Archived: Dr Dilip Shah Also known as Dr D Shah

Updated 27 July 2016

Dr Dilip Shah (located at Bousefield Surgery) is responsible for providing primary care services to approximately 2781 patients. The practice is a long established GP practice working in the centre of Liverpool in a very deprived area of the city. The practice has a General Medical Services (GMS) contract and offers a range of enhanced services such as flu and shingles vaccinations, unplanned admissions and timely diagnosis of dementia. The number of patients with a long standing health condition is comparable to other practices nationally. The practice has one female and one male GP partners, two practice nurses, administration and reception staff and a practice manager.

The practice is open from 8am to 6.30pm Monday to Friday. Extended hours are available until 7pm on a Monday evening. Patients can book appointments in person, via the telephone or online. The practice provides telephone consultations, pre-bookable consultations, urgent consultations and home visits. The practice treats patients of all ages and provides a range of primary medical services. Home visits and telephone consultations were available for patients who required them, including housebound patients and older patients. There are also arrangements to ensure patients receive urgent medical assistance out of hours when the practice is closed.

The practice is part of the Liverpool Clinical Commissioning group. The area in which the practice is based is the sixth most deprived in the city. Unemployment is significantly higher than the city rate and 7% of the population are long term sick or disabled. The average household income is significantly lower than both the Liverpool and national averages. People living in more deprived areas tend to have greater need for health services.

Updated 27 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Dilip Shah on 22 June 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.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their 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.

• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• 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 improvements are

• The provider should improve the care plans in place for patients with complex health needs, who are at high risk of avoidable unplanned hospital admissions.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 July 2016

The practice is rated as good 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. Performance for diabetes related indicators was higher than the national average. For example the percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months was 97% compared to 88% nationally. 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 27 July 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 safeguarding lead staff liaised with the health visiting service, school nurses and midwife to discuss any concerns about children and how they could be best supported. Family planning and sexual health services were provided.

The practice had achieved good results for the percentage of women aged 25-64 who had a cervical smear, 90% had this compared to the CCG average of 79%. The practice made referrals for young people and their families to external agencies to support them to make healthier life choices. Services such as ‘Healthy Families’ to which the practice referred into, worked with children, young people and their families to develop healthier behaviours across four core themes. These included healthy eating, nutrition and weight management, physical activity, confidence and building self-esteem. 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 27 July 2016

The practice is rated as good for the care of older people. The practice offered proactive, personalised care and treatment to meet the needs of the older people in its population. The practice kept up to date registers of patients with a range of health conditions (including conditions common in older people) and used this information to plan reviews of health care and to offer services such as vaccinations for flu. The practice provided a range of enhanced services, for example, the provision of care plans for patients over the age of 75 and screening patients for dementia. Nationally reported data showed that outcomes for patients for conditions commonly found in older people were similar to or better than local and national averages. GPs carried out regular visits to local care homes to assess and review patients’ needs and to prevent unplanned hospital admissions. Home visits and urgent appointments were provided for patients with enhanced needs. The practice used the ‘Gold Standard Framework’ (this is a systematic evidence based approach to improving the support and palliative care of patients nearing the end of their life) to ensure patients received appropriate care. The GPs had special interests in conditions commonly found in older people and there was a designated GP lead for the care of patients over 75 years of age.

Updated 27 July 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.

Updated 27 July 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia), 85% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the local and 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 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 27 July 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).The practice had achieved similar results to local and national averages in relation to the care of patients with poor mental health. For example 85% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the local and 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 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.