Archived: Dr Yogesh Amin Also known as Central Surgery

Updated 17 November 2017

Dr Yogesh Amin (also known as Central Road Surgery) is a single handed General Practitioner (GP) who delivers services from a converted house to patients in the local area of Folkestone, Kent. There are approximately 2,600 patients on the practice list; however they are experiencing an increase in patients registering due to a neighbouring service having closed.

The practice serves a deprived community, which tend to have greater need for health services.. The area also has higher than the local and national averages for people unemployed. Both males and females have below the national life expectancy rates

There is on-site parking and patient areas are accessible to patients with mobility issues, as well as parents with children and babies. The practice is located near bus-stops and the railway station. The practice patient population age is close to national averages but the surrounding area has a higher than average amount of people living in deprived circumstances.

The practice holds a General Medical Service contract. The clinical team consists of a lead GP (male) and a female GP who works one Friday a month. The practice nurse (female) works two mornings a week normally Wednesday and Friday. The GPs and nurse are supported by a practice manager as well as administration and reception staff. A wide range of services are offered by the practice including diabetes clinics and child immunisations.

Alongside several other local GPs in the South Kent Coast Clinical Commissioning Group (CCG) patients from the practice can also access services between 8am to 8pm at the Queen Victoria Hospital Hub in Folkestone, Kent and an urgent home visit service by a paramedic practitioner via funding from the Prime Minister’s Challenge Fund.

Out of hour’s services are provided by Primecare. Details of how to access this service are available at the practice.

Services are delivered from:

Central Surgery, 86 Cheriton Road, Folkestone, Kent, CT20 2QH.

The practice has been inspected on three previous occasions. In March 2016 the practice was rated as requiring improvement overall. In February 2017 the practice was rated as inadequate overall, it was placed in special measures and enforcement notices were issued. A follow up inspection was conducted in July 2017 to assess the risks identified in the enforcement notices served on the provider. As a consequence of the visit the provider was found to have complied with the enforcement notices addressing the risks outlined.

Updated 17 November 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Yogesh Amin also referred to as Central Surgery on 8 February 2017. The overall rating for the practice was inadequate and the practice was placed in special measures for a period of six months. The full comprehensive report on the February 2017 inspection can be found by selecting the ‘all reports’ link for Dr Yogesh Amin on our website at www.cqc.org.uk.

This inspection was undertaken following the period of special measures and was an announced comprehensive inspection on 10 October 2017. Overall the practice is rated as good.

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

• We found there was an effective system for reporting and recording significant events; lessons were shared to make sure action was taken to improve safety in the practice.
• We found there were systems in place for the safe prescribing and monitoring of medicines.
• The practice was clean and tidy and appropriate infection control audits had been conducted to identify and mitigate risks.

• Data from the national GP patient survey showed patients rated the practice consistently higher than others for several aspects of care. Patients reported high levels of satisfaction with the service. One hundred percent of respondents in the national GP patient survey said they had confidence and trust in the last GP they saw compared to the CCG average of 95% and the national average of 95%. Ninety nine percentage of respondents in the national GP patient survey described their experience of making an appointment as good compared with the CCG average of 72% and the national average of 73%.

• Patients praised the practice team. They told us the reception staff were always polite, friendly and helpful and Dr Amin took time to listen to them and consider all their needs explaining their choices and treatment options. They told us they believed he cared about their wellbeing and felt safe.
• The practice had clear leadership and a documented strategy for the service involving the proposed merging of the service with a neighbouring practice.
• We found there were arrangements in place to monitor and improve quality and identify risk.
• Staff had inductions, training opportunities, annual performance reviews and attended staff meetings.
• The practice knew their patients and listened to them. They had an established patient participation group and they told us they felt valued and spoke highly of the service.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by this service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 November 2017

The practice is rated as good for the care of people with long-term conditions.

• The lead GP oversaw the management of all patients with long term conditions.
• The practice achieved 88% of patients with diabetes on the register, in whom the last blood pressure reading (measured in the preceding 12 months) is 140/80mmHg or less.
• 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.
• The lead GP was the patients 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 17 November 2017

The practice is rated as good for the care of families, children and young people.

• From a sample of documented examples reviewed we found there were systems to identify and follow up children living in disadvantaged circumstances and who were at risk.
• Immunisation rates were above the national and local 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.

Updated 17 November 2017

The practice is rated as good for the care of older people.

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice knew their patients and provided personalised care to meet the needs of the older patients in its population. For examples; 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.
• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible.

Updated 17 November 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The practice knew their patients and both the clinical team and members of the reception team adjusted their services to ensure these were accessible, flexible and offered continuity of care, for example, extended appointments where patients had multiple issues to discuss.
• The practice offered online services as well as health promotion and screening that reflects the needs for this age group.

Updated 17 November 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• The practice carried out advance care planning for patients living with dementia.
• 89% of patients diagnosed with dementia that had their care reviewed in a face to face meeting in the last 12 months, which was above the local average of 85% and the national average of 84%.
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.
• 100% of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in the record, in the preceding 12 months. This was above the local average 85% and the national average 89%.
• The lead GP worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• Patients at risk of dementia were identified and offered an assessment.
• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.
• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 17 November 2017

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.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• The practice offered longer appointments for patients who would benefit from them such as patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.