Archived: Dr Rajesh Patel

Updated 24 March 2017

Dr Rajesh Patel (The Fullwell Avenue Surgery) provides primary medical services in Ilford to approximately 3320 patients and is a member of NHS Redbridge Clinical Commissioning Group (CCG).

The practice population is in the fifth least deprived decile in England. Twenty-five percent of children live in income deprived households compared to a local average of 19% and a national average of 20%. The practice had surveyed the ethnicity of approximately 88% of the practice population and had determined that 40% of patients described themselves as white, 30% Asian, 10% black and 3% as having mixed or other ethnicity.

The practice operates from a converted residential property with all patient facilities on the ground floor which is wheelchair accessible. There are offices for administrative and management staff on the ground floor.

The practice operates under a General Medical Services (GMS) contract and provides a number of local and national enhanced services (enhanced services require an increased level of service provision above that which is normally required under the core GP contract). The enhanced services it provides are: meningitis immunisation; alcohol brief intervention; childhood vaccination and immunisation scheme; facilitating timely diagnosis and support for people with dementia; influenza and pneumococcal immunisations; learning disabilities; patient participation; rotavirus and shingles immunisation; and unplanned admissions.

The team at the surgery is made up of one full- time male principal GP along with one part-time female salaried GP. The doctors provide 13 clinical sessions per week. The nursing team consists of one part-time female practice nurse. There are three administrative and reception staff and a full-time practice manager.

The practice is open:

Monday to Wednesday and Friday between: 8.30am to 1.00pm and 2.00pm to 6.30pm.

Thursday: 8.30am to 1.00pm.

Appointments are available:

Monday to Wednesday and Friday between 8.40am to 12.00pm and 3.10pm to 6.00pm.

Thursday between 8.40am to 12.00pm.

The practice does not open on a weekend. The practice has opted out of providing out of hours (OOH) services to their own patients when it is closed and directs patients to the OOH provider for NHS Redbridge CCG.

Dr Rajesh Patel (The Fullwell Avenue Surgery) is registered as a sole practitioner with the Care Quality Commission to provide the regulated activities of: diagnostic and screening procedures; treatment of disease, disorder or injury; maternity and midwifery services.

This practice has not previously been inspected by CQC.

Updated 24 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Rajesh Patel (The Fullwell Avenue Surgery) on 8 December 2016. Overall the practice is rated as good.

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

• The practice was holding regular clinical and practice meetings but was not regularly recording minutes of meetings to reflect matters discussed, decisions reached and action taken.
• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• 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.
• 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.
• 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 should make improvement are:

• Record minutes of clinical and practice meetings to reflect discussions, decisions reached and any actions that follow.

• Develop a protocol for the use and maintenance of the newly purchased defibrillator and ensure that staff are trained in its use.

• Review and correct coding errors that impacted on the practice’ QOF achievement, including in relation to patients diagnosed with dementia.

• Continue to review the practice complaints policy to ensure that both verbal and written complaints are recorded in line with national guidelines.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 March 2017

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.

• 76% of patients with diabetes had a blood sugar level within the acceptable range measured in the preceding 12 months, which was comparable to the national average of 78%.

• 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 24 March 2017

The practice is rated as good for the care of 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 were relatively high for all standard childhood immunisations.

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

• 79% of women aged 25-64 had had a cervical screening test performed in the preceding 5 years, which was comparable to the national average of 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 24 March 2017

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.

• Patients at risk of emergency hospital admission had risk assessed care plans.

Updated 24 March 2017

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 was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.

• Patients could book appointments and request prescriptions online.

Updated 24 March 2017

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

• 63% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was below the national average of 84%.

• 88% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive agreed care plan in the preceding 12 months, which was comparable to the national average of 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 24 March 2017

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

• The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability.

• 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.