Archived: Sinha Medical Teaching Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Sinha Medical Teaching Practice on 27 May 2015. Overall the practice is rated as inadequate.

Specifically, we found the practice to be inadequate for providing well-led, effective, caring, safe and responsive services. It was also inadequate for providing services for the care provided to older people, people with long term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

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

• Patients were at risk of harm because systems and processes were not in place to keep them safe. For example there was a lack of staff safeguarding training, infection prevention and control was not being managed, there was no system to manage medicines within the practice, out of date emergency medicines, no emergency oxygen or defibrillator, no chaperone policy or procedures and no formal recruitment process.
• Staff were not clear about reporting incidents, near misses and concerns and there was no evidence of learning and communication with staff.
• There was insufficient assurance to demonstrate people received effective care and treatment as there was an absence of audit and performance data available.
• There was an absence of leadership and management oversight in the practice no clear formal governance arrangements.
• Patients said they were treated with compassion, dignity and respect and that they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available.
• The practice had good facilities and was well equipped to treat patients and meet their needs.

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

Importantly the provider must:

• Take action to address identified concerns with infection prevention and control practice. Including ensuring the practice is clean and an infection control audit is undertaken.
• Ensure recruitment arrangements include all necessary checks for all staff.
• Put systems in place to ensure all clinicians are kept up to date with national guidance and guidelines, including Gillick competency.
• Ensure staff have completed all mandatory training including basic life support, chaperoning and safeguarding.
• Ensure there are formal governance arrangements in place, including systems for assessing and monitoring risk.
• Ensure staff have appropriate policies and guidance to carry out their roles.
• Ensure all medicines are handled in accordance with current guidelines, and ensure all equipment for use in emergencies is available and maintained.
• Ensure that clinical systems are up to date and acted upon as per national guidelines. Including disease management registers, referrals and test results.

We found that the practice was in breach of regulation 12 (2)(a)(b)(h), regulation 17(b) and regulation 18 (2)(b) of the Health and Social Care Act (RA) Regulations 2014.

We believed that there was a serious risk to patients’ lives, health or wellbeing so we took immediate enforcement action. The registration of Dr Sinah to provide Diagnostic and Screening Procedures, family planning, maternity and midwifery services, surgical procedures and Treatment of Disease Disorder or Injury, at this location, was cancelled with immediate effect by an order of the Court on 29 May 2015.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice