Archived: Dr Gopal Sinha

Updated 28 July 2017

Dr Gopal Sinha (also known as Grove Park Surgery) is a GP practice based in Maidstone, Kent with a catchment area of approximately 2,170 patients.

The practice is similar across the board to the national averages for each population group. For example, 18% of patients are aged 0 -14 years of age compared to the CCG national average of 17%. Scores were similar for patients aged under 18 years of age and those aged 65, 75 and 85 years and over. The practice is in the fourth centile of the most deprived areas of Kent and has a majority white British population.

The practice holds a General Medical Service contract and consists of a principle GP (male). The GP is supported by a locum GP (female) who works alternate Tuesdays, a practice manager, a practice nurse (female) and an administrative team. A wide range of services and clinics are offered by the practice including asthma and diabetes.

The practice is arranged over two storeys, with all the patient accessible areas being located on the ground floor. The practice is accessible to patients with mobility issues, as well as parents with children and babies.

The practice is open between 8am to 12.30pm and 2pm to 6pm Monday to Friday. There is a duty doctor system for patients to access the practice between 13.30pm to 2pm and 6pm to 6.30pm. Extended hours appointments were offered from 6.30pm to 7.30pm on Wednesdays. In addition, appointments that could be booked up to six weeks in advance, urgent appointments were also available for people that needed them. There are arrangements with other providers (Integrated Care 24) to deliver services to patients outside of the practice’s working hours.

Services are provided from:

• Dr Gopal Sinha, Grove Park Surgery, Maidstone, Kent, ME15 9AP

Updated 28 July 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Gopal Sinha on 20 October 2016. The overall rating for the practice was requires improvement. The practice was rated as requires improvement for providing safe and well-led services and rated as good for providing effective, caring and responsive services. The full comprehensive report on the October 2016 inspection can be found by selecting the ‘all reports’ link for Dr Gopal Sinha on our website at www.cqc.org.uk.

This inspection was an announced focused inspection conducted on 18 July 2017 to confirm that the practice had carried out their plan to meet the legal requirements, in relation to the breaches in regulations that we identified in our previous inspection on 20 October 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• The standards of cleanliness had improved. All infection control risks had been identified and mitigated. Audits of infection control had been carried out by a lead with appropriate training.

• Systems and processes had been implemented to ensure that recruitment checks were carried out for all locum staff.

• Risk assessments had been carried out and risks appropriately mitigated for staff working alone within the practice.

• A system had been implemented to ensure that reviews of patients on high risk medicines were being undertaken routinely.

• The practice had established and implemented a system to routinely monitor and audit the use of blank prescription pads.

The practice had also taken appropriate action to address areas where they should make improvements:

• Diabetes performance indicators had improved by 30% on last year’s Quality and Outcomes Framework data.

• Action had been taken to address low satisfaction scores relating to GP consultations and access to the practice. The National Patient GP Survey results for 2016/17 showed an increase of between 5 – 10% increases on last year’s results.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 July 2017

The provider had resolved the concerns for safe and well-led identified at our inspection on 20 October 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for diabetes related indicators were above the local and national averages. For example, 89% of patients with diabetes, on the register, in whom the last IFCCHbA1c is 64 mmol/mol (a blood test to check blood sugar levels) or less in the preceding 12 months (local average 66% and national average 69%).

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met.

• For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 28 July 2017

The provider had resolved the concerns for safe and well-led identified at our inspection on 20 October 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• There were systems 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 were relatively high for all standard childhood immunisations.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The practice’s uptake for the cervical screening programme was 99%, which was above the CCG average of 84% and the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 28 July 2017

The provider had resolved the concerns for safe and well-led identified at our inspection on 20 October 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 28 July 2017

The provider had resolved the concerns for safe and well-led identified at our inspection on 20 October 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• 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.

• The practice offered online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 28 July 2017

The provider had resolved the concerns for safe and well-led identified at our inspection on 20 October 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• Performance for mental health related indicators were comparable or above the local and national averages. For example, 84% of patients diagnosed with dementia that had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the national average. The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 100%, which was higher than the national average.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 28 July 2017

The provider had resolved the concerns for safe and well-led identified at our inspection on 20 October 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how 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.