Letter from the Chief Inspector of General Practice

This is the report of findings from our inspection of Dr Z Ahmed at Sun Valley medical Practice Oldham.

We carried out a comprehensive inspection on 3rd March 2015. We spoke with patients, a member of the patient participation group (PPG), and staff including the management team.

The practice is rated as Good. A safe, effective, caring, responsive and well-led service is provided that meets the needs of the population it serves.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised to support improvement.
• The practice was using innovative and proactive methods to improve patient outcomes and it links with other local providers to share best practice. It was involved in a local scheme with community groups where a holistic approach to health and social care is being trialled.
• Patients said they were treated with compassion, dignity and respect and they were involved in care and treatment decisions. Accessible information was provided to help patients understand the care available to them.
• The practice implements suggestions for improvements and makes changes to the way it delivers services as a consequence of feedback directly from patients, community groups and from the Patient Participation Group (PPG).
• The practice had a clear vision which had quality and safety as its top priority. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

We saw several areas of outstanding practice including:

• The practice had secured external funding and was actively working with a housing association group to screen and manage patients registered with GPs across the locality for the early signs of dementia.
• The practice had close links with local community groups for ethnic minority population groups in the locality and was active in assisting these groups to manage the expectations of their members in a number of health related issues including choosing a ‘preferred place to die’.
• The practice had volunteered to facilitate MIND with space within the practice for two days per week to assist patients with Improving Access to Psychological Therapies (IAPT). MIND is a mental health charity that works to reduce the stigma and raise awareness of mental health problems.

• Patients over 75 years of age residing at home or in a care home, patients with a diagnosis of dementia or those on the palliative care register had access to a named ‘champion’ within the administration team to assist them with any access, complaints or questions they may have. This ‘champion’ rang the patients weekly to ask if they had any needs they could assist with.

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

The provider should:

• Ensure multi-disciplinary meetings are fully recorded and shared with all members of the meeting.
• Ensure an auditable system for reviewing and monitoring the recording of serial numbers on blank hand written prescriptions pads held in storage and once allocated to GPs.
• Raise awareness of risk management within the practice with all staff groups and document risk assessments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Our inspection of 3 October 2013 found that there was no effective recruitment system in place and there was no effective system in place to assess and monitor the quality of the service.

During this inspection we found that a recruitment policy had been put in place and there were personnel files for all staff. The identity of all staff had been confirmed. A Disclosure and Barring Service (DBS) check had not been completed for the recently-employed practice nurse but this was returned within three working days of our inspection.

We saw that the Patient Participation Group (PPG) had started to meet regularly with a view to improving the service. A patient survey had been carried out by the PPG. A new system had been put in place to ensure emergency drugs and equipment were available and ready for use.

The medical practice was accessible to people who used a wheelchair or had mobility problems. The design of the practice , meant there was little privacy in the reception area. However, a private room was available if patients wished to speak with a receptionist in private. An interpreter who spoke several languages was available for patients did not speak English as their first language.

Emergency drugs and equipment were available if a patient had a medical emergency at the practice. Staff had been trained in emergency life support.

The majority of patients we spoke with and those who had completed a survey stated they found appointments difficult to access. The results of the survey had not been analysed.

The building manager carried out regular checks on the quality of the cleaning. They put action plans in place where improvements could be made.

There was no effective recruitment system in place and checks were not completed before staff started work.

There was no system in place to monitor and assess the quality of service that patients received.