Archived: Dr Anil Kumar Kaistha

Updated 27 September 2016

Dr Anil Kumar Kaistha is a two partner practice which provides primary care services to approximately 4400 under a Personal Medical Services (PMS) contract.

• The practice is situated in Warsop in a purpose built building that is fully accessible to patients with wheelchairs and those with limited mobility.

• There is a large car park at the practice with disabled spaces available.

• Services are provided from Dr Anil Kumar Kaistha, The Health Centre,Mansfield, Nottinghamshire, NG20 0BP

• The practice consists of two partners (male and female).

• The all nursing team consists of two practice nurses and one health care assistant (HCA) who is also a phlebotomist.

• The practice has a practice manager who is supported by three clerical and administrative staff to support the day to day running of the practice.

• This practice provides training for doctors who wish to become GPs and at the time of the inspection had one doctor undertaking training at the practice.

• When the practice is closed patients are able to use the NHS 111 out of hours service.

• The practice has a lower than average number of patients aged 35 to 49 years of age and higher than average number of patients over 50 years of age.

• The practice has high deprivation and sits in the fourth more deprived centile.

• The practice is registered to provide the following regulated activities; surgical procedures; family planning, diagnostic and screening procedures and treatment of disease, disorder or injury.

• The practice lies within the NHS Mansfield and Ashfield Clinical Commissioning Group (CCG). A CCG is an organisation that brings together local GPs and experienced health professionals to take on commissioning responsibilities for local health services.

• The practice is open between 8am and 6pm Monday to Friday. Appointments are from 8.50am to 10.20am and 2pm to 5.30pm other than Wednesdays when extended hours appointments are offered until 7.45pm. There are also appointments 10.40am to 11.50am each day that are available to be booked on the day from 8am.

Updated 27 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Anil Kumar Kaistha on 25 August 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.
• Patient survey figures were consistently above average when compared with CCG and national averages.
• Comments about the practice and staff were wholly positive and included patients thanking the staff and GPs for the service provided.
• 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 named GP and there was continuity of care, with urgent appointments available the same day. We saw this to be the case on the day of inspection.
• 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.
• Safety alerts and alerts from Medicines and Healthcare products Regulatory Agency (MHRA) were reviewed and cascaded to the appropriate persons. However, we saw no evidence the practice carried out reviews and completed searches on the patient record system to ensure action was taken against the alerts. A new process and documentation had been devised to rectify this.
• The practice offered extended hours Wednesday until 7.45pm for working patients who could not attend during normal opening hours.

The areas where the provider should make improvement are:

• Ensure actions from the annual infection control audits are addressed.

• Embed new process for the management of safety alerts.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 September 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.

• Other staff had responsibilities to ensure patients were booked in and attending reviews when required.

• Performance for diabetes related indicators was worse compared to the national average. (67% compared to 82% CCG average and 89% national average).

The practice had highlighted diabetes as a concern for them in their business plan and the practice nurse that had been recently employed was looking at ways that this could be improved.

• Longer appointments and home visits were available when needed.

• All 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.

Updated 27 September 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 in line with CCG averages 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.

• The practice’s uptake for the cervical screening programme was 77%, which was comparable to the CCG average of 85% and the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies. The practice was breast feeding friendly.

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

Updated 27 September 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.

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

• The nursing staff and GPs had visited patients homes to provide flu vaccinations for those that could not attend the surgery.

• Reviews were completed in patients home were required by the practice nurse.

Updated 27 September 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 27 September 2016

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

• 92% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which was above the CCG average of 83% and the national average of 84%.

• 97% of patients experiencing poor mental health were involved in developing their care plan in last 12 months which was better than the national average of 89%.

• The practice regularly 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 27 September 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 those with a learning disability.

• The register was monitored to ensure patients were attending for their annual reviews.

• The practice offered longer 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.