Archived: Dr Asma Moghal Also known as Becontree Medical Centre

Updated 21 April 2017

Dr Asma Moghal’s Practice, Becontree Medical Centre is a purpose built practice located in a residential area in Dagenham. There is suitable patient access to the premises and patient parking, including disabled parking. At the time of our inspection there were 5900 patients registered with the practice. Primary medical care is provided under a personal medical services (PMS) contract within NHS Barking and Dagenham Clinical Commissioning Group (CCG). The practice carried out regulated activities: surgical procedures, treatment of disease, disorder or injury, diagnostic and screening procedures, maternity and midwifery services and family planning.

Dr Asma Moghal is the registered manager of the practice and the lead GP. There is one female salaried GP and they are supported by five regular locum GPs. The GPs undertake a combined total of 22 sessions per week. There is one full time nurse and two part time nurses and one part time healthcare assistant who work between Monday to Friday. Non-clinical staff includes, a practice manager, administration manager, reception supervisor, practice secretary and seven part time reception staff.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments are from 9am to 12pm every morning and 2.30pm to 6.30pm daily, with the exception of Wednesdays, when the practice is closed from 1.30pm. Extended hours appointments are offered on Monday, Tuesday and Thursdays with the practice nurse between 6.30pm and 8pm and between 6.30pm and 7pm on Fridays with a GP. In addition to pre-bookable appointments that can be booked up to one week in advance, urgent appointments are also available for patients that needed them. Out of hours service is provided by a different provider and can be accessed by calling the practice out of hours telephone number which is on the practice website and practice leaflet.

The practice population of people aged 65 years and over is lower than the national average. Life expectancy is lower for both male and female people, being 77 years for males and 81 years for females, compared to national averages of 79 years for males and 83 years for females.

Information published by Public Health England rates the level of deprivation within the practice population group as two on a scale of one to 10. Level one represents the highest levels of deprivation and level 10 the lowest.

Updated 21 April 2017

Letter from the Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Asma Moghal practice, Becontree Medical centre on 11 March 2016. The overall rating for the practice was requires improvement and the practice therefore needed to be re-inspected within six months after the report was published. The full comprehensive report published on 27 May 2016 can be found by selecting the ‘all reports’ link for Dr Asma Moghal on our website at www.cqc.org.uk.

This inspection was undertaken following the period of six months and was an announced comprehensive inspection on 17 November 2016 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 11 March 2016. 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.

Our key findings were as follows:

• 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 and the practice had acted upon the findings of our previous inspection in relation to patient safety.
• 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.
• 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.
• The practice had good facilities in a purpose-built building and was well equipped to treat patients and meet their needs.
• There was a leadership structure and staff felt supported by management.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Continue to review system to identify carers in the practice.
• Make patient information leaflets available in other languages spoken by patients in the practice.
• Ensure patients are aware that translation services are available.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 April 2017

The practice had resolved the concerns for safety, effective, responsive and well-led identified at our inspection on 11 March 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this. The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was similar to the CCG and national averages. For example, 68% of patients on the diabetes register had had a recorded blood glucose level of 64mmol/mol or less in the preceding 12 months compared to CCG average of 72% and national average of 78%.
• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• All these patients had a named GP and there was a system to recall patients for 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 21 April 2017

The practice had resolved the concerns for safety, effective, responsive and well-led identified at our inspection on 11 March 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this. The practice is rated as good for the care of families, children and young people.

• The practice’s uptake for the cervical screening programme was 83%, which was comparable with the CCG average of 80% and the national average of 81%.
• From the sample of documented examples we reviewed we found there were systems 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 accident and emergency (A&E) attendances.
• Immunisation rates were comparable to national averages for all standard childhood immunisations.
• Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice worked with midwives and health visitors to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.

Updated 21 April 2017

The practice had resolved the concerns for safety, effective, responsive and well-led identified at our inspection on 11 March 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this. 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 patients in its population.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.

Updated 21 April 2017

The practice had resolved the concerns for safety, effective, responsive and well-led identified at our inspection on 11 March 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this. The practice is rated as good for the care of working age people (including those recently retired and students).

• The practice offered extended hours between 6.30pm and 8.00pm three days a week with the practice nurse and between 6.30pm and 7pm once a week with a GP.
• The practice was proactive in offering online services and electronic prescription service as well as a full range of health promotion and screening that reflects the needs for this age group.
• The practice offered telephone consultations to all patients.

Updated 21 April 2017

The practice had resolved the concerns for safety, effective, responsive and well-led identified at our inspection on 11 March 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this. The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• Performance for mental health related indicators was similar to the CCG and national averages. For example, 92% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in their records in the preceding 12 months, compared to the CCG average of 89% and national average of 88%.
• Performance for dementia related indicators was similar to the CCG and national averages. For example, 82% of patients diagnosed with dementia had had a face-to-face care review in the preceding 12 months compared to the CCG and national averages of 84%.
• 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.

Updated 21 April 2017

The practice had resolved the concerns for safety, effective, responsive and well-led identified at our inspection on 11 March 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this. 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 gave a bypass contact telephone number, which allowed vulnerable people to call the surgery when they needed.
• 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.
• All clinical staff could demonstrate they had completed relevant training for adult safeguarding in the past three years.