Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Dr Syed Ayaz Ahmed on10 May 2016. The overall rating for the practice was requires improvement. The full comprehensive report for the May 2016 inspection can be found by selecting the ‘all reports’ link for Dr Syed Ayaz Ahmed on our website at www.cqc.org.uk.

This planned inspection was undertaken to follow up progress made by the practice since the inspection on 10 May 2016. It was an announced comprehensive inspection on 25 April 2017. Overall the practice is now rated as good.

• During our previous inspection in May 2016 we saw that there was a system in place for reporting and recording significant events. However, we saw an example of where a non-clinical incident was not recorded. During this follow up comprehensive inspection, we saw improvements had been made to the incident reporting process.

• When we inspected the practice in May 2016 we saw processes were not always in place to keep patients safe through appropriate recruitment checks. The practice had not recruited any new staff members since our previous inspection. However, there were plans to recruit new staff. We saw recruitment processes were in place and were assured appropriate recruitment and selection procedure such background and employment history checks would be followed when recruiting new staff.

• During our previous inspection we saw patient clinical outcomes data were low compared to the local CCG and national averages. Data reviewed prior to this follow up inspection also showed low patient outcomes data. On the day of the inspection unpublished and unverified data was available. We looked at the practice record system which demonstrated significant improvements had taken place.

• Previously we were unable to fully identify patient outcomes as audits did not demonstrate quality improvement and there was little evidence that the practice had developed formal care plans for patients in need of extra support. During this follow up inspection we saw evidence that formal care plans had been developed and the practice was able to demonstrate quality improvement through completed audit cycles.

• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment. We saw an example of an audit that was based on NICE guidance.

• When we inspected in May 2016, the practice was unable to provide evidence that a carers register was in place. At this follow up, the practice was able to demonstrate that a register was in place. We saw 108 carers had been identified (1.5% of the practice list size) and offered further support where appropriate.

• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.

• National GP patient results also showed that patient’s satisfaction with how they could access care and treatment was comparable to local averages, but below national averages. The practice planned to become a hub for one of the five local commissioning groups that made up the CCG from September 2017. This would enable the practice to offer access from 8am to 8pm every day and plans were also in place to increase the number of telephone lines and reception staff.

• Previously, we noted that the practice complaints process was not displayed to inform patients of the process. During this inspection we saw complaints leaflets were available and the process for making complaints was displayed in the reception area.

• The lead GP told us that they had increased the number of sessions they offered since the last inspection and patients we spoke with said they found it easier to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.

• The practice was located in purpose built premises and had good facilities to meet patient needs.

The areas where the provider should make improvement are:

• The practice should consider keeping checked copies of proof of identification on file following Disclosure and Barring Service (DBS) checks.

• Continue to review and develop business continuity plan to ensure it is fit for purpose.

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 of Dr Syed Ayaz Ahmed on10 May 2016. The overall rating for the practice was requires improvement. The full comprehensive report for the May 2016 inspection can be found by selecting the ‘all reports’ link for Dr Syed Ayaz Ahmed on our website at www.cqc.org.uk.

This planned inspection was undertaken to follow up progress made by the practice since the inspection on 10 May 2016. It was an announced comprehensive inspection on 25 April 2017. Overall the practice is now rated as good.

• During our previous inspection in May 2016 we saw that there was a system in place for reporting and recording significant events. However, we saw an example of where a non-clinical incident was not recorded. During this follow up comprehensive inspection, we saw improvements had been made to the incident reporting process.

• When we inspected the practice in May 2016 we saw processes were not always in place to keep patients safe through appropriate recruitment checks. The practice had not recruited any new staff members since our previous inspection. However, there were plans to recruit new staff. We saw recruitment processes were in place and were assured appropriate recruitment and selection procedure such background and employment history checks would be followed when recruiting new staff.

• During our previous inspection we saw patient clinical outcomes data were low compared to the local CCG and national averages. Data reviewed prior to this follow up inspection also showed low patient outcomes data. On the day of the inspection unpublished and unverified data was available. We looked at the practice record system which demonstrated significant improvements had taken place.

• Previously we were unable to fully identify patient outcomes as audits did not demonstrate quality improvement and there was little evidence that the practice had developed formal care plans for patients in need of extra support. During this follow up inspection we saw evidence that formal care plans had been developed and the practice was able to demonstrate quality improvement through completed audit cycles.

• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment. We saw an example of an audit that was based on NICE guidance.

• When we inspected in May 2016, the practice was unable to provide evidence that a carers register was in place. At this follow up, the practice was able to demonstrate that a register was in place. We saw 108 carers had been identified (1.5% of the practice list size) and offered further support where appropriate.

• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.

• National GP patient results also showed that patient’s satisfaction with how they could access care and treatment was comparable to local averages, but below national averages. The practice planned to become a hub for one of the five local commissioning groups that made up the CCG from September 2017. This would enable the practice to offer access from 8am to 8pm every day and plans were also in place to increase the number of telephone lines and reception staff.

• Previously, we noted that the practice complaints process was not displayed to inform patients of the process. During this inspection we saw complaints leaflets were available and the process for making complaints was displayed in the reception area.

• The lead GP told us that they had increased the number of sessions they offered since the last inspection and patients we spoke with said they found it easier to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.

• The practice was located in purpose built premises and had good facilities to meet patient needs.

The areas where the provider should make improvement are:

• The practice should consider keeping checked copies of proof of identification on file following Disclosure and Barring Service (DBS) checks.

• Continue to review and develop business continuity plan to ensure it is fit for purpose.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

On the day of the inspection we spoke with three staff members, the principal GP and the practice manager. We also spoke with seven patients about their experience. One patient said: “To be quite honest I’ve got no complaints. Staff are well mannered, you get a smile when you walk in.” Another patient said: “It’s good. They’ve done everything I’ve asked.”

We found that care and treatment was planned and delivered in a way that met patients’ needs. Patients we spoke with told us they were generally happy with the level of care they had received.

Staff had received training in safeguarding and were aware of the appropriate agencies to refer safeguarding concerns to. This ensured that patients were protected from harm.

We found that staff had received appropriate training for the roles they carried out. They also had regular appraisals. This meant that they had been adequately assessed as being competent.

The provider had systems in place for monitoring the quality of service provision. We saw that the practice carried out a range of audits to monitor the quality of its own performance and the level of service being delivered.