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Dr Velupillai Ravikumar Good Also known as Headstone Lane Medical Centre

Inspection Summary


Overall summary & rating

Good

Updated 9 August 2018

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive follow up inspection at Headstone Lane Medical Centre on 18 November 2016. The overall rating for the practice was good. However we rated the practice as requires improvement for providing a caring service and for the care provided to people with long term conditions.

More specifically, we found that the practice:

  • scored below the local and national average for patient experience of consultations and involvement in decisions on the national GP patient survey in 2016
  • was performing below the local and national average for its management of diabetes
  • had lower than average uptake rates for cancer screening services
  • had not fully embedded completed clinical audit cycles as a quality improvement tool.
  • was not always implementing non-clinical safety alerts
  • did not have systems to maintain full prescription security.

The full comprehensive report on the November 2016 inspection can be found by selecting the ‘all reports’ link for Dr Velupillai Ravikumar on our website at www.cqc.org.uk.

This inspection was a focused inspection carried out on 8 December 2017 to confirm that the practice had made improvements since our last inspection.

Overall the practice is rated as good. We have also rated the practice as good for providing a caring service and for the care provided to people with long term conditions.

Our key findings were as follows:

  • The practice results for the national GP patient survey had improved in 2017 and were comparable with the local and national averages. The practice had engaged with patients and taken action to improve the patient experience.
  • The practice had improved its performance in managing diabetes and its results were comparable with local average on the relevant Quality and Outcomes Framework indicators. For example, in 2016/17, 71% of diabetic patients recorded blood sugar levels that were adequately controlled (that is, their last IFCC-HbA1c measurement was 64 mmol/mol or less) compared to the local Clinical Commissioning Group and national average of 80%. The practice exception reporting rate for this indicator was 3% compared to the national exception reporting rate of 12%. (Exception reporting is the removal of patients from QOF calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of side effects). The practice had taken action to improve its care in this area, for example doubling the number of sessions offered by the local specialist diabetic nurse at the practice.
  • The practice had taken action to improve cervical screening uptake rates. The practice had identified that low uptake was more often associated with patients originating from Sri Lanka. The practice had assigned a member of the reception team to follow up women who did not respond to their invitation to attend for cervical screening. This member of staff could speak Tamil and was able to discuss the screening test in a culturally sensitive way. The practice had also engaged a locum nurse who was Tamil-speaking and displayed posters about the screening test in the waiting area in Tamil.
  • The practice carried out completed clinical audit cycles as part of its quality improvement work. The practice demonstrated that audit was used to ensure that effective practice was being sustained. For example the practice had completed two-cycle audits focusing on the prescribing of methotrexate and warfarin (higher risk medicines); its cryotherapy service and the identification and management of "two week wait" cancer referrals.
  • The practice provided evidence that it routinely circulated information about non-clinical safety alerts and acted on these when relevant.
  • The practice had improved prescription security, for example by keeping a record of serial numbers and routinely tracking the use of prescription materials.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 9 August 2018

Effective

Good

Updated 9 August 2018

Caring

Good

Updated 9 August 2018

Responsive

Good

Updated 9 August 2018

Well-led

Good

Updated 9 August 2018

Checks on specific services

People with long term conditions

Good

Updated 9 August 2018

Families, children and young people

Good

Updated 9 August 2018

Older people

Good

Updated 9 August 2018

Working age people (including those recently retired and students)

Good

Updated 9 August 2018

People experiencing poor mental health (including people with dementia)

Good

Updated 9 August 2018

People whose circumstances may make them vulnerable

Good

Updated 9 August 2018