Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Kumar on 16 March 2016. Overall the practice is rated as good. The practice is rated as good for each of the domains and population groups.

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

• The practice ensured that when things went wrong that these were investigated and learning was shared with staff.
• Staff were trained and had access to procedures and information to help safeguard adults and children from risks of abuse and neglect.
• There were systems for assessing and managing risks to patients and staff. These included risks associated with fire, infection control, premises and equipment.
• Medicines were stored securely and checked regularly to ensure that they were in date. The practice had suitable equipment and a range of medicines to use in the event of a medical emergency. However GPs did not carry any emergency medicines when they carried out home visits.
• The arrangements for dealing with repeat prescriptions were not clearly defined and we saw that a small number of patients who were prescribed medicines such as warfarin without a record of the appropriate blood checks having been carried out and checked.
• There was a detailed business continuity plan to deal with untoward incidents that may affect the day to day running of the practice.
• Staff were recruited robustly with all of the appropriate checks carried out to determine each person’s suitability and fitness to work at the practice.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance.

• Data showed that the practice performance for monitoring and treating patients with long term conditions was similar to other GP practices.

• Information was shared with staff and other healthcare professionals appropriately to ensure a coordinated approach to patients care and treatment.

• There were procedures in place for obtaining patients consent to care and treatment and staff were aware of and followed these.

• Clinical audits and reviews were carried out to monitor and improve patient care and treatment.

• Staff were supported and received role specific training to meet the needs of patients and there was a system for staff appraisal.
• Patients said they were treated with dignity and respect and they were involved in their care and decisions about their treatment. They said that staff were helpful, polite and courteous. This was also supported by the results from the most recent GP patient survey.
• The practice sought to identify patients who were carers and to support them as appropriate.
• Information about services and how to complain was available and easy to understand. Complaints were investigated and responded to promptly and apologies given to patients when things went wrong or their experienced poor care or services.
• The practice offered a range of appointments including face to face, telephone and online consultations.
• Late evening appointments were available on two evenings each week.
• Some patients had reported delays in waiting to be seen and the practice had reviewed its appointments system to help address these issues.
• The practice was accessible to patients with mobility difficulties, had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management.
• The practice regularly monitored and reviewed the services offered and carried out a range of audits and reviews to improve the quality and safety of its services.
• Practice policies and procedures were appropriate and kept under review.
• The practice proactively sought feedback from staff and patients, which it acted on.

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

Importantly the provider should:

• Review the arrangements for managing repeat prescriptions to ensure that there is a consistent approach to reviewing them before these are issued.

• Review the arrangements for managing medical emergencies that may occur when GPs carry out home visits and have available medicines as deemed necessary.

• Review the arrangements for identifying patients who are carers.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice