Archived: Dr Sibani Basu Also known as St Thomas Medical Centre

Updated 25 June 2015

Dr S Basu practice serves approximately 1360 patients.

The opening hours of the practice are 8:30am until 7:00pm. The practice held nine patient clinical sessions per week. There were no early appointments available but patients could speak with a GP during the opening hours.

The practice has opted out of providing out-of-hours services to their own patients. This service is provided by a walk-in centre, by phoning 111 or attendance at the Accident and Emergency Department at the local hospital.

The practice staffing levels includes a senior GP (female) a salaried GP (male) who works for one full day each week. Locum GPs are also employed to cover during absences. There are two practice nurses who work part time. The practice manager was recently appointed and had been promoted from the position of lead receptionist. The practice was looking to recruit a receptionist to fill the practice manager’s previous post.

The practice has a higher than national average population of younger adults, whose children may also be registered with the practice.

Updated 25 June 2015

Letter from the Chief Inspector of General Practice

Dr S Basu has a practice population of approximately 1360 patients who live in Dudley, Tividale and Sandwell areas.

We carried out an announced comprehensive inspection at Dr Basu also known as St Thomas Medical Centre on 21 January 2015 to explore the standards of care and treatments patients received.

We have rated each section of our findings for each key area. The overall rating was requires improvement. This was because improvements were required for how safe, effective, responsive and well led the service was. The service was rated as good for caring for the population it served.

Our key findings were as follows:

• We found that patients were treated with respect and their privacy and dignity were maintained. Most patients informed us they were satisfied with the care they received. Patients we spoke with told us they were able to make informed decisions about their care and treatment.

• There were systems in place for ensuring patients received appropriate treatments but patients experienced difficulties in making appointments when they felt they needed to. The provider was failing to carry out comprehensive health checks of patients who had a learning disability.

• Comprehensive clinical audits were not being carried out that resulted in improvements in patient care.

• We found that the practice was visibly clean. Patients who we spoke with were satisfied with the standards of hygiene at the practice. However, there was no formal system in place for protecting patients from risks of unecessary infections.

• Effective systems were in place for reporting safety incidents. Significant events were investigated and where possible improvements made to prevent similar occurrences.

• Documentation that demonstrated staff provided safe care was not in place. Oxygen was not available to enable practice staff to effectively deal with medical emergencies.

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

Importantly, the provider must:

• Implement infection prevention and control audits to ensure that risks of infections are minimised.
• Ensure that all staff annual appraisals to monitor their performance and training needs are recorded and retained within the practice. Develop a procedure for recording the continued registration of nurses with their relevant professional body to evidence they are working legally.
• The provider must carry out risk assessments for fire safety and for areas of the premises.
• The provider must carry out comprehensive health checks of patients who had a learning disability.

In addition the provider should:

• Review the appointments system made available to ensure it meets patients needs.
• Retain all relevant recruitment documentation and recordings from meetings held within the practice so that it is accessible and can be shared appropriately.
• Engage with patients by carrying out annual surveys to gather feedback on the quality of the service provided and respond to them in order to make improvements in service delivery.
• The practice should ensure that clinical audit cycles are completed in order to demonstrate improved outcomes for patients.
• Have oxygen available for immediate use in emergency medical situations.
• The provider should hold a register of people who had carer responsibilities to enable clinical staff to offer them support or signpost them to relevant services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 June 2015

The practice is rated as requires improvement for the population group of people with long term conditions. This is because the practice requires improvement in order to provide safe, effective, responsive, well lead care for its patients and that includes this population group.

The practice staff held a register of patients who had long term conditions. Clinical staff offered reviews for these patients to check their health and medication needs were being met. Patients with long term conditions were reviewed by the GPs and the nurses to assess and monitor their health condition so that any changes could be made. Emergency processes were in place and referrals made for patients in this group that had a sudden deterioration in health.

The practice achievement for Quality Outcomes Framework (QOF) was similar to or lower than average the national average. The QOF is a voluntary performance monitoring tool. We were not given assurances that multidisciplinary meetings were held to ensure this patient group received co-ordinated care.

Updated 25 June 2015

The practice is rated as requires improvement for population group of families, children and young people. This is because the practice requires improvement in order to provide safe, effective, responsive, well lead care for its patients and that includes this population group.

The practice staff worked with local health visitors in providing child immunisations and delivering the Healthy Child Programme. Community midwives held ante natal clinics at the practice every week. Appointments were available outside of school hours, early evening Mondays, Tuesdays and Fridays. Systems were in place for identifying and following-up children living in disadvantaged circumstances and who were at risk.

Updated 25 June 2015

The practice is rated as requires improvement for the care of older people. This is because the practice requires improvement in order to provide safe, effective, responsive, well lead care for its patients and that includes this population group.

Reminder letters were sent to patients aged 65 years and over offering them annual health checks. All patients aged over the age of 75 years had been informed of their named and accountable GP. Care and treatment of older patients reflected current evidence-based practice. The practice was responsive to the needs of older patients, including offering home visits and rapid access appointments and home visits for those with enhanced needs.

Updated 25 June 2015

The practice is rated as requires improvement for the working-age people (including those recently retired and students). This is because the practice requires improvement in order to provide safe, effective, responsive, well lead care for its patients and that includes this population group.

The practice had an above average patient population who were of working age. Patients were offered telephone consultations at any time during the practice opening hours of 8:30am until 7:00pm. The practice was open extended hours until 6pm on Mondays and Fridays and 6:45pm Tuesdays. However, there were no early morning appointments and no online appointment booking or repeat prescription service available which might accommodate the needs of working age patients.

Updated 25 June 2015

The practice is rated as requires improvement for the population group of people experiencing poor mental health (including people with dementia). This is because the practice requires improvement in order to provide safe, effective, responsive, well lead care for its patients and that includes this population group.

Patients who presented with anxiety and depression were assessed and managed in with the National Institute for Clinical Excellence (NICE) guidelines. NICE provide guidance for GPs to work with to ensure patients receive appropriate care and treatment. Clinical staff worked within the Mental Capacity Act 2005 when dealing with patients with dementia. Patients who were reluctant to attend their annual health checks were supplied with short term prescribed medicines and requested to attend the practice for a medicine review.

Updated 25 June 2015

The practice is rated as requires improvement for the population group of people whose circumstances may make them vulnerable. This is because the practice requires improvement in order to provide safe, effective, responsive, well lead care for its patients and that includes this population group.

Reminder letters were sent out to patients when their health reviews were due. GPs carried out regular home visits to patients who were housebound and to other patients on the day they had been requested. Although efforts had been made to complete annual health checks of patients who had learning disabilities the recordings made were not comprehensive to confirm that full health checks had been carried out.