Archived: Dr Sidhu's Medical Practice

Updated 2 February 2017

Dr Sidhu’s Medical Practice is located on the ground floor of a purpose built medical centre. There are three other GP practices in the building as well as community services. There is a patient car park next to the building and very limited street parking. The practice is fully accessible for patients with mobility difficulties.

The practice is run by an individual male GP. There is also a salaried male GP. There are two practice nurses, a phlebotomist, a practice manager, and reception and administrative staff.

The practice and the telephone lines are open from Monday to Friday 8am – 6.30pm. Every Tuesday there is an extended hours surgery in the evening when the practice is open until 9pm.

GP appointments are available:

Monday 8am – 12.30pm and 3.30pm – 6pm

Tuesday 8am – 12.30pm, 2pm – 6pm and 6.30pm – 8.40pm

Wednesday 8am – 12.30pm and 2pm – 6pm

Thursday 8am – 12 noon and 2pm – 5pm

Friday 8am – 12 noon and 3pm – 6pm.

The practice is a member of NHS Oldham Clinical Commissioning Group (CCG). It has a General Medical Service (GMS) contract with NHS England. At the time of our inspection 4918 patients were registered.

The practice has identified 80% of its practice population are of Bangladeshi or Pakistani origin with many not speaking English as a first language. They also have a young practice population with a higher than average number of patients under the age of 39 and a lower than average number of patients aged over 40. Both GPs and two reception staff spoke languages understood by the majority of patients.

The practice is in a deprived area and life expectancy is lower than the national average. Life expectancy for males is 74 years (CCG average 76 years and national average 79 years). Life expectancy for females is 80 years (CCG average 81 years and national average 83 years).

The practice has opted out of providing out-of-hours services to their patients. This service is provided by a registered out of hours provider, Go to Doc.

Updated 2 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Sidhu’s Medical Practice on 20 October 2016. Overall the practice is rated as inadequate.

The practice had been previously inspected on 13 January 2016. Following this inspection the practice was rated inadequate with the following domain ratings:

Safe – Inadequate

Effective – Inadequate

Caring – Inadequate

Responsive – Inadequate

Well-led – Inadequate

The practice was placed in special measures.

Warning notices were issued on 24 March 2016 in relation to regulation 12 (Safe care and treatment) and regulation 17 (Good governance). An inspection was carried out on 17 June 2016 to check the warning notices had been complied with. It was found that the necessary improvements had taken place.

Our key findings across all the areas we inspected on 20 October 2016 were as follows:

• Data showed patient outcomes were usually low compared to the national average.
• Some patients reported that it was difficult to access appointments, and that it was difficult to get through to the practice by telephone.
• Not all clinicians understood issues relating to consent.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Reviews and investigations were thorough.
• Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks
• Audits had been carried out and there was evidence that audits were driving improvements to patient outcomes.
• 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 areas where the provider must make improvements are:

• The provider must ensure appropriate action is taken when alerts are received from the Medicines and Healthcare Products Regulatory Agency (MHRA).

• The provider must ensure patients are appropriately diagnosed and read coded so that clinical prevalence rates are accurate and appropriate care and treatment can be offered.

• The provider must ensure all clinical staff have the required understanding of the Mental Capacity Act 2005 so consent is correctly sought.

• The provider must ensure all relevant information is obtained for staff prior to them being employed.

This service was placed in special measures following the inspection in January 2016. Insufficient improvements have been made and there remains a rating of inadequate for the safe, effective and well-led domains. Due to the improvements that have been made since the initial rating of inadequate we have not yet started the process of preventing the provider from operating the service. Other enforcement action will be taken. They will remain in special measures. Another inspection will be conducted within six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 2 February 2017

The practice is rated as inadequate for the care of people with long-term conditions. The provider was rated as inadequate in the safe, effective and well-led domains and requires improvement for caring and responsive. The issues identified as inadequate and requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

• Clinical prevalence rates were below the CCG and national average in most areas, including chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD). The GP was unsure how to diagnose COPD and asthma for some patient groups.

• Performance for some long term conditions, such as COPD and heart failure, were below the CCG and national average.

• QOF performance for diabetes related indicators was 89%, higher than the CCG average of 87% and below the national average of 90%.

• Longer appointments and home visits were available when needed.  

Updated 2 February 2017

The practice is rated as inadequate for the care of families, children and young people. The provider was rated as inadequate in the safe, effective and well-led domains and requires improvement for caring and responsive. The issues identified as inadequate and requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

• The practice’s uptake for the cervical screening programme was 72%, which was below the CCG and national average of 82%.

• Childhood immunisation rates for the vaccinations given were above CCG and national averages. For example, for 2015-16 childhood immunisation rates for the vaccinations given to under two year olds were at 100%, and five year olds ranged from 93% to 99%.

• Staff had been trained in and had a good understanding of child safeguarding.

• Staff 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.

Updated 2 February 2017

The practice is rated as inadequate for the care of older people. The provider was rated as inadequate in the safe, effective and well-led domains and requires improvement for caring and responsive. The issues identified as inadequate and requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

• Care and treatment of older people did not always reflect current evidence-based practice, and some older people did not have care plans where necessary.

• Nationally reported data showed that outcomes for patients for conditions commonly found in older people were mixed. For example, the most recent Quality and Outcome Framework (QOF) results for indicators relating to stroke and transient ischaemic attack were 87%, less than the CCG average of 98% and the national average of 97%.

• Clinical prevalence rates were below the CCG and national average in most areas, including stroke and transient ischaemic attack and palliative care.

• Care plans were in place for patients in nursing and residential homes, and these were reviewed regularly.

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

Updated 2 February 2017

The practice is rated as inadequate for the care of working-age people (including those recently retired and students). The provider was rated as inadequate in the safe, effective and well-led domains and requires improvement for caring and responsive. The issues identified as inadequate and requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

• The needs of the working age population, those recently retired and students had been identified and the practice was open until 9pm one night each week.

• The practice offered online services as well as NHS health checks for the 40 to 75 age group.

Updated 2 February 2017

The practice is rated as inadequate for the care of people experiencing poor mental health (including people with dementia). The provider was rated as inadequate in the safe, effective and well-led domains and requires improvement for caring and responsive. The issues identified as inadequate and requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

• Performance for mental health related indicators was below the CCG and national average. The most recent QOF results for mental health related indicators were 83% compared to the CCG average of 91% and the national average of 93%.

• Performance for dementia related indicators was below the CCG and national average. The most recent QOF results for dementia related indicators were 88% compared to the CCG average of 96% and the national average of 97%.

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

Updated 2 February 2017

The practice is rated as inadequate for the care of people whose circumstances may make them vulnerable. The provider was rated as inadequate in the safe, effective and well-led domains and requires improvement for caring and responsive. The issues identified as inadequate and requiring improvement overall affected all patients including this population group. There were, however, examples of good practice.

• Not all clinicians were aware of their requirements under the Mental Capacity Act 205 so consent was not always correctly sought.

• GPs and reception staff could speak languages such as Urdu and Bangladeshi. 80% of patients were from a Bangladeshi or Pakistani background and this helped with translation difficulties.

• 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.