Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Devadeep Gupta on 15 December 2016. Overall the practice is rated as good.

The practice was previously inspected on 19 Feb 2015. Following that inspection the practice was rated as good for caring, effective and responsive services and required improvement in safe and well led.

Three compliance actions were issued as the practice was not meeting the legislation in place at that time for the following:

• Regulation 10 HSCA 2008 (Regulated Activities) Regulations 2010 Assessing and monitoring the quality of service provision
• Regulation 21 HSCA 2008 (Regulated Activities) Regulations 2010 Requirements relating to workers
• Regulation 23 HSCA 2008 (Regulated Activities) Regulations 2010 Supporting staff

Following this re-inspection on 15 December 2016 our key findings across all the areas inspected were as follows:

• The practice had reviewed the systems they had in place for communicating information within the practice. There was an open and transparent team approach where all practice issues were regularly discussed and reviewed.
• The number of staff had increased and the leadership structure had been reviewed and improved. There was a clear leadership structure and staff felt supported by management. The practice management team proactively sought feedback from staff and patients and acted on it.

• Staff had undertaken training to provide them with the skills, knowledge and experience they needed to deliver effective care and treatment.

• The provider was aware of and complied with the requirements of the duty of candour.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored and informally reviewed and addressed.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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 said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.

The areas where the provider should make improvement are :

• In relation to managing reviews of medication the practice should consider using review dates to improve the system they currently have in place.

• In relation to health and safety which is managed by NHS property services, the practice should keep a record of all up to date documentation.

We saw an area of outstanding practice :

• The practice were involved in a CCG initiative to carry out C-reactive protein (CRP) testing at the surgery. This was a blood test marker for inflammation in the body providing an early indication of whether an infection was viral or bacterial. The test enabled the practice to immediately detect and offer reassurance to their patients when antibiotics would not be effective treatment and also to reduce the number of wrongly prescribed antibiotic medicines. The practice could evidence a reduction in the number of antibiotics that were prescribed and said that feedback from patients was positive in this respect.

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 Devadeep Gupta on 15 December 2016. Overall the practice is rated as good.

The practice was previously inspected on 19 Feb 2015. Following that inspection the practice was rated as good for caring, effective and responsive services and required improvement in safe and well led.

Three compliance actions were issued as the practice was not meeting the legislation in place at that time for the following:

• Regulation 10 HSCA 2008 (Regulated Activities) Regulations 2010 Assessing and monitoring the quality of service provision
• Regulation 21 HSCA 2008 (Regulated Activities) Regulations 2010 Requirements relating to workers
• Regulation 23 HSCA 2008 (Regulated Activities) Regulations 2010 Supporting staff

Following this re-inspection on 15 December 2016 our key findings across all the areas inspected were as follows:

• The practice had reviewed the systems they had in place for communicating information within the practice. There was an open and transparent team approach where all practice issues were regularly discussed and reviewed.
• The number of staff had increased and the leadership structure had been reviewed and improved. There was a clear leadership structure and staff felt supported by management. The practice management team proactively sought feedback from staff and patients and acted on it.

• Staff had undertaken training to provide them with the skills, knowledge and experience they needed to deliver effective care and treatment.

• The provider was aware of and complied with the requirements of the duty of candour.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored and informally reviewed and addressed.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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 said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.

The areas where the provider should make improvement are :

• In relation to managing reviews of medication the practice should consider using review dates to improve the system they currently have in place.

• In relation to health and safety which is managed by NHS property services, the practice should keep a record of all up to date documentation.

We saw an area of outstanding practice :

• The practice were involved in a CCG initiative to carry out C-reactive protein (CRP) testing at the surgery. This was a blood test marker for inflammation in the body providing an early indication of whether an infection was viral or bacterial. The test enabled the practice to immediately detect and offer reassurance to their patients when antibiotics would not be effective treatment and also to reduce the number of wrongly prescribed antibiotic medicines. The practice could evidence a reduction in the number of antibiotics that were prescribed and said that feedback from patients was positive in this respect.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We spoke with four patients on the day of our visit. They told us they were very satisfied with the service provided and spoke positively about the staff. They confirmed there was time to discuss their concerns during the consultation and that treatment was explained to them

Patient electronic records were available to staff in all consulting and treatment rooms and patients we spoke with confirmed their medical information was read and updated during the consultation.

The practice had up to date ‘child protection’ and ‘vulnerable adult’ policies and procedures in place. Staff we spoke with told us they had received training and read the policies and procedures.

The consulting and treatment rooms appeared clean and well lit. Procedures for the safe storage and disposal of needles and waste products were evident in order to protect the staff and patients from harm. These included wall mounted ‘sharps’ boxes and foot operated clinical waste bins.

We were shown around the practice and observed it provided spacious waiting, reception and consultation/treatment rooms. Patients we spoke with told us the waiting area was comfortable and they found the call system easy to follow.

The practice had a patient participation group in place. We saw the minutes of a meeting in March which included a request for changes to allow easier access to the consulting rooms for wheelchair users. The practice had acted upon this and changes to the door openings had been made.