Dr Uday Kanitkar Also known as Moss Side Medical Centre

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The practice did not have a culture to drive high quality sustainable care. Systems of accountability to support good governance and management were not in place. Risks, issues, and performance were not effectively managed. Systems and processes for learning, continuous improvement and innovation were not effective.

This service scored 25 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Since the previous inspection on 30 and 31 August 2023 a GP had joined the practice as a joint lead GP. They also spent half their time at a neighbouring practice. The practice manager who had been employed at the previous inspection had left. The business manager from the same neighbouring practice as the new GP had started to work at the practice, and they split their time between the 2 sites. This business manager left both practices the day following our first site visit during this assessment. A new business manager started work the week prior to our 1st site visit, and they were also splitting their time between 2 practices. The practice told us that the 2 GPs and the business manager had been leading on the improvements required following our previous inspection. The 2 lead GPs told us they were surprised by the issues we found during this inspection. They said they had delegated non-clinical issues to the business manager who they had trusted. The 2 lead GPs had prioritised improving clinical issues found during the previous inspection. Staff told us they felt supported by leaders and managers, who were visible and approachable.

Governance, management and accountability arrangements were not clear or effective. A document titled “working doc cqc march 24” gave information about changes the practice had made and would make following our August 2023 inspection. There was no indication as to who had written the document. It was not being monitored and priority had not been given to making the necessary improvements. For example, the document stated all out of date clinical items had been removed from the practice and a new system of audit would be in place to prevent recurrence. We found out of date items with an expiry date of prior to the previous inspection, along with more recently expired items, so this system was not effective. It stated that training or refresher training in waste management would be put in place for all staff. This had not happened. The document stated, “We are committed to cooperating fully with the CQC and other regulatory authorities. I will ensure that all requested evidence is provided promptly and accurately, demonstrating our commitment to compliance and quality improvement”. Systems of governance were not in place to enable the practice to provide us with information in a timely manner, and some evidence we requested to be submitted a week prior to our site visit was still not available on the day of our first site visit. The document stated, “In conclusion, we take the concerns raised by the CQC very seriously, and we are fully committed to addressing them in a timely and effective manner. We are confident that the actions outlined above demonstrate our dedication to ensuring the safety, wellbeing, and quality of care for all our service users”. Although some areas of concern had been actioned, such as concerns we had with the monitoring of patients prescribed high risk medicines, undiagnosed long term conditions, and the process of implementing DNACPR orders, it had not been recognised that improvements had not been made around other areas of concern.

The inspection of 30 and 31 August 2023 found little evidence of learning, improvement, and innovation. At this assessment the lead GPs told us their last CQC inspection had been the biggest challenge they had faced. They said they had made improvements and put plans in place over the past 8 months, and they felt more happy and confident that they had made the improvements. They told us they had reflected on our findings and responded by changing management and putting systems and processes in place to ensure good quality of care. The lead GPs told us they were both GP trainers and so regularly had GP trainees in the practice. In addition, they had recruited salaried GPs who had been their trainees. They said they encouraged the development of clinicians and also supported non-clinicians who wanted career development.

Leaders did not have a good understanding of how to make improvements happen. Although the lead GPs described new systems that were in place and improvements that had been made, our assessment found that a lot of the required improvements had not taken place. The GPs had prioritised clinical improvements. With the exception of the authorising of nurses and healthcare assistants to administer injections, and the availability of clinical audit cycles, we saw improvement in clinical areas. Improvements to the governance within the practice had not been evidenced. Processes to ensure that learning happened when things went wrong were not effective. Significant events were not well-organised or documented, so opportunities to make improvements were not taken.