Archived: Dr NJ Bhatt

Updated 3 March 2016

Dr NJ Bhatt is registered with the Care Quality Commission to provide primary care services.

The practice provides services to approximately 2,248 patients from one location at the Health Centre, Victoria Road, Washington, NE37 2PU. This is the location we visited on the day of our inspection.

The practice is based in a purpose-built surgery shared with four other GP practices and other local healthcare providers. The building is owned and managed by NHS Property Services Limited and has level-entry access and a car park for patients to use. All the services provided to patients by Dr NJ Bhatt were on the ground floor.

The practice has seven permanent members of staff, comprising the single-handed GP (male) a salaried GP (female), one practice nurse (female), a practice manager and three reception/administrative staff. The practice also has an apprentice and a regular locum GP (male).

The practice is part of Sunderland clinical commissioning group (CCG). Information taken from Public Health England placed the area in which the practice was located in the fourth most deprived decile. In general, people living in more deprived areas tend to have greater need for health services.

The surgery is open from 8am until 6pm from Monday to Friday, with extended opening hours from 6.30pm to 7.30pm on Mondays. The telephone lines operate at all times during these opening times. Outside of these times, a message on the surgery phone line directs patients to out of hours care, NHS 111 or 999 emergency services as appropriate. Appointments with a GP are available as follows:

• Monday: 8.30am to 12pm, 1pm to 3pm, 4.30pm to 6pm and 6.30pm to 7.30pm
• Tuesday: 8.30am to 12pm, 1pm to 2.50pm and 4pm to 6pm
• Wednesday: 8.30am to 12pm and 4.30pm to 6pm
• Thursday: 10.30am to 12pm and 4.30pm to 6pm
• Friday: 10.30am to 12pm, 12.30pm to 2.30pm and 4.30pm to 6pm
• Weekends: closed

The practice provides services to patients of all ages based on a Personal Medical Services (PMS) contract agreement for general practice. The practice population includes a much higher-than-average number of 15-19 year old males. The number of men and women aged between 40 and 59 who are registered with the practice is also higher than the national average, while the number of patients over the age of 70 is lower. The service for patients requiring urgent medical attention out of hours is provided by the NHS 111 service and Northern Doctors Urgent Care Limited.

Updated 3 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr NJ Bhatt on 12 January 2016. Overall the practice is rated as good.

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

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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 the skills, knowledge and experience to deliver effective care and treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that 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 improvement are:

• Appropriate background checks should be carried out when employing new staff, including obtaining photographic identification, and copies of these should be kept in personnel files.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 3 March 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 indicators for patients with diabetes were generally higher than the national average. For example, 92.2% of patients on the diabetes register had a foot examination and risk classification within the preceding 12 months (01/04/2014 to 31/03/2015) compared to the national average of 88.3%.
• 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 3 March 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 good and higher than CCG and national averages for all standard childhood immunisations.
• The practice had contributed to a locality-wide innovation project on the development and subsequent promotion of a booklet and accompanying smartphone app for managing minor childhood illnesses. The project had won a national “GP Recognition” award.
• 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.
• 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 3 March 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.

Updated 3 March 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.
• 85.8% of women aged 25-64 had had a cervical screening test in the past five years, compared to the national average of 81.8%.

Updated 3 March 2016

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

• Results for outcomes for patients experiencing poor mental health were generally good, however only 70% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, compared to the national average of 84%.
• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record in the preceding 12 months (01/04/2014 to 31/03/2015), compared to the national average of 88.5%.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those 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 3 March 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 those with a learning disability.
• At the time of our visit staff were due to undertake training for the practice to become part of a “Safe Haven” project. This project aimed to turn public areas, such as swimming pools, libraries and GP practices, into places where people suffering any form of abuse could come to report it and receive help.
• The practice offered longer appointments for patients who needed them.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• 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.