Dr Amanullah Shamsher Khan Also known as Khan Medical Practice

Updated 10 May 2017

Dr Amanullah Shamsher Khan surgery also known as Khan Medical Practice is located in Walsall West Midlands. It is situated in a multipurpose modern built NHS building, providing NHS services to the local community. Based on data available from Public Health England, the levels of deprivation in the area served by Khan Medical Practice are lower the national average, ranked at one out of 10, with 10 being amongst the least deprived. The practice serves a higher than average patient population aged under 64 and over 85 years.

There are1,880 patients of various ages registered and cared for at the practice. Khan Medical Practice is a single handed GP practice. Services to patients are provided under a General Medical Services (GMS) contract with the Clinical Commissioning Group (CCG). GMS is a contract between general practices and the CCG for delivering primary care services to local communities.

The practice has expanded its contracted obligations to provide enhanced services to patients. An enhanced service is above the contractual requirement of the practice and is commissioned to improve the range of services available to patients.

Dr Amanullah Shamsher Khan is registered with the Care Quality Commission (CQC) to deliver Diagnostic and screening procedures, Family planning, Maternity and midwifery services, Surgical procedures, Treatment of disease, disorder or injury.

The practice is situated on the ground floor of a multipurpose building shared with other healthcare providers. There is parking for cyclists and patients who display a disabled blue badge. The surgery has automatic entrance doors and is accessible to patients using a wheelchair.

There is a single male GP. The nursing team is made up of one practice nurse and one health care assistant. Service delivery is supported by a practice team which consists of one practice manager, one data clerk and four receptionists.

The practice is open between 8am to 7.30pm on Mondays, and 8am to 6.30pm Tuesdays to Thursdays and 8am to 1pm on Fridays.

GP consulting hours are from 9am to 11am and 4:30pm to 6:30pm Monday to Thursday, Friday consulting times are from 9am to 12pm. GP extended hours are offered on Mondays from 6.30pm to 7:30pm.The practice has opted out of providing cover to patients in their out of

hours period. During this time services are provided by Primecare. The practice also has a contract with Waldoc who provide cover from 1pm to 6.30pm on Fridays.

Updated 10 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Amanullah Shamsher Khan surgery also known as Khan Medical Practice on 21 June 2016. The overall rating for the practice was good. The full comprehensive report on the June 2016 inspection can be found by selecting the ‘all reports’ link for Dr Amanullah Shamsher Khan surgery on our website at www.cqc.org.uk.

This inspection was an announced desk based inspection carried out on 28 March 2017 to confirm that the practice had carried out their plan to meet the required improvements in relation to the breaches in regulations that we identified in our previous inspection on 21 June 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall, the practice continues to be rated as good.

Our key findings were as follows:

• Since our comprehensive inspection, which took place in June 2016 the practice management team reviewed their policies to ensure all staff had received a Disclosure and barring service check (DBS). As a result DBS checks had been carried out non-clinical staff members.

• Previously staff we spoke with were unable to provide documentation to evidence that fire safety checks had been carried out. During the follow up inspection, we were provided with documents which showed that fire safety checks were taking place.

• When we carried out the comprehensive inspection we saw that the practice did not have access to medicines which could be used to respond to suspected opioid overdose or carry out a risk assessment to mitigate identified risks. During the follow up inspection staff explained that they have access to appropriate medicines within the practice, staff had received training and guidelines which staff were required to follow were in place.

• Data from the January 2016 national GP patient survey showed that the practice were below local and national averages for its scores on consultations with GPs. As a result staff we spoke with as part of the follow up inspection explained that during team meetings they discussed how to effectively greet patients. GPs were advised to obtain an overview of patient’s conditions before calling them into consultation rooms and were advised to place less focus on the computer monitors and actively engage in patient conversation. As a result data from the 7 July 2016 national GP patient survey showed improvements in all areas.

• Previous data from the National Cancer Intelligence network published March 2015 showed that the practice were performing below local and national averages for the uptake of breast and bowel cancer screenings.

