This practice is rated as Good overall. (Previous inspection March 2015 – Good)

The key questions are rated as:

Are services safe? – Good

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 at Dr Muhammad Misbah-Ur-Rehman Siddiqui on 27 February 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear 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.

• 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.

• Staff involved and treated patients with compassion, kindness, dignity and respect. However, patient satisfaction with their consultations were below local and national averages.

• The practice understood the needs of its population and tailored services in response to those needs.

• Patient satisfaction with access to the service was below local and national averages. The practice were taking action to rectify this.

• There were effective leadership and governance arrangements.

The areas where the provider should make improvements are:

• Review antibiotic prescribing to bring in line with local and national averages.

• Review feedback from the national GP survey and implement actions to improve performance particularly in respect of access to the service.

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 9.00 am on 21 April 2015. The practice had previously been inspected during our pilot phase in August 2014. We must conduct inspections at those practices that were inspected during our pilot phase in order to provide a rating for the service under the Care Act 2014.

Overall the practice is rated as good.

Specifically, we found the practice to be requires improvement for providing effective services, good for providing safe, caring and responsive services and good for being well led. It was also good for providing services for the older people, people with long-term conditions, families, children and young people, working age people (including those recently retired), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

Our key findings were as follows:

Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses.

Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.

The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG).

The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.

There was clear leadership in place with named members of staff in lead roles.

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

The provider should:

Provide training for non-clinical staff in safeguarding children and vulnerable adults.

Provide annual update training for all staff in basic life support in line with the UK resuscitation council guidelines.

Ensure a legionella risk assessment is in place to identify and mitigate risk associated with legionella bacteria.

Ensure clinical audit cycles are completed to demonstrate improvements in patient outcomes.

Carry out annual, written appraisals for non-clinical staff.

Develop a vision for the practice which involves the improvement of the quality of patient care and share with staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We completed an announced comprehensive inspection of the service on the 27th August 2014. The practice is rated as good overall. This reflects the safety and quality of the provider’s provision of care and treatment on offer and the availability of suitable and qualified staff who are responsive to patients’ and the local community needs.  

Dr Muhammad Misbah-Ur-Rehman Siddiqui provides general practice (GP) services to over 3,300 patients within the Ruislip area of Hillingdon. There are two GPs, one practice nurse, one practice manager, two staff members for reception duties and two administration support staff. The practice is registered for providing the following regulated activities at this location: treatment of disease, disorder and injury, and diagnostic and screening procedures. The practice operates from a converted house with step free and wheelchair access and is situated on a suburban road with restricted parking. The practice is open Monday to Friday with a morning surgery from 09:00 to 12:00 midday and evening surgery from 17:00 to19:30 hours and is closed half a day on Thursdays from 013:30. We carried out an announced inspection on the 27 August 2014. During our inspection we spoke with patients and four members of the Patient Participation Group (PPG) and reviewed 33 Care Quality Commission (CQC) comment cards that had been completed by patients during the two week period prior to our visit. Patient feedback about the care and treatment they received was mainly positive, although some commented negatively about the size of the waiting area, securing an appointment or getting though through to the practice on the telephone to make an appointment.

Our key findings were as follows:

• Arrangements for reporting incidents were in place. Complaints and significant events were recorded and discussed, and learning from them was shared with the practice team. Infection prevention and control policies and procedures were in place and staff had completed infection control training. The provider had adequate staff numbers in place to provide care and treatment to patients.
• Staff were skilled and qualified to do so. There were effective governance arrangements, and systems in place to conduct regular audits and reviews of patient care plans and treatment to support and manage patients in the treatment of disease, disorder or injury effectively.
• Patients were cared for in a kind and compassionate manner, and were treated with dignity and respect at all times. The provider was engaging with the local community and other services and organisations to support and deliver appropriate care to the patient population list.

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

Importantly, the provider must take action to:

• Take action to ensure that at all times, there are sufficient numbers of suitably qualified skilled and experienced persons employed for the purposes of carrying out the regulated activity.
• Implement formal procedures for recording and documenting records of all staff meetings and minutes to safeguard internal practice and information challenges.

In addition the provider should take action to:

• Ensure that the practice leaflet is up to date with information on what to do when the practice is closed during the day.
• Make the patient leaflet available within the waiting area of the practice.
• Update the practice induction policy and documentation which was out of date.

Plan, agree and record meetings with the Patient Participation Group (PPG) to formalise arrangements and communication around practice specific concerns, issues or suggestions.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice