Archived: Dr Baskaran & Partners, Parkway Health Centre 1

Updated 12 May 2016

Dr Baskaran Surgery is a medium sized practice based in Croydon. The practice list size is approximately 6269. Whilst the practice population is diverse, patients are mainly from white British backgrounds. The practice is in one of the most deprived areas in London. There is a high percentage of younger patients (aged between 5-24) and also a higher than average number of single parents. The practice had a Primary Medical Services (PMS) contract.

The practice facilities include four consulting rooms, one treatment room, one patient waiting room and one administration office. The premises are wheelchair accessible and there are facilities for wheelchair users including a disabled toilet and hearing loop.

The staff team compromises of three male GP partners and one female GP partner. Two of the partners worked seven sessions a week and the other two partners worked five sessions per week. Other staff included a female practice nurse, a female health care assistant, a female practice manager, a female assistant practice manager five receptionists (all female) and two administrators (one male and one female).

The practice is open between 8.00am and 6.30pm Monday to Friday and offers extended opening on Monday and Thursday from 6.30pm to 8.00pm. Appointments are available from 9.00am to 11am Monday to Thursday mornings and 4.00pm to 6.00pm Monday to Thursday afternoons and from 9.00am to 6.30pm on Fridays. When the practice is closed patients are directed (through a recorded message on the practice answerphone) to contact the local out of hour’s provider. This information is also available on their website.

The practice is registered as a partnership with the Care Quality Commission (CQC) to provide the regulated activities of; treatment of disease, disorder and injury; diagnostic and screening procedure; family planning; maternity and midwifery services and surgical procedures at one location.

Updated 12 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr B Baskaran & Partners on 5 April 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a GP and there was continuity of care, with urgent appointments available the same day.
• 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.
• The provider was aware of and complied with the requirements of the duty of candour.

The area where the provider should make improvement is:

• Review procedures in place for receiving alerts and updates such as those from NHS central alerting system, MHRA and NICE to ensure staff stay up to date with guidance.

• Review how they identify carers so they are able to offer appropriate support.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 12 May 2016

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 their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• Annual flu vaccination was offered to all patients with a long term condition.

• The practice was signed up to the unplanned admissions direct enhanced service.

• Ninety eight percent of patients on the diabetes register had received the influenza vaccination.

Updated 12 May 2016

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. The practice maintained a register of children at risk. There were currently 13 children on the register.

• 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. Same day appointments were always offered to children and pregnant women.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

• The practice offered weekly baby clinics run by a GP and the nurse (who also ran the immunisation clinic).

• Immunisation uptake rates were comparable to the CCG averages.

• Post-natal patients were reviewed by GPs and any concerns were discussed with the health visitor.

• Children that have high ‘did not attend’ DNA’s rates were monitored by reception staff and the practice manager and referred to the appropriate GP.

Updated 12 May 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population. This included being offered an annual health check (either at the practice or at home if more appropriate).

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• All patients over 75 have a named GP.

• A social worker attends the practice on a monthly basis to discuss referrals.

• The practice worked closely with two care homes in the local area providing GP services to residents.

• Reception staff were longstanding members of staff and had excellent knowledge of the older population, including knowing them by name and medical needs so they could triage appropriately.

Updated 12 May 2016

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.

• The practice offers extended hours on Monday and Thursdays for patients who work and other who find it more convenient to attend in the evenings.

• The practice supported out of area registrations.

• Patients aged 40-74 are offered a Wellman or Wellwoman check with the nurse.

Updated 12 May 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

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  100% of patients with dementia had their criteria fulfilled before being referred to the memory clinic.

• A comprehensive agreed care plan was in place for 94% of patients with schizophrenia, bipolar affective disorder and other psychoses.

• The notes of 98% of patients with physical and / or mental health conditions recorded their smoking status.

• The practice worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice 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.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 12 May 2016

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.

• The practice offered longer (20 minutes) appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed 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. 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.

• Annual health checks were offered to vulnerable patients.

• The practice provided assistance to local charities that requested medical letters of supportor reports, without a fee.

• The practice had shared care with a local organisation for patients with substance misuse.