Dr A Hayat & Partners Also known as Maybush Medical Centre

We carried out an announced comprehensive inspection at Dr A Hayat & Partners on 14 February 2018. The overall rating for the practice was good, with a rating of requires improvement for providing safe services. The full comprehensive report on the February 2018 inspection can be found by selecting the ‘all reports’ link for Dr A Hayat & Partners on our website at .

In addition to the areas for improvement identified under the key question of providing safe services, at the inspection on 14 February 2018 we also said the practice should consider improving the following areas:

• Review the areas of low patient satisfaction contained in the National GP Patient Survey linked to timely access to the service and take steps to improve patient satisfaction in these areas.
• Review and complete the current work developing capacity to enable support and mentoring processes to be in place for all clinical areas.

This inspection was an announced focused inspection carried out on 11 September 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulations that we identified at our previous inspection on 14 February 2018. This report covers our findings in relation to those requirements, and also additional improvements made since our last inspection.

Overall the practice is now rated as good, with the practice rated as good for providing safe services.

Our key findings were as follows:

• The practice had adopted a suite of health and safety risk assessments which had been embedded within the practice. We saw that health and safety issues had been discussed at team meetings.
• The practice had reviewed and updated a number of key policies and procedural documents such as safeguarding, chaperoning and infection prevention and control. These had been reissued and were available to staff on the practice computer system and in hard copy format.
• Issues identified in relation to the infection prevention and control audit carried out in September 2017 had been addressed, with improvements made.
• New processes and procedures had been put in place for issuing and recording blank prescriptions. Staff had been informed of the revised processes and, as required, had been given specific duties in the operation of these new procedures.
• The practice had proactively carried out an extensive risk assessment exercise regarding key areas of practice activity. This had resulted in the identification and subsequent improvement of workstreams which included prescription handling, pathology processes and chaperoning.
• In the previous inspection report we had informed the practice that they should review and complete work that was underway to develop capacity to increase support and mentoring processes for clinical activities. We saw during the inspection that the practice had increased capacity in this area, improved induction processes, and expanded training opportunities and workforce development.
• In the previous inspection report we had informed the practice that they should review areas of low patient satisfaction contained in the National GP Patient Survey linked to timely access. Whilst areas of satisfaction had not improved in the latest release of this survey data in August 2018 (from views collected January to March 2018), the practice was able to demonstrate that it had:
  • Reviewed the latest data and developed an action plan to improve satisfaction. Activities included increasing the salaried GP’s availability.
  • Recruitment of extra GP sessional cover.
  • Worked with the Patient Participation Group to improve the understanding and expectations of patients with regard to appointment access.

         The practice told us that they would continue to seek improvement in this area.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

This practice is rated as Good overall.

The practice was previously inspected in September 2015 when it was rated Good overall.

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Dr A Hayat & Partners on 14 February 2018 as part of our inspection programme and also because the practice had recently experienced organisational change and new GP partners had taken over the running of the practice.

At this inspection we found:

• The practice had some systems in place to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes. However it was noted that some policies and procedures were out of date and needed review; that some health and safety risk assessments had yet to be fully embedded in the practice and that actions in relation to a recent infection prevention and control audit had not been fully complied with within required timescales.

• The practice routinely reviewed the effectiveness, quality and appropriateness of the care it provided. For example, we saw that the practice had carried out a number of clinical audits over the last six months.

• We were informed by patients that staff involved and treated patients with compassion, kindness, dignity and respect.

• The practice worked with secondary care providers to deliver a quarterly diabetes clinic for patients with more complex needs.

• The practice had introduced a patient liaison service which sought to deal with patient concerns and complaints quickly and effectively and to prevent further escalation.

• Clinical waste was not correctly labelled so as to identify the practice as the originator.

• The practice procedure for issuing and recording blank prescriptions was not understood by all staff involved in the process.

The area where the provider must make improvements as they are in breach of regulations is:

• Ensure care and treatment is provided in a safe way to patients.

The areas where the provider should make improvements are:

• Review the areas of low patient satisfaction contained in the National GP Patient Survey linked to timely access to the service and take steps to improve patient satisfaction in these areas.

• Review and complete the current work developing capacity to enable support and mentoring processes to be in place for all clinical areas.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice