Archived: Dr Rao

Updated 17 December 2015

Dr Rao also known as Rillwood Medical Centre provides primary medical services to residents in the eastern area of Northampton. The practice has been at its current purpose built location since 1991.

The practice population has a lower than average number of patients over 65 years and a higher than average below 40 years. National data indicates that the area is one of higher deprivation. The practice has approximately 3450 patients and provides services under a general medical services contract (GMS).

The practice is managed by a principal GP, male. There is a nurse practitioner and a number of reception and administration staff led by a practice manager. The practice also employs two regular locum GPs, both male.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments were available from 9am to 1pm and 4pm to 6pm daily. Extended hours surgeries are offered until 7pm on Mondays and Tuesdays and 7.15pm on Wednesdays.

When the practice is closed out-of-hours services are provided by the Northamptonshire GP Out of Hours service which is run by Integrated Care 24 and can be accessed via the NHS 111 service.

Updated 17 December 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Rao on 9 September. Overall the practice is rated as requires improvement.

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

• Staff understood there was a process to follow to raise concerns, and to report incidents and near misses. However this was not implemented fully within the practice as incidents were not always identified.
• Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks and infection control training.
• Data showed patient outcomes were at or above average for the locality. Audits had been carried out in order to improve patient outcomes.
• Patients said they were treated with kindness, 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.

• Urgent appointments were usually available on the day they were requested.
• The practice had a number of policies and procedures to govern activity, but staff did not know what they were and how to access them.
• Non-clinical staff including the practice manager had not received any appraisals.

The areas where the provider must make improvements are:

• Ensure recruitment arrangements include all necessary employment checks for all staff. This includes making sure all nursing staff have a criminal records check through the Disclosure and Barring Service (DBS). Where non-clinical staff perform chaperone duties, the practice must risk assess and record whether a DBS check is required.

In addition the provider should:

• Ensure lessons learned from significant events, incidents and accidents are  shared with practice staff.
• Ensure all staff have received training appropriate to their role, for example, infection control and chaperone training.
• Ensure that all staff are supported by receiving appraisals.
• Carry out regular fire drills to ensure staff know what to do in the event of a fire.
• Keep cleaning records to demonstrate adequate levels of cleanliness are maintained.
• Ensure all staff know how to access policies, procedures and guidance to carry out their role.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 December 2015

The provider was rated as requires improvement for safety and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group. The nurse practitioner had a lead role in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met . For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 17 December 2015

The provider was rated as requires improvement for safety and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group. 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 for the standard childhood immunisations were in line with other practices. Urgent and same day appointments were available for all sick children and appointments were available outside of school hours. The premises were suitable for families, children and young people. We saw good examples of joint working with midwives and health visitors.

Updated 17 December 2015

The provider was rated as requires improvement for safety and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. Longer appointments and home visits were available for older people when needed. All these patients had a named GP and care plans in place.

Updated 17 December 2015

The provider was rated as requires improvement for safety and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group. Extended hours opening was available three evenings a week and the practice offered telephone consultations for those who could not attend during normal hours. Appointments and repeat prescriptions could be booked online. There was a full range of health promotion and screening that reflects the needs for this age group.

Updated 17 December 2015

The provider was rated as requires improvement for safety and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group. Patients experiencing poor mental health had received an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It 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. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health.

Updated 17 December 2015

The provider was rated as requires improvement for safety and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group. The practice held a register of patients living in vulnerable circumstances including those with a learning disability. It had carried out annual health checks for people with a learning disability.

The practice worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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 and 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.