Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Manoj Maini on 02 March 2016. Overall the practice is rated as good.

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

• The practice had developed protocols on the patient record system as a result of new guidelines, the system then alerted GPs to carry out certain tests for specific medical conditions.

• There was an effective system in place for reporting and recording significant events and staff were aware how to report an incident. However, a summary of significant events was not maintained to identify potential trends.

• Detailed discussions were held to ensure lessons were learnt and shared, however minutes did not always record who was responsible for agreed action points and when they should be completed by.

• There were embedded systems in relation to obtaining, prescribing, recording, handling, storing and security of medicines.

• Data from the Quality and Outcomes Framework showed patient outcomes were average compared to the national average. The practice had high exception reporting in some clinical areas, however had investigated the reasons for exception reporting and taken action.

• Staff worked with multidisciplinary teams to understand and meet the range and complexity of patients’ needs. This included the community matron, integrated care co-ordinator, district nurse and LOROS (a county based charity specialising in hospice care for persons over the age of 16).

• Referrals through the choose and book system were made during a patient consultation and GPs completed the referral template with the patient.

• Data from the National GP Patient Survey showed patients rated the practice higher than others for several aspects of care.

• Patients said they were very satisfied with the care and treatment received and staff treated them with dignity and respect.

• The practice supported patients and carers emotionally with their care and treatment and signposted them to relevant support groups as required.

• The practice engaged with the NHS England Area Team and Clinical Commissioning Group to review the needs of the local population and participated in service improvements and local initiatives. For example, utilising the local area co-ordinator to ensure patients social care needs were also cared for.

• Patients told us they found it easy to make an appointment with a GP and nurse.

• Information about how to complain was available in the patient waiting area. However, aspects of the complaints procedures was not in line with recommended guidance.

• The practice had a clear vision to support the delivery of good quality care and staff were aware of their roles to achieve the vision.

• There were arrangements for identifying, recording and managing risks. Actions were carried out to mitigate potential risks.

• There was a clear leadership structure in place and staff felt supported by management.

• There was an active patient participation group which met on a regular basis and assisted with health promotion. The practice acted on feedback from the group and also feedback from patients and staff.

• The provider was aware of and complied with the requirements of the Duty of Candour. The partners encouraged a culture of openness and honesty.

The areas where the provider should make improvements are:

• Maintain a summary of significant events to identify trends.

• Record when agreed actions should be completed by within meetings.

• Ensure annual registration with professional bodies, for instance General Medical Council and Nursing and Midwifery Council, are checked for all clinical staff.

• Ensure complaints procedures and policies are in line with recommended guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice