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CQC agrees to cancel the registration of Inadequate GP Practice in Liverpool

8 October 2015
Dr Srinivas Dharmana
  • Media,
  • GP and GP out-of-hours services

The Care Quality Commission (CQC) has agreed to cancel the registration of a Liverpool GP practice which had failed to improve the quality of care for its patients.

In response to this, NHS Liverpool Clinical Commissioning Group (CCG) has already taken steps to ensure that the 2,400 patients on the practice’s list have appropriate GP provision moving forward.

CQC had identified concerns at Dharmana’s Family and General Practice in Walton, Liverpool during an inspection in October 2014. As a result the practice was rated as Inadequate and placed into special measures. This is a national scheme, which gives practices that are rated by CQC as Inadequate access to support and funding to improve their care from NHS England and the Royal College of General Practitioners.

Following a period of six months in special measures, CQC re-inspected the practice in July 2015, and found continued concerns. These included lessons not being learnt from medication errors, letters from hospitals about its patients not being responded to in a timely manner and systems not being in place to guarantee this, and staff lacking training in immunisations, vaccinations and other key areas.

Also, inspectors raised concerns that there was no oxygen available at the practice or a defibrillator for use in an emergency and that the premises were in a poor state of repair. There was no evidence of legionella testing and actions required to improve infection control had not been progressed.

CQC concluded that the practice had failed to make the required improvements and was again rated Inadequate overall.

The practice has been rated as Inadequate for being safe, effective and well-led, and Requires Improvement for being responsive, and caring.

A full report of the inspection can be read here.

Following the latest inspection, Dr Dharmana submitted an application to cancel his practice’s registration with CQC. CQC has approved this application and the practice will close in December 2015 when its current contract with NHS England expires.

In the meantime, CQC understands that NHS England and NHS Liverpool CCG continue to support the practice and are taking action to arrange the transfer of patients to alternative GP services in the local area. Patients will be informed directly of this by NHS Liverpool CCG and involved in the process.

Sue McMillan, Deputy Chief Inspector of General Practice said:

“It is important that the people who are registered with Dharmana’s Family and General Practice can rely on getting the high quality care which everyone is entitled to receive from their GP. 

“It is extremely disappointing that the practice has not made the required improvements and is still not providing care of an acceptable standard. The people who rely on this practice deserve better.

“We had told Dr Dharmana in January that if improvements were not made after a period of six months, we would consider taking steps to cancel the practice’s registration.

“Following our latest inspection Dr Dharmana has decided to close the practice voluntarily. In the meantime, NHS England and NHS Liverpool Clinical Commissioning Group continue to support the practice and are arranging the transfer of patients to alternative GP services in the local area.”

Katherine Sheerin, Chief Officer, NHS Liverpool Clinical Commissioning Group said:

“NHS Liverpool CCG’s priority is making sure all patients at Dharmana Family and General Practice are able to access GP care once the practice closes.

“We are working to put additional GP provision in place locally, which will be managed by an existing Liverpool practice. This will be on an interim basis while we make plans for the longer term.

“We understand that the closure of Dr Dharmana’s practice will cause uncertainty for patients, and we will be writing to patients to inform them of what is happening and let them know what their options are. If patients have any concerns in the meantime they can contact Healthwatch Liverpool or the CCG directly.


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Last updated:
29 May 2017

Notes to editors

CQC has published a full report here


As of 24 September 2015, there are 57 general practices in special measures. In September 2015, the first general practice came out of special measures following improvements it made to the quality and safety of its care for patients.


Since 1 April, providers have been required to display their ratings on their premises and on their websites so that the public can see their rating quickly and easily.


If patients would like to speak to the CCG, they can contact the Primary Care Team on: 0151 295 3537.


Healthwatch Liverpool can be contacted as follows:

  • Telephone: 0300 77 77 007 (Calls cost the same as to a local landline number. The team are happy to return calls to help keep bills down).
  • Text: 07842 552 878
  • Email:


Call in: 1st Floor, 151 Dale Street, Liverpool, L2 2AH.
Alternatively, NHS Choices,, has information on GP practice alternatives. The postcode search can be used to find GP practices – patients then simply contact the practice they would like to register with.


All practices in Liverpool are currently accepting patients, however they have different practice boundaries based on home address, therefore they might not accept new patients who live outside of the boundary.


About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.