We carried out an announced comprehensive inspection at Amaanah Medical Practice on 24 January 2019 as part of our inspection programme.

At the last inspection in May 2015 we rated the practice as good for providing safe, effective, caring, responsive and well-led services.

At this inspection, we found that the providers had satisfactorily moved in line with changes within the healthcare economy and had shaped the practice to sustain delivery of high quality services.

We based our judgement of the quality of care at this service is 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. People with long-term conditions population group was rated outstanding as the outstanding features in responsive benefited this population group. Working age people (including those recently retired and students) population groups was rated as requires improvement because the issues identified in effective impacted on this population group.

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. Clinical audits demonstrated quality improvements.
• There was areas where the practice 2017/18 Quality Outcomes Framework (QOF) performance was below local and national averages as well as areas of high exception reporting. The providers demonstrated awareness of this and the practice were taking actions to improve clinical areas where performance was below local and national averages. Unpublished data provided during our inspection, showed actions were having a positive impact on patient outcomes.
• Following our inspection, the practice provided additional unpublished data from the 2018/19 QOF year which demonstrated actions carried out enabled further improvements in patients care and treatment.
• Staff dealt with patients with kindness, respect and involved them in decisions about their care. The was an action plan in place and the practice was taking steps to further improve patient satisfaction.
• There was a strong person-centred culture. Patients as well as members of the patient participation group we spoke with confirmed this.
• Services were tailored to meet the needs of individual patients. They were delivered in a flexible way that ensured choice and continuity of care with innovative approaches to providing integrated person-centred care.
• The practice had identified areas where there were gaps in service provision locally and had taken steps to address them.
• The culture of the practice and the way it was led and managed drove the delivery and improvement of high-quality, person-centred care. This was supported by strong and effective governance arrangements.

We saw several areas of outstanding features including:

• The practice actively encouraged patients to engage in health and prevention services run by local voluntary, community or social enterprise organisations. For example, 44 patients who attended the practice for their health review were signposted to Parkrun UK (a series of three mile runs held on Saturday mornings in areas of open space around the UK) and 18% had taken part in up to five runs. Some patients who attended the runs also went onto accessing other services which delivered movement based programmes aimed at teaching people with disabilities the full range of skills required to promote an active lifestyle.
• The clinical management team attended local Mosques to deliver talks to the community regarding diabetes and healthy lifestyles. The talks were part of healthy Ramadan held by the British Islamic Medical Association in May 2018.

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

• Continue improving the identification of carers to enable this group of patients to access the care and support they need.
• Continue carrying out actions to improve the uptake of national screening programmes as well as childhood immunisations.

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

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Amaanah Medical Practice on 11 May 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well led services. It was also good for providing services to older people, people with long term conditions, families, children and young people, the working age population and those recently retired, people in vulnerable circumstances and people experiencing poor mental health.

Our key findings across all the areas we inspected were as follows:

• 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 for patients and easy to understand.

• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.

• Staff told us that they were able to share their views with senior management. They felt that there was a more open culture in place recently where staff were listened to and supported.

However there were areas of practice where the provider needs to make improvements.

The provider should:

• Continue to develop robust multidisciplinary arrangements with partners to ensure that patients with complex needs benefit from joined up care packages.
• Ensure that cervical screening and childhood immunisations carried out by the practice are monitored closely to provide positive outcomes for patients
• Ensure that staff are informed of the safeguarding lead at the practice
• Ensure that staff have copies of minutes of all relevant meetings

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

There were two managers at the surgery and we spoke with both. We also with six patients, one GP, a practice nurses and a member reception staff during our visit. All of the patients we spoke with were generally pleased with the service they received from the practice. One patient said: “I find when I walk in the reception staff are well mannered, they always smile. It calms a person down.”

Patients told us they were mostly able to see a GP when they needed to. Patients told us they felt listened to and involved in their care. They said treatment options were discussed with them and results of tests were fully explained.

Most staff had received training in safeguarding children and vulnerable adults. For those staff that did not have current training, the practice had made efforts to ensure arrangements were made for them to attend. Staff were aware of the appropriate agencies to refer safeguarding concerns to that ensured patients were protected from harm.

Staff we spoke with told us they were supported to deliver care to an appropriate standard.

The practice carried out a range of audits to monitor the quality of the service. There was a system to ensure on-going improvements could be made by learning from any accidents and incidents.