Background to this inspection
Updated
5 August 2019
Dr Anis and Anis is the registered provider and provides primary care services to its registered list of 4725 patients. The practice delivers commissioned services under the General Medical Services (GMS) contract and is a member of NHS Wigan Borough Clinical Commissioning Group (CCG).
The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities. The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of diagnostic and screening procedures; family planning; maternity and midwifery services; surgical procedures, and treatment of
disease, disorder and injury.
Regulated activities are delivered to the patient population from the following address:
Golborne Health Centre
Kidglove Road
Golborne
WA3 3GS
The practice has a website that contains information about what they do to support their patient population and the in house and online services offered:
There are three GPs (two female and one male), and they are supported by two practice nurses. There is also a practice manager and supporting administration staff. This is a teaching practice for second year foundation doctors.
The average life expectancy and age profile of the practice population is broadly in line with the CCG and national averages. Information taken from Public Health England placed the area in which the practice is located in the fifth less deprived decile (from a possible range of between 1 and 10). In general, people living in more deprived areas tend to have greater need for health services.
Patients requiring a GP outside of normal working hours are advised to contact the surgery and they will be directed to the local out of hours service through NHS 111. Additionally, patients can access GP services in the evening and on Saturdays and Sundays through the Wigan GP access alliance at locations across Wigan Borough.
Updated
5 August 2019
This practice is rated as Inadequate overall. (Previous rating 18 October 2019 – (Inadequate)
The key questions at this inspection are rated as:
Are services safe? – Inadequate
Are services effective? – Inadequate
Are services caring? – Requires Improvement
Are services responsive? – Requires Improvement
Are services well-led? - Inadequate
We carried out an announced comprehensive inspection at Dr Anis and Anis on 30 May 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This full comprehensive inspection took place following concerns found at the previous inspection on 18 October 2018 resulting in a rating then of ‘Inadequate’. Two warning notices for Regulation 12 Safe Care and Treatment and Regulation 17 Good governance were issued and the practice was placed in special measures. A follow up inspection to check the progress of the improvements highlighted in the warning notices took place on 4 February 2019 and we noted some improvement had taken place. This most recent inspection was to measure the improvements made to date.
At this inspection we found:
We identified that not all improvements from the previous inspection in 18 October 2018 had been made and found new serious concerns resulting in continuing breaches of regulation.
We rated the practice as inadequate for providing safe services because:
- There was evidence that some patients on high risk medicines were not being monitored appropriately and consultation records were inadequately detailed.
We rated the practice as inadequate for providing effective services because:
- Continuing concerns were found regarding the level of detail recorded in medical records.
- Coding for medication reviews had been added to the clinical system with no evidence of these reviews taking place therefore patients were not receiving the monitoring they required. A large number of these had been completed when the surgery was closed and on the same day.
- There were some patients identified with a raised indicator for diabetes but had not had a coded diagnosis of diabetes or pre-diabetes and therefore not been followed up or offered appropriate management.
We rated the practice as inadequate for providing well-led services because:
- Leaders had not demonstrated the capacity or capability to make required improvements or provide safe care to patients.
- At the pre-inspection briefing we were informed by the lead GP that the workload at the practice was now unmanageable for clinical and administration staff
These areas affected all population groups so we rated all population groups as inadequate.
We rated the practice as requires improvement for providing caring services because:
- The GP National Survey data was below the CCG and National averages for providing caring services.
We rated the practice as requires improvement for providing responsive services because:
- The GP National Survey data was below the CCG and National averages for providing responsive services.
- There was insufficient data presented that demonstrated that quality had improved in response to complaints and no evidence that this was considered.
The areas where the provider must make improvements as they are in breach of regulations are:
- Ensure care and treatment is provided in a safe way to patients.
- Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
This service was placed in special measures following the inspection on 18 October 2018. Insufficient improvements have been made such that there remains an overall rating of inadequate. We will now be taking action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration. The practice will remain in special measures.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care