Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hirsel Practice also known as Dr Geetha Ramachandran & Dr Prasanna Balakrishnan on 07/10/2015. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• 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.
• Patients said and that there was continuity of care, with urgent appointments available the same day. Several patients said they found it difficult to make an appointment and accessing same day appointments.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

However there were areas of practice where the provider needs to make improvements.

Importantly the provider should

• Ensure there is a practice business plan.

• Ensure action plans are formalised with named staff responsible for implementation.

• Ensure access to appointment and telephone consultations are promoted to patients.

• Ensure medicines required in an emergency are easily accessible

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Geetha Ramachandran & Dr Prasanna Balakrishnan (Hirsel Surgery), 5 Trinity Mews, North Ormesby, Middlesbrough. TS3 6AL on 14 January 2019. Our inspection team was led by a CQC inspector and included a GP specialist advisor.

Our judgement of the quality of care at this service is based on a combination, of what we found when we inspected, information from our ongoing monitoring of data about services, and information from the provider, patients, the public and other organisations.

We have rated this practice as good overall.

We concluded that:

• Systems were in place to report, record and disseminate learning from significant events and complaints.
• Staff worked to clear protocols and evidence based clinical guidance to meet patients’ needs.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines
• Quality improvement activity was carried out which resulted in improved outcomes for patients.
• Staff treated patients with courtesy and respect. Feedback from patients confirmed this.
• The leadership, governance and culture of the practice promoted an inclusive supportive environment for staff.

Whilst we found no breaches of regulations, the areas where the provider should make improvements are:

The practice should improve in their identification of carers.

The practice should carry out a fire drill.

Details of our findings and the evidence supporting our ratings are set out in the evidence table.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice