Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Usman Akbar also known as The Family Practice on 19 July 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. The practice worked closely with two other practices in the area and outcomes and learning from complaints and significant events were shared appropriately between the practices at joint team meetings.

• We saw evidence of “competition” between three collaborating practices which helped incentivise staff to ensure that patient needs were prioritised for example; we saw that flu vaccination targets were met.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. We saw that development and learning was prioritised by the practice and staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment during consultations with their GP. Satisfaction rates for consultations with nursing staff was lower than the national average but comparable to other practices in the area.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with on the day said it was difficult to make an appointment with their preferred GP. Urgent appointments were available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs. However, the practice shared with us that they faced a number of challenges with the building.
• There was a clear leadership structure and staff felt supported by management. Staff told us that they would feel confident to raise any concerns with the lead GP or practice manager.
• The practice sought feedback from patients and the Patient Participation Group (PPG), which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw two areas of outstanding practice:

The practice offered a level two diabetes clinic where patients could be commenced on insulin therapy without having to attend the hospital. (Insulin is a drug used for diabetics which keeps blood sugar levels from getting too high or too low). This combined clinic could offer a multi-disciplinary service, including the input of a specialist dietician, a podiatrist and the lead GP who had specialist knowledge in this area. By offering these services closer to the patients’ home the practice could also reduce the burden on hospital services. In an area of high deprivation where travel costs could be prohibitive for some patients, services were planned to meet patient needs.

Patients at the practice could be difficult to engage due to their cultural diversity and understanding of health services. However, the percentage of women who had undergone a cervical screening test was 88% which was higher than the Clinical Commissioning Group (CCG) average of 77% and the national average of 82%. Patients would be contacted by the nurse who would explain the importance of this test in a culturally sensitive manner and in the patients' own language where appropriate.

The areas where the provider should make improvements are:

The service should continue to review the access to appointments and review the necessity of making changes to the telephone systems.

The practice should continue to review the results of patient satisfaction surveys in order to meet the needs of the patient population in the future taking into account improvements to the accessibility of services and clinicians.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We observed staff speaking with people on the telephone and in person. We saw staff were friendly and polite and offered choices to patients. We found people who used the service were treated with dignity and respect.

People who used the service were protected against the risk of abuse. Staff received training in abuse awareness and protecting children and vulnerable adults. The policies and procedures were available to all staff in relation to safeguarding.

We found people were protected from the risk of infection as treatment was delivered in a clean and hygienic environment.

There were effective recruitment and selection processes in place.

There was an effective complaints system in place. Complaints people made were responded to appropriately.