Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Masud Prodhan (also known as) Old Trafford Medical Practice on 29 July 2016. The overall rating for the practice was requires improvement and the practice were given a period of twelve months to make improvements. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Old Trafford Medical Practice on our website at www.cqc.org.uk.

This inspection was undertaken following the period of time provided for the practice to make improvements and was an announced comprehensive inspection on 11 July 2017. Overall the practice is now rated as Good.

Our key findings were as follows:

• Since the previous inspection the provider had introduced a significant number of systems and processes to improve safety, effectiveness and leadership at the practice. It was evident that the systems were embedded into every day working practice and were being followed.

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Learning and improvement from incidents were evidenced and thorough analysis was taking place.

• The practice used proactive methods to improve patient outcomes. Following an increase in excess of 1500 patients from another practice, two data quality clerks were recruited and new systems were introduced. Data from 2015/2016 evidenced that the practice met or exceeded targets for risk reduction and treatment in most of the indicators.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met patients’ needs. For example, as part of their involvement in Productive General Practice a “choose well” system was introduced

• The surgery was working closely with two local cancer screening providers to increase cancer awareness and a champion was introduced within the practice. The practice could evidence an increase in the uptake of cancer screening because of this intervention.

• The practice implemented suggestions for improvements and made changes to the way it delivered services. They increased the number of telephone appointments, recruited new reception staff and provided customer care training as a consequence of feedback from patients and from the patient participation group.

• There was a clear practice vision with quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff. All staff were aware of, and signed up to the practice ethos and values.
• The practice had introduced strong and visible clinical and managerial leadership and governance arrangements. All staff felt supported by management and complied with the duty of candour.

We saw areas of outstanding responsiveness :

• The number of patients with long term conditions, particularly diabetes, increased substantially due to a neighbouring practice closure.The team responded by identifying all those patients with poorly managed diabetes and providing structured education plans with regular monitoring.They were able to evidence a positive impact on the number of patients with poorly managed diabetes that were now being well-managed and required less input from primary and secondary services.

• Known patients who were hard of hearing had direct access to communicate by email with the medical secretary who arranged appointments and interpreters if and when required. We saw positive feedback from a patient in relation to this service.

• As a result of the need to identify and support all genders within the community, clinical and non-clinical members of the team signed up to the pride in practice award run by the lesbian, gay, bisexual, and transgender (LGBT) foundation. Additional questions introduced to the new patient registration form helped to identify patients and offer advice and support that may not otherwise have been sought. The practice had received a Gold Award for their interventions.

In addition, there were areas of practice where the provider could continue to make improvements. The provider should:

• Introduce a standardised agenda for meetings involving all staff to include items such as safeguarding, significant events and practice developments.

• Review significant events trends more frequently than annually and include review dates on documentation.

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 Dr Masud Prodhan (also known as) Old Trafford Medical Practice on 29 July 2016. The overall rating for the practice was requires improvement and the practice were given a period of twelve months to make improvements. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Old Trafford Medical Practice on our website at www.cqc.org.uk.

This inspection was undertaken following the period of time provided for the practice to make improvements and was an announced comprehensive inspection on 11 July 2017. Overall the practice is now rated as Good.

Our key findings were as follows:

• Since the previous inspection the provider had introduced a significant number of systems and processes to improve safety, effectiveness and leadership at the practice. It was evident that the systems were embedded into every day working practice and were being followed.

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. Learning and improvement from incidents were evidenced and thorough analysis was taking place.

• The practice used proactive methods to improve patient outcomes. Following an increase in excess of 1500 patients from another practice, two data quality clerks were recruited and new systems were introduced. Data from 2015/2016 evidenced that the practice met or exceeded targets for risk reduction and treatment in most of the indicators.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met patients’ needs. For example, as part of their involvement in Productive General Practice a “choose well” system was introduced

• The surgery was working closely with two local cancer screening providers to increase cancer awareness and a champion was introduced within the practice. The practice could evidence an increase in the uptake of cancer screening because of this intervention.

• The practice implemented suggestions for improvements and made changes to the way it delivered services. They increased the number of telephone appointments, recruited new reception staff and provided customer care training as a consequence of feedback from patients and from the patient participation group.

• There was a clear practice vision with quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff. All staff were aware of, and signed up to the practice ethos and values.
• The practice had introduced strong and visible clinical and managerial leadership and governance arrangements. All staff felt supported by management and complied with the duty of candour.

We saw areas of outstanding responsiveness :

• The number of patients with long term conditions, particularly diabetes, increased substantially due to a neighbouring practice closure.The team responded by identifying all those patients with poorly managed diabetes and providing structured education plans with regular monitoring.They were able to evidence a positive impact on the number of patients with poorly managed diabetes that were now being well-managed and required less input from primary and secondary services.

• Known patients who were hard of hearing had direct access to communicate by email with the medical secretary who arranged appointments and interpreters if and when required. We saw positive feedback from a patient in relation to this service.

• As a result of the need to identify and support all genders within the community, clinical and non-clinical members of the team signed up to the pride in practice award run by the lesbian, gay, bisexual, and transgender (LGBT) foundation. Additional questions introduced to the new patient registration form helped to identify patients and offer advice and support that may not otherwise have been sought. The practice had received a Gold Award for their interventions.

In addition, there were areas of practice where the provider could continue to make improvements. The provider should:

• Introduce a standardised agenda for meetings involving all staff to include items such as safeguarding, significant events and practice developments.

• Review significant events trends more frequently than annually and include review dates on documentation.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

The Old Trafford Medical Practice is a small GP practice with 2100 registered patients based within Seymour Grove Medical Centre. There were three GP’s, one nurse and one health care assistant working at the practice.

Patients we spoke to told us: “Doctors are very good, very nice and soft. I see both Doctors and both are very good” and “Reception are very good at accommodating appointments, never had any problems here.” Another patient told us: “They know you, very personal, they take time. If you have on-going issues, they chase up for you and make referrals, there is never any issues referring you to specialists.”

We looked at five patients’ electronic records and noted where verbal or written consent was required this had been recorded.

Patients’ records were in chronological order and gave details of the most up to date consultation, with details of assessments, treatments, referrals and test clearly recorded.

We saw clear policies and procedures were in place for protecting children and vulnerable adults as well as a policy relating to domestic abuse. These policies were easily accessible to staff via the computer system in both consultation rooms.

The practice was clean and tidy. We found the practice had appropriate hand gel dispensers in both consulting rooms and reception area. Personal protective clothing was available for staff in consulting rooms.

During our visit we found the practice had systems to assess and monitor quality.