Dr Rana Chowdhury

Updated 28 December 2017

Dr Rana Chowdhury is located on Oak Road, Harold Wood within a converted two storey house and is well served by Harold Wood over ground station. The building is owned and maintained by the lead GP. The practice provides NHS primary medical services to 3008 patients on behalf of Havering Clinical Commissioning Group (CCG), through a Personal Medical Services contract (a locally agreed alternative to the standard GMS contract used when services are agreed locally with a practice which may include additional services beyond the standard contract).

The premises have step free access with an accessible toilet and baby changing facilities.

The practice is open between 8.00am and 6.30pm on Monday, Tuesday, Thursday and Friday. The practice is open from 8.30am to 11.30am on a Wednesday. Appointments are from 8.00am to 11.30am each morning and from 4.00pm to 6.30pm on Monday, Tuesday, Thursday and Friday afternoons. Extended hours appointments are not offered. In addition to pre-bookable appointments that could be booked up to four weeks in advance, urgent appointments are also available for people that needed them.

The practice provides telephone consultations and home visits, the home visits are carried out between the morning and afternoon sessions. The practice does not offer extended hours, however out of hour’s services and weekends are covered by the Havering GP hub weekdays from 2.00pm to 6.00pm and from 9.00am to 5.00pm weekends (who provide telephone consultations, home visits and appointments at the local hospital) and the 111 service.

There is one principal GP (male) who carries out nine sessions per week and a female practice nurse who works sixteen hours per week. The practice also employs female locums for two sessions per week. The practice manager works 28 hours per week and there are a variety of administration and reception staff.

The practice has a larger older population, 24% of whom are over 65 years of age (17% nationally) and 52% of the population is aged between 25 and 64. The practice population is 83% white British and 17% non-white minority ethnic groups. Information published by Public Health England rates the level of deprivation within the practice as seven on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

They are regulated to carry out the following activities:

• Diagnostic and screening procedures;

• Family planning;

• Maternity and midwifery services;

• Treatment of disease, disorder or injury.

Updated 28 December 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Rana Chowdhury on 11 January 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 January 2017 inspection can be found by selecting the ‘all reports’ link for Dr Rana Chowdhury 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 18 October 2017. Overall the practice is now rated as good.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. The practice learnt from significant events.
• There was no child safeguarding policy in place despite external contact details being available. However since the inspection, the practice has provided evidence of a new child safeguarding policy that has been implemented.
• Improvements had been made to the governance of the practice which had impacted on patient outcomes.
• Risks to patients who use the services were well managed.
• Patients said they were treated with compassion, dignity and respect, and they were involved in their care and decisions about their treatment.
• 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.
• Staff had knowledge of the practice vision and there was a business plan to support this vision and the practice strategy.

However, there were also areas of practice where the provider needs to make improvements.

The provider should:

• To continue review how patients with caring responsibilities are identified and recorded on the patient record system to ensure information, advice and support is made available to all.

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

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 28 December 2017

The provider is rated as good for providing a service to people with long-term conditions.

• The nurse had lead roles 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.

• Patients had a named GP and a structured annual review to check their health and medicines needs were being met. For patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• The practice had a system in place to review patients on high risk medicines.

Updated 28 December 2017

The provider is rated as good for providing a service to families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances who were at risk. For example, children and young people who had a high number of A&E attendances. Immunisation rates were high for the standard childhood immunisations.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The practice uptake for the cervical screening programme was 79%, which was comparable to the national average of 82%.

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

• We saw positive examples of joint working with midwives and health visitors.

Updated 28 December 2017

The provider is rated as good for providing services to older people.

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

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. Nationally reported data showed that outcomes for patients for conditions commonly found in older people were above average.

• The percentage of patients diagnosed with dementia whose care plan had been reviewed in a face to face review in the preceding 12 months was 91% which was above the national average of 84%.

Updated 28 December 2017

The provider is rated as good for providing a service to working age people (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 of this age group.

• The practice did not offer extended hours, but did have appointments from 8.00am for this group.

• Telephone consultations with clinicians were available to meet the needs of this population group.

Updated 28 December 2017

The provider is rated as good for providing services to people experiencing poor mental health (including people with dementia)

• 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 have attended accident and emergency where they may have been experiencing poor mental health.

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

Updated 28 December 2017

The provider is rated as good for providing services to 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 learning disability.

• The practice offered longer appointments for patients with a learning disability.

• 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 and safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.