Archived: Dr Mohua Chowdhury

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Mohua Chowdhury (also known as The Chowdhury Practice) on 19 November 2015. Overall the practice is rated as inadequate.

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

• Staff did not always understand their responsibilities to raise concerns, and to report incidents and near misses. Reviews and investigations of incidents did not always show lessons had been learned.
• Clinical risks to patients were usually assessed and well managed. However other risks, such as those relating to recruitment checks, were not.
• Data showed patient outcomes were low for the locality.
• Although some audits had been carried out, we saw no evidence that audits were driving improvement in performance to improve patient outcomes.
• The majority of patients said they were treated with compassion, dignity and respect.

• Information about services was available but not everybody would be able to understand or access it. Information about services was available but not everybody would be able to understand or access it. For example written information was not available in a language most patients could understand, and the practice told us most patients were illiterate in their spoken language.

• Urgent appointments were usually available on the day they were requested. There could be a long wait for routine pre-bookable appointments.
• The practice held a number of policies and procedures, but some were not practice specific or dated.

The areas where the provider must make improvements are:

• Ensure recruitment arrangements include all necessary employment checks for all staff. This includes the need for a Disclosure and Baring Service (DBS) check when appropriate, for example when staff perform chaperone duties.

• Ensure clinical audits and re-audits to improve patient outcomes.
• Ensure there are adequate arrangements in place for safeguarding adults and children. This must include appropriate staff training and ensuring safeguarding referrals are made in a timely manner.
• Ensure policies in place are specific to the practice, dated, and include a review date.
• Ensure safety checks, such as on emergency medicines boxes, are accurately carried out.
• Ensure the complaints policy contains all the required information, complaints are responded to giving the required information, and that patients are not discouraged from making complaints.

In addition the provider should:

• Monitor staff training to make sure mandatory and other training is up to date.

• Provide training to all appropriate staff on consent, including consent for patients under the age of 16 and for patients with learning disabilities.

I am placing this practice in special measures. Practices placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The practice will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration. Special measures will give people who use the practice the reassurance that the care they get should improve.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice