Archived: Sinha Medical Practice

Updated 7 April 2016

The Sinha Medical Practice is located in the London Borough of Newham. The practice is part of the NHS Newham Clinical Commissioning Group (CCG) which is made up of 61 practices.it currently holds a PMS contract (a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract) and provides NHS services to 5600 patients.

The practice serves a diverse population with many patients attending where English is not their first language. The majority of the practice patient list is between the ages of 20 and 39. The practice is situated within a purpose built centre. Consulting rooms are available on two levels and there is a lift available for those patients with impaired mobility. The practice is currently run by McLaren Perry Limited. The practice staff comprised of two salaried GPs (male and female undertaking 8 and 5 sessions per week respectively), two long term locum GP’s (male and female undertaking 4 sessions per week each) a female practice nurse (10 sessions per week per week), practice manager, assistant practice manager and reception staff).

The practice is open between 8am and 6.30pm Monday to Friday. Appointments are from 9am to 11.30am every morning and 3.30pm to 6pm daily. Extended surgery hours are offered on a Saturday morning between 9am and 1pm. In addition to pre-bookable appointments that could be booked up to six weeks in advance, urgent appointments are also available for people that needed them. The practice did not provide out of hours treatment but referred patients to the local out of hour’s provider.

The practice has been inspected on a number of occasions, firstly in August 2013 where it was found to be non-compliant in the areas of safeguarding people who use the service from abuse and supporting workers. At the follow up inspection in July 2014 the provider was found to have complied with the regulations. The practice was inspected again on 27 May 2015 and was rated inadequate and urgently closed through a Section 30 order on 29 May 2015. The practice was re-opened and McLaren Perry took over the management of the practice in July 2015 as a new provider of services.

The service is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures, family planning, surgical procedures, treatment of disease, disorder or injury and maternity and midwifery services.

Updated 7 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Sinha Medical Practice on 28 January 2016. Overall the practice is rated as good.

The Sinha Medical Practice was inspected on 27 May 2015 and rated as inadequate. The issues found within the practice were so significant as to warrant urgent closure of the service through a Section 30 order of the Health and Social Care Act 2008. From July 2015 the practice re-opened under a new provider McLaren Perry Limited. .

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.
• Risks to patients were assessed and well managed.

• Previously published data was not available for the practice but the year to date data that was available showed patient outcomes were on target to meet the national average.

• A programme of continuous clinical and internal audit was being developed which was to be used to monitor quality and to make improvements.

• Not all staff had undertaken the necessary training needed to keep the practice safe including infection control, safeguarding and basic life support. However, a date was set for this training to be undertaken.

• Patients said they were treated with compassion, dignity and respect.
• Urgent appointments were usually available on the day they were requested.
• The practice had a number of policies and procedures to govern activity.
• The practice had an active patient participation group which was in the process of being developed further.

The areas where the provider must make improvements are:

• Ensure all staff receive the training needed to keep patients safe including safeguarding, infection control and chaperone training.

• Ensure all staff who carry out chaperone duties have received a Disclosure and Barring Service (DBS) check.

In addition the provider should:

• Follow up the actions identified in the infection control audit undertaken in June 2015.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 7 April 2016

The provider was rated as good for providing care to people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Performance for patients on the diabetes register (374 patients) that had received an annual review so far this year was 60%. The national average for 2014/2015 was 77%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 7 April 2016

The provider was rated as good for providing services to families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk. For example, children and young people who had a high number of A&E attendances.

• Immunisation rates for the standard childhood immunisations were mixed. For example the year to date

• Patients told us that children and young people were treated in an age-appropriate way and we saw evidence to confirm this.

• Appointments were available outside of school hours.

Updated 7 April 2016

The provider was rated as good for providing care for older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 7 April 2016

The provider was rated as requires improvement for providing services to working age people (including those recently retired and students)

• The practice offered extended opening hours for appointments on a Saturday morning.

• Patients could not book appointments or order repeat prescriptions online. The practice was in the process of developing this system.

• Health promotion advice was offered and there was accessible health promotion material available through the practice.

Updated 7 April 2016

The provider was rated as good for providing services to people experiencing poor mental health (including people with dementia)

• Sixty percent

• The practice worked with multi-disciplinary teams in the case management of people experiencing poor mental health.

• It carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• It had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health. Most staff had received training on how to care for people with mental health needs.

Updated 7 April 2016

The provider was rated as good or providing services to people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours. However not all staff had been appropriately trained.