Archived: Dr D Dhaduvai & Dr S Chaudhuri Also known as Parkside Surgery

Updated 12 November 2015

Dr D Dhaduvai and Dr S Chaudhuri’s practice (also known as Parkside Surgery) is in Barnehurst in the London Borough of Bexley. The practice has one practice GP principal who manages the practice which is based at a single site. The practice is based in a converted house which has been modified to ensure that it is fit for clinical use.

The practice provides primary medical services to approximately 4,900 patients. The practice currently uses a long term locum following the departure of the other partner in the practice. The GP principal is lead for most areas in the practice. Both GPs in the practice are female. The practice also employed two nurse practitioners (equivalent to 1.1 whole time equivalent [WTE]), two nurses (equivalent to one whole time equivalent), a practice manager, a data manager, a senior receptionist and three other receptionist. The practice manager told us that another administrator would be starting work at the practice the week after the inspection to fill a previously vacant post.

The practice is contracted to provide General Medical Services (GMS) and is registered with the CQC for the following regulated activities: treatment of disease, disorder or injury, maternity and midwifery services, family planning, surgical procedures, and diagnostic and screening procedures at one location.

The practice provides a number of enhanced services, including childhood vaccinations, influenza immunisations, learning disabilities, and rotavirus and shingles Immunisation.

The practice is open from 8:00am until 6:30pm on Mondays, Tuesdays, Wednesdays and Fridays and from 7:00am until 1:00pm on Thursdays. A local Bexley co-operative provides services to patients who need to see a practitioner between 1:00pm and 6:30pm on Thursdays. Outside of normal opening hours the practice used a Bexley based out of hours provider.

Updated 12 November 2015

Letter from the Chief Inspector of General Practic

We carried out an announced comprehensive inspection Dr D Dhaduvai & Dr S Chaudhuri’s practice on 17 September 2015. Overall the practice is rated as good.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• Regular multi-disciplinary team meetings were in place at the practice.

• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

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

Importantly the provider should

• Ensure that safeguarding is a standing item on the agenda of formal clinical meetings and that a more formal register is kept of vulnerable adults.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 November 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. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. The practice met regularly with the palliative care team, health visitors and district nurses to provide care for these patients. Most patients with long term conditions were reviewed annually. For example 96% of all diabetic patients had been reviewed in the last year.

Updated 12 November 2015

The practice is rated as good for the care of families, children and young people. There were safeguarding processes in place at the practice and children who were potentially at risk could be identified. 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 12 November 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. All patients over 75 had a named GP. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

Updated 12 November 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 hours offered extended hours from 7am on a Thursday for commuters. There were also telephone consultations available. The practice offered access to appointments and precriptions online as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 12 November 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). 78% of 18 patients with Dementia had received an annual review in the last 12 months. 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. A system was in place to recall any patients with poor mental health who had not attended appointments, and also any patients who had attended accident and emergency. Staff had received training on how to care for people with mental health needs and dementia.

Updated 12 November 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. It had carried out annual health checks for people with a learning disability with 88% of 11 of these patients having received a health check in the last year. Patients with a learning disability were offered longer appointments.

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. Staff knew how to recognise signs of abuse in vulnerable adults and children. The care of vulnerable adults was discussed in clinical meetings, but not as a standing agenda item. The practice could search for vulnerable adults on a database, but no formal register of vulnerable adults was kept. 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.