Archived: The Nayar Practice

Updated 16 April 2019

The Nayar Practice is located in a purpose built facility, the Martinwells Centre in Edlington. The practice shares the building with another GP practice.

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, family planning and treatment of disease, disorder or injury.

The Nayar Practice is situated within the Doncaster Clinical Commissioning Group (CCG) and provides services to 4857 patients under the terms of a general medical services (GMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.

The practice has three GP partners who registered with the CQC in April 2013. The practice has two male and one female GPs, two locum GPs (male), one first contact practitioner, two nurses, one health care assistant and one phlebotomist. Non clinical support is provided by a practice manager and an experienced administration/reception team.

The Public Health National General Practice Profile shows that around 97% of patients are of a White/British origin. The level of deprivation within the practice population is rated as two, on a scale of one to ten. Level one represents the highest level of deprivation; and level ten the lowest. The practice has a lower than average number of patients aged over 65 years. The age/sex profile of the practice shows a higher number of patients aged between five and 14 years registered at the practice. The average life expectancy for patients at the practice is 77 years for men and 82 years for women, compared to the national average of 79 years and 83 years respectively.

Updated 16 April 2019

We carried out an announced comprehensive inspection at the Nayar Practice on 5 March 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected

• information from our ongoing monitoring of data about services and

• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.

• Patients received effective care and treatment that met their needs.

• Staff dealt with patients with kindness and respect and involved them in decisions about their care.

• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.

• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

We saw several areas of outstanding practice including:

• Staff, teams and services were committed to working collaboratively and have found innovative and efficient ways to deliver more joined-up care to patients. In March 2017 the practice and six neighbouring practices developed the proactive primary coordinated care pathway. The practices hosted the pro-active care team, which included three pro-active care nurses, who visited frail, vulnerable or older patients in their own homes and implemented an advanced care plan with the patient/family/carers. The service involved working with other agencies such as social prescribing, admiral nurses, occupational therapists and community geriatrician to enable the patient to remain in either the home/community setting to reduce hospital admissions. Initially, patients were assessed using a risk stratification tool which included a review of patients living with dementia, learning difficulties, frailty, at risk of hospital admission, housebound, residing in care home or those with multiple long term conditions. The pro-active care nurse had identified 109 patients at risk and 102 of these have care plans in place. Of that 65 patients had consented to an enriched summary care record. Each patient with a care plan in place was asked to rate their confidence in their health needs and repeated when the care plan is reviewed. 80% of patients' are in the range of fairly confident/very confident in terms of managing their own health.

Whilst we found no breaches of regulations, the provider should:

• Consider completing a risk assessment in the absence of keeping some  emergency drugs.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Updated 16 April 2019

Updated 16 April 2019

Updated 16 April 2019

Updated 16 April 2019

Updated 16 April 2019

Updated 16 April 2019