Archived: Dr F J Ahmad Also known as Windermere Road Surgery

Updated 8 May 2015

The practice of Dr F J Ahmad is situated in the Langley area of Middleton. At the time of this inspection we were informed 2,300 patients were registered with the practice. The population experiences much higher levels of income deprivation than the practice average across England. There is a lower proportion of patients above 65 years of age (10.8%) than the practice average across England (16.7%). There is a higher proportion of patients under 18 years of age (17.5%) than the practice average across England (14.8%). 59.9 per cent of the patients have a longstanding medical condition compared to the practice average across England of 54%.

A wide range of medical services are provided at the practice (details of which are provided on the practice website) and in printed patient information. At the time of our inspection 4 long term locum GPs (2 male and 2 female) were providing primary medical services to patients registered at the practice. The principal doctor (female) who is also the registered provider is currently conducting 2 clinical sessions a week in relation to drug dependency and cytology and 1 session per week in relation to administration. The GPs are supported in providing clinical services by a practice nurse (female). Clinical staff are supported by the staff in the practice team. This team is led by the practice manager.

The practice has opted out of providing out-of-hours services to their patients. This service is provided by a registered out of hours provider. The practice website provides patients with details of how to access medical advice when the practice is closed. Patients are also provided with these details via a recorded message when they telephone the practice outside the usual opening times. Patients registered at the practice are also enabled to access medical advice by attending a medically led walk in centre and a local GP practice that provides access to appointments 7 days per week.

The provider informed us that they have purchased a property adjacent to the existing practice. We have been informed plans have been submitted for the purchased property to house the existing practice and thereby improve the facilities and develop the services currently provided. We understand the provider is consulting with NHS England and NHS Heywood, Middleton and Rochdale Clinical Commissioning Group (CCG) regarding this proposed development.

Updated 8 May 2015

Letter from the Chief Inspector of General Practice

Dr F J Ahmad was inspected on 26 February 2015. This was a comprehensive inspection. This means we reviewed the provider in relation to the five key questions leading to a rating on each on a four point rating scale. We rated the practice as requires improvement in relation to being safe and good in respect of being effective, caring, responsive and well-led.

Our key findings were as follows:

The practice has a system in place for reporting, recording and monitoring significant events. Significant incidents and events are used as an opportunity for learning and improving the safety of patients, staff and other visitors to the practice.

The practice has systems in place to ensure best practice is followed. This is to ensure that people’s care, treatment and support achieves good outcomes and is based on the best available evidence.

Information we received from patients reflected that practice staff interact with them in a positive and empathetic way. They told us that they were treated with respect, always in a polite manner and as an individual.

Patients spoke positively in respect of accessing services at the practice. A system is in place for patients who require urgent appointments to be seen the same day.

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

Importantly, the provider must:

Take action to ensure the effective operation of systems designed to assess the risk of and to prevent, detect and control the spread of health care associated infection.

Ensure that patients, staff and others accessing the premises are protected against the risks associated with fire.

Improve the system of staff recruitment to ensure that patients are protected by operating effective recruitment and selection procedures that includes relevant checks being carried out (and evidenced) when staff are employed or are engaged in a role where such checks are required.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 8 May 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. The practice had established and developed strong links with the integrated care programme in Rochdale and in particular had frequent contact with the local community matron to minimise the need for patients to go to the local A+E department or be admitted to hospital. This was particularly helpful for patients with complex health conditions who were at higher risk of being admitted to hospital.

Updated 8 May 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. 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. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 8 May 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. The practice had established and developed strong links with the integrated care programme in Rochdale and in particular had frequent contact with the local community matron to minimise the need for patients to go to the local A+E department or be admitted to hospital. This was particularly helpful for elderly patients and those with complex health conditions who were at higher risk of being admitted to hospital.

Updated 8 May 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. To improve patient access a late surgery and Saturday morning surgery was provided. This was particularly helpful to patients who worked or attended further education training. Patients were also enabled to access (along with other practices in the area) medical advice by attending a medically led walk in centre and a local practice that provides access to GP appointments 7 days per week.

Updated 8 May 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 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 including MIND and SANE. 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 8 May 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 living in vulnerable circumstances including homeless people, travellers and those 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. The practice had established links with a local gay and lesbian group as well as other voluntary and third sector groups. The purpose of these links are to encourage and maximise access to primary medical care and treatment particularly for those patient groups who may find it difficult (for various reasons) to readily engage with such services. 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.