Archived: Dr Raju Raithatha Also known as Holly Park Clinic

Updated 23 November 2016

Dr Raju Raithatha provides GP primary care services to approximately 3,700 people living in Friern Barnet, London Borough of Barnet. The practice, also known as Holly Park Clinic, has a General Medical Services (GMS) contract for providing general practice services to the local population. A General Medical Services (GMS) contract is the contract between general practices and NHS England for delivering primary care services to local communities.

The practice team is made up of two (male) GPs, both of whom work part time, and a locum practice nurse who also works part time. Dr Raju Raithatha is the lead GP and the practice is registered with CQC as a sole provider. The practice provides ten GP sessions and two nurse sessions each week.

There is also a practice manager, two administrative and five reception staff. The practice is registered with the Care Quality Commission to provide the regulated activities of maternity and midwifery services, surgical procedures, treatment of disease, disorder or injury, diagnostic and screening procedures and family planning.

The practice opening hours are 8:30am to 1:00pm and 2:00pm to 6.30pm on Mondays, Thursdays and Fridays, 8:30am to 1:00pm and 2:00pm to 7:30pm on Tuesdays and 8:30am to 1.00pm on Wednesdays. The practice had arrangements in place to answer telephones between 8:00am and 8:30pm daily and between 1:00pm and 6:30 on Wednesdays. The practice is closed on Saturdays and Sundays.

The out of hours services are provided by an alternative provider. The details of the out-of-hours service are communicated in a recorded message accessed by calling the practice when it is closed and on the practice website.

Patients can book appointments in person, on-line or by telephone. Patients can access a range of appointments with the GPs and the nurse. Face to face appointments are available on the day and are also bookable up to four weeks in advance. Telephone consultations are offered where advice and prescriptions, if appropriate, can be issued. Home visits are offered to patients whose condition means they cannot visit the practice.

The practice provides a wide range of services including clinics for diabetes, weight control, asthma, contraception and child health care and also provides a travel vaccination clinic. The practice also provides health promotion services including a flu vaccination programme and cervical screening.

Information published by Public Health England rates the level of deprivation within the practice population group as six on a scale of one to ten. Level one represents the very highest levels of deprivation and level ten the lowest.

The practice is located in a purpose built, single storey building

The practice was inspected in May 2014 using our previous inspection methodology and was found to be meeting the required standards in place at the time.

.

Updated 23 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Raju Raithatha on 11 October 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice organised regular ‘afternoon tea parties’ with guest speakers and presentations about health conditions or other issues relevant to the practice population. The practice invited patients at risk of social isolation and patients with specific conditions to these events and themes had included diabetes, diet and information for carers. The most recent event had been attended by over thirty patients.
• The practice had a process to review patient satisfaction and took steps when survey results indicated that improvements were required. The practice undertook follow-up surveys to assess the impact of any actions taken.
• 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.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• The practice should consider updating the process followed when a prescription is not collected to include making contact with the patient to be assured of their welfare.
• The practice should review arrangements in place to ensure a patient has access to a female GP if this is requested.
• The practice should continue to review results from the National GP Survey and take steps to improve patient satisfaction.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 23 November 2016

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

• GPs had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was similar to the national average. For instance, 76% of patients diagnosed with diabetes had well controlled blood sugar levels compared to the CCG average which was also 76% and the national average of 78%. The exception reporting rate for this indicator was 4% (CCG average 8%, national average 12%).
• 81% of patients with hypertension had well controlled blood pressure. (CCG average 82%, national average 84%). The exception reporting rate for this indicator was 2% (CCG average 3%, national average 4%).
• 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 23 November 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 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 84%, which was above the CCG average of 79% and similar to 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 and health visitors.

Updated 23 November 2016

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

• 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.
• The practice had agreed a scheme with the local library which involved GPs issuing prescriptions for books to patients diagnosed with dementia. This means that these patients and their families could go to the local library and borrow books which were important to the patient. The library had stocked a range of books with information about dementia and the practice told us these were popular with patients.

Updated 23 November 2016

The practice is rated as good 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.
• 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.
• The practice provided telephone consultations during every GP session and had an extended hours clinic every Tuesday evening until 7:30pm.

Updated 23 November 2016

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

• 96% of patients diagnosed with dementia (68 patients) had their care reviewed in a face to face meeting in the last 12 months, which was above the national average of 84%. The practice exception reporting rate for this indicator was 0%.
• 98% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record compared to the national average of 88%. The practice exception reporting rate for this indicator was 2% compared to the national average of 12%.
• 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 in place 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 23 November 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 including homeless people, travellers and 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.