Dr Uday Kanitkar Also known as Moss Side Medical Centre

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

The practice had systems and processes to keep clinicians up to date with current evidence-based practice. We found that patients’ immediate and ongoing needs were fully assessed. These included interventions required to ensure effective care was delivered. Do not attempt cardiopulmonary resuscitation orders were appropriately completed. However, clinical audit cycles were not a priority.

This service scored 33 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The inspection of 30 and 31 August 2023 found patients were identified who had a potential missed diagnosis of diabetes. Patients with hypothyroidism did not routinely have regular thyroid function tests. Patients with asthma who had been prescribed 2 or more doses of steroid medication in 12 months were not issued with steroid warning cards. At this assessment the practice told us they had carried out searches, reviewed all the patients identified at the previous inspection, contacted the patients and updated the records.

Our clinical searches found only 2 patients with a potential missed diagnosis of diabetes. We reviewed the records of these patients, and both had been coded as being pre-diabetic. Both also had the appropriate reviews in place. For patients with hypothyroidism, we saw only 1 of 202 patients had not had a thyroid function test in 18 months, and they had been recalled repeatedly. Steroid warning cards were discussed with the Registered Manager. They told us that steroid warning cards were issued, and these were either electronic or in a format that could be printed.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

The inspection of 30 and 31 August 2023 found that there was a lack of quality improvement initiatives, including clinical and non-clinical audits and an annual audit plan. We saw 2 audits, carried out by trainees at the practice. These were a 2 week rule referrals audit dated May 2023 and a high opioid use audit dated July 2022. For both audits, it was not apparent that the conclusions and recommendations from the audit had been actioned nor had led to any meaningful outcome or improvements. At this assessment the Registered Manager told us, during their interview, that there was an audit programme with different audits being carried out monthly, 3 monthly, 6 monthly or annually. They told us they had carried out a few audits which they would share on our site visit, and they had oversight of these audits. At the site visit they told us there was no documented audit programme; they knew what audits to carry out as they were decided on at each practice meeting. They told us that since the previous inspection they had carried out a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) audit and updated their opioid audit, but not carried out any further clinical audits. They said the medicines management team carried out anti-biotic prescribing audits.

The practice supplied us with the results of 1 clinical audit, “A QIP on High Dose Opioid Prescriptions at Moss Side Medical Centre”. This had been carried out by a doctor in their second year of general practice training. It was not dated so we could not determine the period the audit covered. There was a section titled ‘Results and comparison from audit in 2023’. However, the only comparison made was for the number of patients fitting the criteria of the audit. There was no comparison of results. In addition, we were not provided with any audit from 2023; the initial audit we had been provided with at the previous inspection was dated July 2022. The practice provided us with the minutes from their 4 most recent practice meetings. We examined these to check what discussion around audits had taken place. The meeting minutes for 7 December 2023, 27 February 2024 and 21 May 2024 did not contain any information about clinical audits. The February 2024 minutes stated that a staff member had been appointed as the health and safety representative. It was noted that they were not in work at the time of the meeting but they would complete monthly audits on their return. The minutes from the practice meeting on 9 April 2024 made 2 references to audits. They stated, “Dr Sid completed scan audit coding up to Feb. March due”. This was the dip sampling carried out by the Registered Manager, previously referred to. The minutes also stated, “2 clinicians have commenced audit on high dose opioids px and DNACPR”. We saw no evidence of discussion around what audits should be completed or what was due to be repeated.

We were not provided with any evidence to confirm recommendations from previous clinical audits had been actioned, and we saw no evidence of any meaningful outcome or improvements following the completion of a clinical audit cycle.

The inspection of 30 and 31 August 2023 found issues with all 5 DNACPR orders we checked. Mental capacity assessments were not being carried out appropriately, and a mental capacity assessment was carried out for 1 patient without any consultation being recorded. At this assessment the Registered Manager told us they had carried out a DNACPR audit and were assured all current orders were appropriately in place.

Our clinical searches found a DNACPR order was in place for 3 patients in total. We reviewed the records for all 3 patients. All records provided full details of why the orders had been put in place and there was a record of a discussion with the patient and/or their family. We saw that mental capacity had been considered and appropriately assessed.