Dr Vishwambhar Sinha

This practice is rated as Good overall. (Previous rating January 2018 – Good overall with Requires Improvement for well led)

The key questions at this inspection are rated as:

Are services safe? – Not inspected

Are services effective? – Not inspected

Are services caring? – Not inspected

Are services responsive? – Not inspected

Are services well-led? - Good

We carried out an announced comprehensive inspection at Dr Vishwambhar Sinha (also known as Crane Park Surgery) on 9 January 2018. During that inspection we found a breach of regulation in respect of Regulation 17 (Good Governance) of the Health and Social Care Act 2014. Following that inspection the practice submitted an action plan, outlining how they intended to address the issues identified. We returned to the practice on 9 August 2018 to carry-out an announced focused inspection, looking at the Well Led key question, in order to check that the practice’s action plan had been implemented and that the issues identified at the previous inspection had been addressed.

At this inspection we found:

• Following the previous inspection in January 2018 the practice had begun to keep minutes of staff meetings, which were made available to all staff. However, the practice’s arrangements in respect of recording discussions about patient care in weekly meetings between the principal GP and long-term locum GPs had not changed. Notes of these discussions were still not comprehensive and were not made available to all participants of the meeting; details of these discussions were not routinely saved in the relevant patient’s records.
• The practice was able to demonstrate that they used available information to assess their performance against other practice’s locally, and clinical audits were completed as required by the CCG medicines team; however, there remained no culture of two-cycle clinical audit as a tool for quality improvement at the practice.
• The practice had up to date policies in place, which were available to all staff.
• Comprehensive records were maintained of activities such as the cleaning of clinical equipment, the monitoring of stocks of equipment and medicines, and the receipt and allocation of prescription stationery.
• The practice had identified 34 patients who had caring responsibilities (compared to 33 patients identified at the time of the previous inspection), this represented approximately 1% of the patients registered at the practice.
• The practice had stocks of all recommended emergency medicines, and there were processes in place to ensure that adequate stocks were maintained and all medicines were in date.
• During the previous inspection we reviewed examples of complaint responses from the practice and noted that these did not contain contact information for the Parliamentary and Health Service Ombudsman (PHSO). At the time of the re-inspection the practice had not received any further complaints; however, following a discussion during the follow-up inspection about the availability of information for patients on how to make a complaint, we saw evidence that the practice had produced a complaints leaflet, which contained contact details for PHSO.

The areas where the provider should make improvements are:

• Introduce a process for recording and sharing with all participants, details of informal discussions about patient care, and where appropriate, record these discussions directly into patient’s medical records.
• Introduce a formal programme of clinical quality improvement activity.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.