Archived: Dr George and Dr Rajcholan

Updated 21 January 2016

Dr George and Dr Rajcholan Practice is located in a residential area of Wolverhampton. It is a purpose built single storey building. The practice is located in an area of high deprivation and falls within the 30% most deprived in England. The total practice patient population is 3,782. There is one female and one male GP who provide services which equate to two whole time equivalent GPs. The practice team includes one practice manager, one practice nurse, one healthcare assistant. There are four practice support staff including a secretary and three receptionists. In total there are 9 staff employed either full or part time hours.

The practice opening times are 8am to 6pm Monday, Tuesday, Thursday and Friday and Wednesday 8am to 1pm. The practice does not offer extended GP appointment opening times. The practice does not provide an out-of-hours service to its patients but has alternative arrangements for patients to be seen when the practice is closed. Patients are directed to the out of hours services, Primecare, Monday, Tuesday, Thursday and Friday and Wolverhampton Doctors on Call on Wednesday afternoons.

The practice has a contract to provide General Medical Services (GMS) for patients. This is a contract for the practice to deliver general medical services to the local community or communities. They provide Directed Enhanced Services, such as the childhood vaccination and immunisation scheme and minor surgery. The practice provides a number of clinics for example long-term condition management including asthma, diabetes and high blood pressure. It also offers services for health checks and foreign travel.

Updated 21 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr George and Dr Rajcholan Practice on Tuesday 3 November 2015. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded. However information recorded was not sufficient to confirm that significant occurrences were appropriately reviewed and monitored to demonstrate improvement.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance.
• Clinical staff had received training appropriate to their roles and 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 that although they had to wait 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.
• The practice was well equipped to treat patients and meet their needs.
• There was a leadership structure. The patient participation group felt the practice could be more encouraging and supportive in ensuring they were involved in the improvement and future plans for the practice.

There are areas where the provider needs to make improvements in particular the provider should:

• Ensure that records of significant occurrences provide sufficient information to show that they are appropriately reviewed and monitored to demonstrate improvement.
• Have a system in place to record, investigate and demonstrate the outcome of verbal complaints received.
• Complete the process of ensuring staff have a criminal records check through the Disclosure and Barring Service (DBS) where appropriate.
• Ensure that two cycle clinical audits are completed that demonstrate any improvements for patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 January 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 that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 21 January 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. 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 and health visitors. The practice had improved its uptake of cervical screening for women aged 25-65 years over the last 12 months from 73.61% to 90%.

Updated 21 January 2016

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.

Updated 21 January 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.

Updated 21 January 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Patients experiencing poor mental health had received an annual physical health check and on the day of the inspection we found that 14 of the 27 (52%) patients eligible since April 2015 had been in receipt of their annual review. The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. We found that 36 of the 47 (77%) patients with a diagnosis of dementia had received a care review. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. 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 21 January 2016

The practice is rated good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients with a learning disability. It had carried out annual health checks and longer appointments were available for people with a learning disability. An easy read (pictorial) letter was sent to patients with a learning disability inviting them to attend the practice for their annual health check.

Staff had been trained 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. 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.