Dr Muhammad Misbah-Ur-Rehman Siddiqui Also known as Dr Siddiqui - Walnut Way GP Practice

Updated 29 March 2018

• Dr Muhammad Misbah-Ur-Rehman Siddiqui’s practice is based at 21 Walnut Way, Ruislip, Middlesex, HA4 6TA. The practice provides primary medical services through a General Medical Services (GMS) contract to approximately 3,618 patients living within the local area. (GMS is one of the three contracting routes that have been made available to enable commissioning of primary medical services). The practice is part of the NHS Hillingdon Clinical Commissioning Group (CCG) which is made up of 48 GP practices.

• Online services can be assessed from the practice website: www.walnutwaysurgery.nhs.uk

• Staff include a male GP (six sessions), two regular female locum GPs (three sessions), a nurse (five sessions), a practice manager and four non-clinical staff.

• The practice population is culturally diverse with a high number of patients 15-44 years old.

• The local area is the second least deprived in the Hillingdon CCG (people living in more deprived areas tend to have greater need for health services).

• Services offered include long-term condition management, cervical smears, family planning and contraception, NHS healthchecks, childhood immunisations and travel vaccinations.

• The service is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures, and treatment of disease, disorder and injury.

• The practice's opening hours are Monday to Friday 8am to 6.30pm with the exception of Thursday were the practice closes at 12.30pm. GP appointments are available from 9am to 12.30pm and 4pm to 6.30pm daily. A local extended access HUB service is available weekday evenings and half days at weekends. Between 1 and 2pm the practice is closed however patients can access the GP if urgent via NHS 111.

• The practice has opted out of providing out-of-hours services to their own patients and directs patients to a local out-of-hours provider. Patients can also access a 24 hour urgent care centre adjacent to the local hospital.

Updated 29 March 2018

This practice is rated as Good overall. (Previous inspection March 2015 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Dr Muhammad Misbah-Ur-Rehman Siddiqui on 27 February 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

• Staff involved and treated patients with compassion, kindness, dignity and respect. However, patient satisfaction with their consultations were below local and national averages.

• The practice understood the needs of its population and tailored services in response to those needs.

• Patient satisfaction with access to the service was below local and national averages. The practice were taking action to rectify this.

• There were effective leadership and governance arrangements.

The areas where the provider should make improvements are:

• Review antibiotic prescribing to bring in line with local and national averages.

• Review feedback from the national GP survey and implement actions to improve performance particularly in respect of access to the service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 July 2015

The practice is rated as good for the care of people with long-term conditions. The percentage of patients at the practice with a long standing health condition or with health related problems in daily life were 52.8% and 42.8%. These were lower than the England averages of 54% and 48.8%. The practice had signed up for the Whole System Integrated Care Programme (a programme where health and social care services work together to provide integrated care to patients with long-term conditions). The practice participated in the avoiding unplanned admissions Enhanced Service and used the BIRT 2 tool (Business Intelligence Risk Stratification Tool) to identify patients with long-term conditions who were at risk of hospital admissions. The practice had identified 2% of the practice population who were at risk of hospital admissions which was 72 patients and care plans were in place to manage their care needs. Patients were given copies of their care plans and a questionnaire to feedback their opinions of the service. The practice’s Quality and Outcomes Framework (QOF) performance for all long-term conditions was above both the Clinical Commissioning Group (CCG) and National averages in 2013/14.

Updated 9 July 2015

The practice is rated as good for the care of families, children and young people. The practice had a higher number of children aged 0 to 4 years compared to the National average (7% compared to 6%) and the percentage of children aged 5 to 14 years was 11.4% which was in line with the national average. The practice provided a range of services for families, children and young people. These included post-natal checks for mother, six week baby checks, family planning clinics and contraceptive services. The practice did not provide antenatal checks for mothers, however along with patients from other practices in the locality patients were referred to an adult and child centre through choose and book. The practice provided the routine childhood immunisations including the new Hepatitis B and Rotavirus vaccinations. Uptake for most childhood immunisations was above the National average in the previous year. The practice offered the Measles, Mumps and Rubella (MMR) vaccinations for young people aged 16 and over. Chlamydia screening was available and patients were referred to a specialist clinic for Sexually Transmitted Diseases (STDs).

Updated 9 July 2015

The practice is rated as good for the care of older people. The practice had a lower than National average number of older patients. The percentage over 75 years was 6.6% and over 85 years was 1.6% (National average 7.6% and 2.2% respectively). Patients over 75 years had a named GP and were prioritised to see the GPs including emergency appointments. Those at risk of unplanned admission to secondary care had care plans in place. End of life care was managed by district nurses who liaised with the practice at multidisciplinary team meetings. The practice offered open access appointments for older people.

Updated 9 July 2015

The practice is rated as good for the care of working age people (including those recently retired and students). The percentage of patients in paid work or full time education was 60% which was in line with the national average of 60.2%. The practice provided the extended opening hours Enhanced Service (ES) for those patients of working age. Nine additional appointment slots per week after 7 pm were available for patients who could not attend the practice during normal working hours. Appointments and repeat prescriptions could be accessed online for those of working age. Telephone consultations were available for minor ailments. NHS Health Checks were available for patients between the ages 40-74 years and Meningitis C vaccinations for students attending university.

Updated 9 July 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Patients experiencing poor mental health were called in for reviews at the practice and referred to the local mental health team for mental health assessments and management. The practice’s QOF performance for mental health and dementia was 100% in 2013/14. All patients in the age group 40-74 who do not have any disease registered were offered a NHS Health Check and asked to complete a dementia questionnaire. Patients with any signs of dementia were referred to secondary care.

Updated 9 July 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice kept a register of patients with learning disabilities and provided annual physical health checks. Patients with no fixed abode such as asylum seekers, substance misusers and travellers who were not registered with a GP practice were seen as temporary patients and were signposted to support groups and services according to their needs. The practice had been adapted to meet the needs of patients who were disabled. For example, there was a ramp at the entrance for wheelchair access, wide doorways to the consultation rooms, and the toilet had an emergency pull cord which was connected to all rooms in the practice. A hearing loop was available for those patients hard of hearing. The practice provided care for a small number of patients in a local nursing home and home visits were available for patients who were unable to travel to the practice. The practice had access to online and telephone translation services for those patients whose first language was not English.