Archived: Dr Jayesh Bhatt Also known as Park Medical Centre

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Dr Jayesh Bhatt on 9 June 2016. Overall the practice is rated as requires improvement.

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 however learning was not always clear and patients did not always receive information about the incident.
• Risks to patients were not always assessed and well managed. For example the practice had not addressed the action points identified in their infection control audit, testing of non-clinical electrical equipment had not been completed for a number of years and one of the oxygen masks had expired. In addition the practice were not undertaking adequate recruitment checks prior to employment including DBS checks and obtaining references for all new staff. The practice’s supply of emergency medicines was not in line with guidelines and the absence of certain medications had not been risk assessed.
• There were significant gaps in mandatory staff training including safeguarding, information governance, infection control and fire safety. Additionally basic life support training had not been completed by any staff member within the last 12 months. Evidence was provided after our inspection that this had been completed or was scheduled.
• There was no evidence of care planning for those with long term conditions or who were at the end of their lives. However we saw evidence that care was being delivered in line with current evidence based guidance. Staff had received clinical training 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. However responses to complaints were not entirely in line with current legislation and guidance.
• The majority of 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.
• With the exception of infection control issues and emergency equipment the practice had good facilities and was well equipped to treat patients and meet their needs.
• Though in a number of respects lines of responsibility were clear there was a lack of leadership or effective management in a number of areas; particularly infection control and training and recruitment. The practice proactively sought feedback from staff and patients, which it acted on.

The areas where the provider must make improvement are:

• Ensure that there is appropriate learning from significant events and that patients are always provided with a written apology and explanation of action taken to address the issues arising from significant events.

• Put systems and processes in place to ensure that mandatory training is completed at appropriate intervals.

• Take action to address and monitor all infection control risks.

• Put robust arrangements in place to ensure that the practice are able to respond effectively to medical emergencies including a risk assessment of required emergency medicines.

The areas where the provider should make improvement are:

• Consider installing a hearing loop in the reception area.

• Ensure that all clinical staff are aware of and acting in accordance with the mental capacity act 2005.

• Undertake regular reviews of the practice’s business plan.

• Assess the risks associated with non-medical electrical equipment and take appropriate follow up action to ensure those risks are mitigated.

• Continue to review staffing resources and ensure that sufficient numbers of staff are employed.

• Ensure that all appropriate pre-employment checks completed prior to new staff commencing employment and that all staff have a completed schedule of induction.

• Employ strategies to promote and increase breast screening and the number of reviews of patients with Chronic Obstructive Pulmonary Disease (COPD).

• Ensure that staff are completing care plans for all patients where appropriate and that appropriate action is taken in response to correspondence from other organisations.

• Consider advertising translation services in the practice waiting area.

Ensure complaints policy and responses comply with current legislation and that systems are in place to ensure compliance with the duty of candour.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice