Archived: IH Medical Practice

Letter from the Chief Inspector of General Practice

We completed a comprehensive inspection at Drs Pahwa and Pahwa Surgery on 27 November 2014. The provider also operates a branch surgery (Goldthorn Medical Centre) but we did not inspect the branch surgery as part of our visit. The overall rating for the practice is requires improvement. We found the practice required improvement in providing a service that is safe, effective, caring, responsive and well-led.

Our key findings were as follows:

• Systems in place were not robust to ensure patients received a safe service. Staff lacked an understanding of risk management to keep patients safe.

• There was some evidence of clinical audits, significant event analysis and best practice guidance in place. However, the practice was unable to show how it effectively used information and audits to drive improvements in patient outcomes.

• Services provided did not always demonstrate a responsive service. Patients did not always find it easy to access appointments including urgent appointments.

• Complaints processes did not ensure patients concerns were adequately addressed.

• The governance arrangements were not clearly defined to ensure effective management of risks and performance.

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

Importantly, the provider must:

• Ensure that robust systems to identify, monitor and manage risks to patients and others who use the service are put in place to protect patients from unsafe care. This includes risks relating to (but not exclusively) the premises, staffing, staff training, fire safety, records and prescriptions, potential emergencies.

• Identify patients who are most at risk due to complexity of their disease or multiple co-morbidities so that their comprehensive care needs can be identified, planned and managed.

• Ensure staff undertaking chaperoning duties have an understanding of their role and responsibilities.

• Ensure that all appropriate equipment at the practice has been tested for electrical safety, calibrated and serviced regularly.

• Ensure appropriate recruitment checks are undertaken to protect patients from the risk of unsuitable staff.

• Review its processes for handling and managing complaints and ensure they are fully investigated as far as practicable. Patients should be made aware of the process for escalating complaints. Information from complaints should be used to support learning and service improvement.

In addition the provider should:

• Maintain accurate training records for staff and ensure that the learning needs of staff are identified to enable them to do their job effectively and where appropriate plans implemented to ensure those learning needs are met.

• Ensure staff are aware of processes to support all patients whose first language is not English so that they can access the healthcare they need.

• Improve information available to patients so that they can access support services relevant to their needs.

• Review the appointment system and identify how it may be improved. This should include raising awareness of the online booking system and informing patients as to how they can access it.

• Ensure the whistle blowing policy supports staff to report concerns appropriately. Staff should be made aware as to where they can report concerns if they do not feel able to within the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice