, caring and responsive overall and this includes for this population group. The provider was rated as requires improvement for effective and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group.

Updated 23 April 2015

The practice is rated as requires improvement for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The practice refers patients to services which included Community Mental Health teams, Improving Access to Psychological Therapies (IAPT) and Leicester Open Mind.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations which included MIND. MIND is a mental health charity in England and Wales. Mind offers information and advice to people with mental health problems.

The provider was rated as good for safe, caring and responsive overall and this includes for this population group. The provider was rated as requires improvement for effective and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group.

Updated 23 April 2015

The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability. It had carried out annual health checks for people with a learning disability and 95% of these patients had received a follow-up. It offered longer appointments for people with a learning disability. Referrals from the practice to the care navigators could be made for patients who were vulnerable. Consent from the patient was obtained before the referral was made. Care navigators are employed by Leicestershire County Council and support patients who are identified at risk. They support the patient to maintain their independence and stay in their own home when it is appropriate and safe to do so.

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.

The provider was rated as good for safe, caring and responsive overall and this includes for this population group. The provider was rated as requires improvement for effective and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group.