You are here

CQC places Liverpool GP Practice into Special Measures

22 January 2015
Dr Srinivas Dharmana
Dr Srinivas Dharmana
  • Media

England’s Chief Inspector of General Practice has placed a Liverpool GP into special measures following an inspection by the Care Quality Commission

A specialist team of inspectors rated the service provided by Dr Srinivas Dharmana’s Family and General Practice in Walton, Liverpool as Inadequate for being safe, effective well-led, caring and responsive. The practice has been given an overall rating of Inadequate.

Under CQC’s new programme of inspections, led by Professor Steve Field, Chief Inspector of General Practice, all of England’s GP practices are being inspected and given a rating.

Dr Dharmana’s practice was inspected in October 2014 by an inspection team which included a GP advisor, a practice manager and an Expert by Experience. A full report of this inspection is available here

At the time of the inspection Dr Dharmana had not been delivering clinical care to patients for approximately 12 months and during this period services had been provided by several locum doctors.

Although inspectors received some positive comments from patients they spoke to during the inspection, they identified a number of significant concerns.

Inspectors found that there were no systems in place to monitor the safe running of the practice and no evidence of any recent clinical audits having been undertaken.

Concerns were also raised regarding medicines management and the inability of staff to locate emergency drugs and equipment quickly.

Systems to ensure locum GPs had access to vital information such as alerts for medicine and equipment were not in place, and some of the services the practice was registered to deliver, such as minor surgery or contraceptive implants, were no longer being provided. Patients had not been informed of choices they could make on how and where they could go to receive those services.

The Care Quality Commission has identified 10 areas for improvement, including:

  • The practice must take action to protect patients from the risks of inappropriate or unsafe care and treatment by implementing a system to regularly assess and monitor the quality and safety of the service.
  • The practice must ensure alerts about potential issues with medicines and equipment are shared with all staff so that changes to the treatment of patients can be undertaken swiftly if necessary.
  • The practice must take action to protect patients by ensuring suitable arrangements are in place to share information with other healthcare professionals when they move between services.
  • The practice must ensure that suitable arrangements are in place so that all staff respond appropriately to any safeguarding concern.
  • The practice must ensure necessary employment checks are in place for all staff.

CQC has been working closely with Liverpool clinical commissioning group, NHS England to support the practice while it addresses the issues identified by the inspection.

Sue McMillan, Deputy Chief Inspector of General Practice said:

“Patients should be able to expect high quality and consistent care from their GP practice. It is important that the 2,400 people who are registered with Dr Dharmana can rely on getting the high quality care which everyone is entitled to receive from their GP.

“While patients we met spoke highly of the care they had received from this practice in the past – we heard that recently they had not been receiving the same continuity of care from the locum GPs who had been delivering services since the end of 2013.

“We have found significant areas of concern. I do not believe that the practice is likely to resolve its challenges without external support. This is why we are placing the practice into special measures.

“With the right support, I expect this practice to be transformed. After a period of six months we will inspect again to check whether sufficient improvements have been made. If we find that the service provided by this practice remains inadequate, we will consider taking steps to cancel its registration with CQC.”

Patients registered with the practices being placed into special measures should be aware that the package of support being offered by NHS England and the Royal College of GPs will ensure that there are no immediate risks to patient safety at these GP practices whilst improvements are being made. These practices will not close.


For media enquiries, call the CQC press office on 020 7448 9401 during office hours or out of hours on 07789 876508. For general enquiries, call 03000 61 61 61.

Last updated:
29 May 2017

Notes to editors

CQC has published a full report on Dr Srinivas Dharmana’s Family and General Practice.

This is among the first GP practices to receive a rating following the introduction of our new inspection regime, which features specialist teams including GPs and practice nurses and trained members of the public.

To get to the heart of people’s experiences of care, we always ask the following five questions of services.

  • Are they safe?
  • Are they effective?
  • Are they caring?
  • Are they responsive to people’s needs?
  • Are they well-led?

For every NHS GP practice we will look at the quality of care for the following six population groups: Older people, People with long-term conditions, Families, children and young people, Working age people (including those recently retired and students),People whose circumstances may make them vulnerable, People experiencing poor mental health (including people with dementia).

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.