• During the desk based follow up inspection members of the management team explained that the practice were taking part in a CCG programme which involved carrying out a search to identify eligible patients. Letters were sent to all identified patients, those who had not contacted the practice were followed up by the practice nurse and health care assistant to encourage them to book appointments. Data provided by the practice showed that further improvements had been made to engage patients with national screening programmes.

• March 2015 data showed that exception reporting for cancer related indicators was above local and national average (Exception reporting is the removal of patients from QOF calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of side effects).

• Staff we spoke with as part of the March 2017 follow up inspection explained that there has been a reduction in the use of exception reporting as GPs were advised to make further attempts to encourage patients to attend for reviews and national screenings.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 October 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. We saw that the practice held a data base to monitor their unplanned admissions and there was clear evidence of actions taken to reduce further hospital admissions. For example the GP carried out follow up appointments.

• Performance for diabetes related indicators was similar to the national average. For example, 81% had a specific blood glucose reading of 64 mmol/mol or less in the preceding 12 months (01/04/2014 to 31/03/2015) compared to the CCG and national average of 78%.

• The percentage of patients with diabetes on the register who had had influenza immunisation in the preceding 1 August to 31 March (01/04/2014 to 31/03/2015) was 99%, compared to the CCG average of 97% and national average of 94%.

• 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 7 October 2016

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. We saw positive examples of joint working with safeguarding

• The practice held nurse-led baby immunisation clinics and vaccination rates were relatively high for all standard childhood immunisations.

• The practice provided family planning and contraceptive which included IUDs (coils), implants and Depo-Provera injections (a hormone injection used to prevent pregnancy).

• Staff we spoke with were able to demonstrate how they would ensure children and young people were treated in an age-appropriate way and that they would recognise them as individuals.

• The practice’s uptake for the cervical screening programme for patients aged 25-64 in the preceding five years was 80%, which was comparable to the CCG average of 81% and the national average of 82%.

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

Updated 7 October 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, for example they offered weekly support to registered patients who resided in a local care home. Home visits and urgent appointments were available for those with enhanced needs.

• Data provided by the practice showed that 95% of patients aged 75 plus had had their health needs reviewed in the past two years.

• The practice held a list of patients over the age of 65 who were unable to access the practice and those residing in care homes. For example 20% were in residential care homes, 3% in nursing care homes and 20% were house bound. We were told that the GP carried out weekly visits to care homes and provided home visits for housebound patients.

• The practice provided data which showed that their uptake for the flu vaccination for patients aged 65 plus was 80%.  

Updated 7 October 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 was proactive in offering online services such as access to appointments and repeat prescription requests as well as a full range of health promotion and screening that reflected the needs for this age group.

• The practice provided new patient health checks and routine NHS health checks for patients aged 40-74 years.

• The practice offered extended clinic hours on Mondays from 6:30pm to 7:30pm.  

Updated 7 October 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 had their care reviewed in a face to face meeting in the last 12 months, which was above the national average of 84%.

• Performance for patients with a mental health related disorder who had a comprehensive, agreed care plan documented in their record, in the preceding 12 months was above the national average

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. For example, the GP carried out weekly visits to the local residential and nursing care homes. The GP also held a list of patients unable to access the practice who they visited upon request.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations, we also saw posters located in the reception area.

• 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 we spoke with had a good understanding of how to support patients with mental health needs and dementia.

Updated 7 October 2016

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 (LD). The practice provided data which showed that 90% of patients with a LD have had a care plan, medication and face to face review in the last 12 months.

• 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. For example they provide shared care service in partnership with the local addiction service for patients with opiate dependency allowing them to obtain their medication at the surgery. The practice found that this reduced stigma and allowed the practice to manage any physical and psychological problems that may coexist with illicit substance misuse.

• 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.

• Carers of patients registered with the practice had access to a range of services, for example annual health checks, flu vaccinations and a review of their stress levels.