We carried out an announced comprehensive inspection on Dr Hany Azmy 20 December 2017. The overall rating for the practice was good, although the practice was rated as requires improvement for safety. The full comprehensive report on the 20 December 2017 inspection can be found by selecting the ‘all reports’ link for Dr Hany Azmy on our website at .

This focussed inspection was carried out on 2 July 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach identified in the requirement notice.

The practice is now rated as good for safe services, and overall the practice is rated as good.

Our key findings were as follows:

• The practice had taken action to address the concerns raised at the CQC inspection in December 2017. It had put measures in place to ensure it was compliant with regulations.
• Staff training had been completed in key areas including Health and Safety, records of training were maintained to give management overview.
• Infection control audits had been completed.
• Control of substances hazardous to health (COSHH) data sheets were available.
• Emergency medicines, previously not held by the practice had been added to the existing supply.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 06/10/2015 Good, with key question Caring rated as Outstanding).

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection of Dr Hany Azmy, The Surgery 30 Brinnington Rd, Stockport on 20 December 2017. This inspection was carried out under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

• The GP and small staff team provided patient centred care and treatment that was appreciated by patients. Staff involved and treated patients with compassion, kindness, dignity and respect

• 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.

• Patients told us they liked the daily open surgeries and found the appointment system easy to use. They told us they were able to access care when they needed it.

• The practice had some systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes. However, improvements were required. These included undertaking an infection prevention and control audit and implementing actions in response to this, ensuring staff received regular mandatory training and maintaining records of this, reviewing the availability of emergency medicines and or implementing a risk assessment to mitigate any potential risks if not available.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

• Continue to work with the Public Health department to promote and encourage the uptake cervical screening.

• Records of staff induction training should be completed as soon as possible after the training is provided.

• Consider developing a formal patient participation group to consolidate communication channels.

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 The Surgery - Dr Hany Azmy on 06/10/2015. 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 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 liked the open surgery process at the surgery and said there was continuity of care.
• 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.

We saw some area of outstanding practice:

• The practice used enhanced communication methods with their patients to ensure they had sufficient information and knowledge to make informed decisions on their care. This included the use of the internet during consultations to provide a detailed explanation of any care or procedure.

• The practice had a very flexible process for seeing patients during their surgery times and patients were never turned away if the GP was on the premises.

• The GP had pioneered a process for photographs to accompany any referral to the dermatology specialists at the local NHS hospital. This had been commended by the CCG for other practices to follow. The photograph accompanying the referral allowed the dermatology surgeon to make an immediate decision as to the appropriate pathway for the patient.

• During the inspection the GP was able to show us evidence where he had advised a patient via text and a photograph on a skin condition which was causing concern. This had negated the need for the patient to attend the surgery.

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

Importantly the provider should;

• Ensure a written fire policy is available and fire risk assessment is carried out as soon as possible and there is adequate signage for all emergency exits in the surgery.

• Ensure there is an auditable system for reviewing and monitoring the recording of serial numbers on blank hand written and electronic prescriptions pads held in storage and once allocated to the GP.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice