Dr Haffizullah Bhat Also known as Savile Town Medical Centre

Updated 31 May 2017

Dr Haffizullah Bhat provides services for 3,044 patients and is situated in the Savile Town area of Dewsbury at 786 Scarborough Street, Dewsbury WF12 9AY.

Dt Haffizullah Bhat is situated within the North Kirklees Clinical Commissioning Group (CCG) area.

The practice is based in a rented two storey property which has been renovated to improve disabled access and infection prevention and control, and to provide an additional consulting room and office

They offer a range of enhanced services such as childhood immunisations and extended hours opening.

The practice is situated in a relatively deprived area in the second decile on the scale of deprivation. The practice has a diverse ethnic population with 91% of patients reporting themselves as being from a black and ethnic minority population.

There is one whole time equivalent male GP and a female partner who provides three clinical sessions per week. A male locum GP from another local practice provides cover as required. A female locum advanced nurse practitioner works two days per week. The clinical team are supported by a practice manager and a team of administrative staff. The practice manager and a member of the reception team were trained to provide phlebotomy services.

The practice is open between 8am and 6.30pm Monday to Fridays. Appointments are available 9.30am to 1pm every morning and 3.45pm to 6pm daily. Extended hours appointments are offered 6.30pm to 8pm on Mondays.

Out of hours services are provided by Local Care Direct and can be accessed either by using the practice telephone number or through NHS111.

When we returned for this inspection we checked and saw that the previously awarded ratings were displayed as required in the premises and on the practice’s website.

Updated 31 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Haffizullah Bhat on 28 July 2016. The practice is rated as requires improvement for safety. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Not all risks to patients were assessed and well managed. For example, Staff were not familiar with how to operate the temperature gauge on the vaccine fridge. The temperature of the vaccine fridge had exceeded the accepted minimum and maximum temperature of the accepted range for the safe storage of vaccines.
• Emergency medicines were not easily accessible. We noted that one of the emergency medicines had expired. The practice did not stock some emergency medicines and this had not been risk assessed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had a vision to deliver high quality care, promote good outcomes for patients and treat all patients fairly and equally. Staff were clear about the vision and their responsibilities in relation to it.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

• The practice must ensure staff understand and follow practice policies and procedures for the management of the vaccine fridge and the cold chain.
• Review the arrangements for the storage and develop systems to monitor expiry dates for emergency medicines and equipment. Carry out a risk assessment to identify a list of medicines that are suitable for the practice to stock and provide emergency oxygen at the practice.

The areas where the provider should make improvement are:

• Review the labelling arrangements for clinical waste bags to be able to identify the source of the waste in line with current legislation and guidance.
• Review and update the information in the complaints policy and procedure about how to take action if patients are not satisfied with how the complaint is dealt with. Discuss the complaints procedure with staff to ensure they are familiar with practice procedures.
• The practice should continue to monitor their QOF exception reporting rates in line with their exception reporting policy to ensure that patients are only excepted when there is justification for doing so.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 4 November 2016

The practice is rated as good for the care of 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.
• The GP had a special interest in diabetes and the practice provided a level three service for diabetic patients. Level three diabetic care is the management of patients stabilised on injectable therapies. Performance for diabetes related indicators was better than the national average. For example, 100% of patients with diabetes, on the register, had a record of a foot examination and risk classification (CCG average 89%, national average 88%).
• Patients were provided with shared management plans to help them manage long term conditions. For example, patients with hypertension (high blood pressure) were provided with their results and any recommended actions. Blood pressure monitoring devices were loaned to patients and they were provided with a template to record their own blood pressure readings to discuss at their next review appointment.
• 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 31 May 2017

Updated 4 November 2016

The practice is rated as good for the care of 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.
• The practice encouraged patients aged over 65 to be vaccinated against seasonal flu. The practice had received a letter from NHS England congratulating them on increasing the percentage of eligible patients who received the vaccination from the previous year and achieving the national target of 75%.
• The practice encouraged its patients to attend national screening programmes for bowel and breast cancer screening. Uptake rates for screening were low. For example, 21% of patients aged 60 to 69 were screened for bowel cancer in the preceding 30 months (CCG average 55%, national average 58%).
• Older people with frequent hospital accident and emergency (A&E) or out-of-hours contact were included on the avoiding unplanned admissions register. This provided patients with priority for appointments and an individual care plan which enhanced GP awareness of any specific needs.

Updated 4 November 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
• The practice offered extended hours clinics on a Monday evening until 8pm for working patients who could not attend during normal opening hours.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.
• The ‘patient pod’ was available in the waiting room which enabled patients to test their blood pressure and carry out self assessments during opening hours. We observed staff assisting patients to use the equipment.
• The practice offered telephone consultations to patients who were unable to attend the surgery.
• Text messages were sent to patients to remind them of their appointment.

Updated 4 November 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• 100% of patients diagnosed with dementia had their care reviewed in a face-to-face review in the preceding 12 months which is better than the national average of 84%.
• Performance for mental health related indicators was better than the national average. 100% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan documented in the record, in the preceding 12 months (CCG average 89%, national average 88%).
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice 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.
• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 4 November 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• Staff were aware of how to identify adults and children at risk who were known to local safeguarding services and the police. However, not all staff were aware if there was a system to identify patients who were vulnerable or at risk in the practice.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• 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.