Archived: Dr Anna Ungaro

Updated 16 April 2015

Dr Anna Ungaro provides a range of personal medical services for people of Bedford in Bedfordshire and serves a registered population of approximately 3000 patients. The practice population is a mix of white British and patients from ethnic minority groups mostly of Italian, Bengali and eastern European backgrounds.

Clinical staff at this practice include a sole GP Partner, one salaried GP, a locum GP, two practice nurses, and one healthcare assistant. Management, administration and reception staff support the practice. Community nurses, health visitors and a midwife from the local NHS trust also provide a service to this practice. A mix of male and female clinical staff is available.

Out of hours care when the surgery is closed was through BEDOC (a GP co-operative service). Patients were diverted to this service by telephoning the normal surgery contact number.

Updated 16 April 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Anna Ungaro’s practice. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing well-led, safe, effective, caring and responsive services. It was also good for providing services for the six population groups.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.
• Most 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.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should:

• Introduce a system so blank prescription forms are tracked through the practice and kept securely

• Assess the risk of liquid spillage to the carpeted area around the hand washing sink in GP consultation rooms and take appropriate action

• Take action to ensure the water temperature of the hot tap in GP consultation rooms is such that hand washing under running water can be done without the risk of a scald
• Identify areas where liquid nitrogen and oxygen are stored and mark them with 'hazardous substance' notices
• Review the above the CCG average referral rates to hospital and other community care services
• Identify repeat audit dates so at least two cycles of a clinical audit can be demonstrated
• Consider options in the reception area so a patient whose circumstances may make them vulnerable can discuss their needs in private with the receptionist or other appropriate clinicians
• Consider options so patients in wheelchairs could communicate with the receptionist without being overheard

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 16 April 2015

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. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 16 April 2015

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. Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 16 April 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 16 April 2015

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 16 April 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). People experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It 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. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health.

Updated 16 April 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients with a learning disability. It had carried out annual health checks for people with a learning disability. It offered longer appointments for people with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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.