Dr Naseem Akbar Also known as Balham Health Centre (Dr Akbar)

Updated 12 April 2017

Dr Naseem Akbar provides primary medical services in Balham to approximately 1600 patients and is one of 44 member services of the NHS Wandsworth Clinical Commissioning Group (CCG). The practice operates under a General Medical Services (GMS) contract and provides a number of local and national enhanced services (enhanced services require an increased level of service provision above that which is normally required under the core GP contract).

Wandsworth has 50% more 20 to 40 year olds, but 33% fewer older people than other south west London boroughs. This is reflected in the patient demographics for the practice with 14% of patients aged 65 or over, 64% of patients aged 18-65 years old and 22% aged 18 or younger.

The practice population is in the fifth less deprived decile with income deprivation affecting children and adults in line with local and national averages.

Dr Naseem Akbar provides services from within the purpose built Balham Health Centre which is owned and operated by NHS Property Services. The health centre is shared with local Clinical Commissioning Group (CCG) services and a GP group practice. There are car parking facilities, an automatic door at the entrance and step free access throughout the building. The health centre is within walking distance of Balham train station and is served by local bus services.

Dr Naseem Akbar operates from one GP consulting room and one practice nurse treatment room, one practice manager office, shared staff facilities, shared records management room with separate purpose built records storage unit, a shared reception and waiting area with a separate reception desk and receptionist for Dr Naseem Akbar patients. There are toilets for staff and patients with disabled access and baby change facilities. Breast feeding areas are made available on request. All of these facilities are located on the ground floor.

Dr Naseem Akbar is a full time female GP providing 11 clinical sessions per week and is supported by two female part time practice nurses who each provided services one day per week. The non-clinical team consists of one part time practice manager and three part time administrative and reception staff.

Reception and telephone lines are operational between 9.00am and 1.00pm and 4.00pm and 6.30pm Monday to Friday. Appointments are available between 10.00am and 12.30pm Monday to Friday and between 4.30pm and 6.30pm on a Monday, Tuesday, Wednesday and Friday.

Patients are able to request a telephone consultation with the GP to be held daily after the morning session. Extended hours are available on Monday evening from 6.30pm until 7.30pm and Friday evening from 6.30pm until 7.00pm for pre booked appointments.

The provider has opted out of providing out-of-hours (OOH) services to their own patients between 6.30pm and 9.00am when the practice directs patients to seek assistance from the locally agreed out of hours provider. Between 12.30pm and 4.30pm on a Monday, Tuesday, Wednesday and Friday, and between 12.30pm and 6.30pm on a Thursday, calls to the practice are diverted to the locally agreed out of hours provider who will call Dr Akbar with any patients needing to be seen urgently.

The practice is registered with the Care Quality Commission (CQC) to provide the regulated activities of maternity and midwifery services, family planning, diagnostic and screening procedures and treatment of disease, disorder or injury.

Updated 12 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Naseem Akbar on 16 August 2016. The overall rating for the practice was good, with the rating for providing safe services requires improvement. The full comprehensive report on the 16 August 2016 inspection can be found by selecting the ‘all reports’ link for Dr Naseem Akbar on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 27 February 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 16 August 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

The practice is now rated as Good for providing safe services. The overall rating remains unchanged from our previous inspection.

Our key findings were as follows:

• Controlled drugs were no longer kept on the premises (Controlled drugs require specific measures in place for their safe handling, storage, security, prescribing, administering, recording and destruction). Controlled drugs previously held on the premises had been appropriately denatured and destroyed in line with the relevant guidance.

• The practice had reviewed and improved arrangements for the security and use of blank prescription forms, including implementing a prescription security protocol. The practice now maintains a register to monitor blank prescriptions, received and distributed, and all staff had been made aware of the security requirements and the administrative procedures in respect of prescription management. The practice told us blank prescription forms were no longer left in printers overnight but are locked away.

• The practice had reviewed stocks of emergency medicines, ensuring these were in line with guidelines and the needs of the practice patient population, implementing a reviewed emergency medicines protocol.

• The practice had reviewed the need for non-clinical staff acting as chaperones to have checks through the disclosure and barring service and all staff now had these checks carried out.

We also reviewed the areas we identified where the provider should make improvement:

• The practice had made copies of its business continuity plan available off site as well as on site for use in emergencies.

• The practice had continued to hold, record, monitor and review weekly governance meetings.

• The practice had reviewed how patients were informed about how to make a complaint and had ensured the practice complaints policy was available to patients in the reception area.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 19 October 2016

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

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Clinical indicators for diabetes related care showed the practice performed comparably with other practices locally and nationally.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and 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 19 October 2016

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

• 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 were relatively high for all 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’s uptake for the cervical screening programme was comparable to the CCG and the national average.

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

Updated 19 October 2016

The practice is rated as good for the care of 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.

• Older people had a named GP responsible for their care.

Updated 19 October 2016

The practice is rated as good for the care of 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 for this age group.

Updated 19 October 2016

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

• Performance for mental health related indicators showed the practice performed comparably with practices locally and nationally.

• 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 had 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 19 October 2016

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 including homeless people, travellers and those with a 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 of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.