Bharani Medical Centre

Updated 28 January 2016

The Bharani Medical Centre is situated in Slough. The practice is located in a converted building with car parking for patients and staff. There is ramp access for patients and visitors who have difficulty managing steps. All patient services are offered on the ground and first floors. The practice comprises of 11 consulting rooms, four treatment rooms, two patient waiting areas, administrative and management office and a meeting room. The practice has a branch surgery in the Slough area.

There is one principal GP and seven salaried GPs at the practice. Five GPs are male and three female. The principal GP has been awarded MBE (An MBE is an award given by the Queen to an individual for outstanding service to the community or local 'hands on' service).The practice employs two practice nurses and a health care assistant. The practice manager and business manager are supported by a lead receptionist and a team of administrative and reception staff. Services are provided via a Primary Medical Services (PMS) contract (PMS contracts are negotiated locally between GP representatives and the local office of NHS England).

The practice has approximately 12,900 patients registered and patients can attend either of the two practice locations. We have visited both locations as part of this inspection. The practice population of patients aged between 1 and 14 years is higher than national and clinical commissioning group (CCG) (a CCG is a group of general practices that work together to plan and design local health services in England. They do this by 'commissioning' or buying health and care services) averages and there are a lower number of patients over 45 years old compared to national average. The practice has a transient patient population; patients are often outside of the country for long periods. This has an impact on screening and recall programmes. The practice population is identified as having a deprivation rating of five in a rating scale of ten. People living in more deprived areas tend to have greater need for health services.

Services are provided from the following two locations:

Bharani Medical Centre

16-18 Lansdowne Avenue

Slough

SL1 3SJ

Bharani Medical Centre

450 Bath Road

Slough

SL1 6BB

The practice has opted out of providing out of hours services to their patients. There are arrangements in place for services to be provided when the practice is closed and these are displayed at the practice, in the practice information leaflet and on the patient website. Out of hours services are provided during protected learning time and between 8am and 8:30am by East Berkshire out of hours services or after 6:30pm, weekends and bank holidays by calling 111.

Updated 28 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bharani Medical Centre, 16-18 Lansdowne Avenue, Slough, SL1 3SJ on 25 November 2015. Overall the practice is rated as good.

Specifically, we found the practice good for providing safe, effective, responsive, caring and well led services.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. The majority of information about safety was recorded, monitored and reviewed.
• Risks to patients were assessed and well managed.
• We found that completed clinical audits cycles were driving positive outcomes for patients.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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 were available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

In addition the provider should:

• Ensure to develop and implement a clear action plan, to improve the outcomes for diabetic and dementia patients.
• Implement a system to promote the benefits of breast and bowel screening to increase patient uptake.
• Take action to review their approach and support for patients with carers responsibility.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 28 January 2016

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

• There were clinical leads for 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 patients with long term conditions had a named GP and a structured annual review to check that 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 28 January 2016

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

• 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 patients who had a high number of A&E attendances.

• Immunisation rates were high for all standard childhood immunisations.

• Patients told us that children and young patients were treated in an age-appropriate way and were recognised as individuals.

• The practice’s uptake for the cervical screening programme was 80%, which was above to the CCG average of 72% and national average of 77%.

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

• We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 28 January 2016

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

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.

• It was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• The percentage of patients aged 65 or over who received a seasonal flu vaccination was higher than the national average.

• The premises were accessible to those with limited mobility. However, the front door was not automated and the practice did not provide a low level desk at the front reception.

• There was a register to manage end of life care and unplanned admissions.

• There were good working relationships with external services such as district nurses.

Updated 28 January 2016

The practice is rated as good for the care of working-age patients (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 as well as a full range of health promotion and screening that reflects the needs for this age group.

• Extended hours appointments were available five evenings from 6:30pm to 8:30pm during week days and every Saturday and Sunday from 9am to 1pm at Bath road branch practice.

Updated 28 January 2016

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

• 52% of patients experiencing poor mental health were involved in developing their care plan in last 12 months.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice had told patients experiencing poor mental health how to access various support groups and voluntary organisations.

• Systems were in place to follow up patients who had attended accident and emergency, when experiencing mental health difficulties.

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

Updated 28 January 2016

The practice is rated as good for the care of patients whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability. The practice did not have any homeless patients or travellers.

• It offered annual health checks for patients with learning disabilities. Health checks were completed for 14 patients out of 20 patients on the learning disability register.

• Longer appointments were offered to patients with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients.

• 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. 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.