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Dr Aamer Khan Good Also known as The Lister Surgery

Inspection Summary


Overall summary & rating

Good

Updated 28 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Aamer Khan, also known as The Lister Surgery, on 2 August 2016. Overall the practice is rated as good.

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

  • 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.
  • 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.

We saw one area of outstanding practice:

  • The practice had undertaken work to ensure cervical smear targets had been met. This included providing information sheets in a number of languages and offering appointments with the practice nurse prior to the procedure being carried out, to explain the procedure and the risks associated with not attending an appointment. As a result, cervical smear uptake was recorded at 93%.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 28 September 2016

The practice is rated as good for providing safe services.

  • There was an effective system in place for reporting and recording significant events. Learning was widely shared with the staff team and across the BD8 group of practices. Staff we spoke with were aware of the incident reporting process, and knowledgeable regarding incidents and outcomes. We saw that action was taken to improve safety in the practice.
  • When things went wrong patients received reasonable support, truthful information, and a written apology.
  • The practice had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse. We saw evidence of multidisciplinary discussions at team meetings, where vulnerable children, adults and families were discussed.
  • Risks to patients were assessed and well managed.
  • The BD8 collaboration enabled the practice to maintain appropriate staffing levels and adopt a flexible approach to meeting patients’ needs.

Effective

Good

Updated 28 September 2016

The practice is rated as good for providing effective services.

  • Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were at or above average compared to the national average in the majority of areas. There were clear arrangements in place to recall patients for reviews and follow up appointments.
  • We saw evidence that guidelines were followed and shared with the staff team.
  • Clinical audits demonstrated quality improvement.
  • Staff had the skills, knowledge and experience to deliver effective care and treatment.
  • Staff were encouraged to remain up to date with their training and attend additional learning and development events which would improve patient care.
  • There was evidence of appraisals and personal development plans for all staff.
  • Staff worked effectively and collaboratively with other health care professionals to understand and meet the range and complexity of patients’ needs.

Caring

Good

Updated 28 September 2016

The practice is rated as good for providing caring services.

  • Patients said they were treated with compassion, dignity and respect and they were involved in decisions about their care and treatment.
  • Information for patients about the services available was easy to understand and accessible.
  • We saw staff treated patients with kindness and respect, and maintained patient and information confidentiality.

Responsive

Good

Updated 28 September 2016

The practice is rated as good for providing responsive services.

  • Practice staff reviewed the needs of its local population and engaged with the NHS England Area Team and Clinical Commissioning Group to secure improvements to services where these were identified. The practice liaised closely with the CCG and took part in CCG initiatives such the Faecal Calprotectin Point of Care Testing. Calprotectin is a protein released by white blood cells involved in inflammation of the bowel. Testing assists with diagnosing disorders such as irritable bowel syndrome.
  • The practice held an extended hours clinic on a Tuesday until 8pm. Patients could also be seen at the two other collaborating practices until 7.30pm on a Monday and a Wednesday.
  • The practice had good facilities and was well equipped to treat patients and meet their needs. The practice website could be translated into 80 different languages, including those relevant to the patient group.
  • The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group. The practice held a healthy living event attended by multiple voluntary and care organisations following suggestions made by the PPG.
  • Learning from complaints was shared with other practices, staff and stakeholders.
  • We were told that young children would always be seen on the day regardless of whether appointments were available or not. Parents would be asked to bring their children to the surgery and they would be seen as soon as possible.

Well-led

Good

Updated 28 September 2016

The practice is rated as good for being well-led.

  • The practice had a clear vision and strategy to deliver patient focused high quality care. Staff were clear about the priorities of the practice and this was discussed and reviewed in meetings.
  • There was a clear leadership structure and staff felt supported to develop and improve their skills by the GP and practice manager. The practice had a number of policies and procedures to govern activity and held regular governance meetings.
  • There was an overarching governance framework which supported the delivery of the strategy and good quality care. This included arrangements to monitor and improve quality and identify risk.
  • The provider was aware of and complied with the requirements of the duty of candour. The lead GP encouraged a culture of openness and honesty. The practice had systems in place for notifiable safety incidents and ensured this information was shared with staff to ensure appropriate action was taken
  • The practice proactively sought feedback from staff and patients, which it acted on. The patient participation group was active and patients from the BD8 group held regular joint meetings which were attended by GPs.
  • There was a strong focus on continuous learning and improvement at all levels.
Checks on specific services

People with long term conditions

Good

Updated 28 September 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. Nursing staff were encouraged to develop competencies and skills to lead in the management of long term conditions.
  • The practice offered a level two diabetes clinic where patients could be commenced on insulin therapy without having to attend the hospital.
  • The practice offered flexible nurse appointments for complex patients.
  • Outcomes for diabetes related indicators were comparable to other practices. For example the percentage of patients on the register who had a flu immunisation in the preceding 12 months was 98% compared to the CCG average of 96% and the national average of 94%.
  • 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.

Families, children and young people

Good

Updated 28 September 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. Vulnerable children, young people and vulnerable family groups were discussed and reviewed in a multidisciplinary meeting every month.
  • Immunisation rates were higher than the CCG average 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 percentage of women who had undergone a cervical screening test was 93% which was higher than the CCG average of 76% and the national average of 82%.
  • We saw positive examples of joint working with midwives, health visitors and school nurses. The practice offered joint eight week baby checks where mothers and babies could be seen at the same time.
  • The practice participated in regular screening for Cardiovascular Disease, Diabetes and Hepatitis C.

Older people

Good

Updated 28 September 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 urgent appointments for those with enhanced needs.
  • All patients had access to a named GP.
  • The practice offered home visits for older people and this included GP appointments and phlebotomy. Flu vaccinations were offered to older patients in their own homes by the practice nurse.
  • Medication reviews were carried out every six months and these could be conducted at the patients home.

Working age people (including those recently retired and students)

Good

Updated 28 September 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.
  • Telephone consultations were available for patients who could not attend the surgery.
  • The practice offered an extended hours clinic until 8pm on a Tuesday. Patients could also access a GP at the two other BD8 group surgeries until 7.30pm on a Monday and Wednesday.

People experiencing poor mental health (including people with dementia)

Good

Updated 28 September 2016

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

  • 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.
  • 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a record of alcohol consumption in the preceding 12 months, which was better than the CCG average of 95% and national average of 86%.
  • 100% of women aged 25 or over (and who had not attained the age of 65) with schizophrenia, bipolar affective disorder and other psychoses had a record that a cervical screening test had been performed in the preceding 5 years (CCG average 91% and national average 89%).

People whose circumstances may make them vulnerable

Good

Updated 28 September 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 homeless people, travellers and those with a learning disability.
  • The practice offered longer appointments for patients with a learning disability.
  • The practice regularly worked with other health care professionals in the case management of vulnerable patients.
  • 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.