Archived: Dr Sharma Also known as Sharma Practice

Updated 2 June 2016

Dr Sharma is located in a residential area of Wolverhampton. It is situated in a purpose built single storey building. The practice is located in an area of high deprivation and falls within the 10% most deprived in England. The practice provides medical services to approximately 3,219 patients. The practice has a higher proportion of patients aged 85 plus compared with the practice average across England.

The practice team consists of one lead GP and two salaried GPs (one male and two female), who provide services which equate to 1.9 whole time equivalent GPs. The practice used GP locums occasionally to cover long term staff absences only. The clinical practice team includes two practice nurses. One of the nurses is an independent prescriber. The clinical staff are supported by a practice manager, a deputy practice manager and seven receptionists and administration staff. In total there are 11 staff employed who all work part time hours. The practice is accredited with a number of universities for the training of undergraduate doctors and postgraduate nurse training.

Updated 2 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Sharma on 23 February 2016. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• 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.
• The practice had a programme of continuous clinical and internal audit in order to monitor quality and make improvements. All staff were encouraged to carry out individual audits.
• Feedback from patients about their care was consistently positive.
• Written information for patients on how to complain was not available at the surgery.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, 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 the 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.

There was one area where the provider should make improvements:

• Ensure that patients have easy access to information about how they can make a complaint.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 2 June 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. Performance for diabetes assessment and care was higher than the national average (96% compared to the national average of 91%). Patients with complex needs and more than one health condition were offered a double appointment (20 minutes) which gave them more time to discuss health issues with a clinician. 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 care professionals to deliver a multidisciplinary package of care. The practice worked with hospital consultants who specialised in the treatment of patients with respiratory conditions and diabetes.

Updated 2 June 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. The practice responded promptly to child protection information. The GP who was the lead for safeguarding children had completed a diploma in child health. 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. 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. The practice’s uptake for the cervical screening programme was 92%, which was higher than the national average of 82%.

Updated 2 June 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. All patients aged 75 years plus had a named GP. Older patients were offered a double appointment (20 minutes) which gave them more time to discuss health issues with a clinician. The practice offered home visits and urgent appointments for those older patients with enhanced needs. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people.

Updated 2 June 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 made provision to accommodate the needs of working people by offering the appointments at a time to suit their needs. This included extended appointments one evening per week. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.

Updated 2 June 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The data showed that 93% of patients on the practice register who experienced poor mental health had a comprehensive agreed care plan in the preceding 12 months, which was higher than the national average of 88%. Appointments were available to support patients experiencing mental health problems. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations and a community based counselling service was available at the practice. The practice regularly worked with multi-disciplinary teams in the case management of people who experienced poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. The percentage of patients diagnosed with dementia whose care had been reviewed in a face to face review in the preceding 12 months was 84%, which was comparable to the national average of 84%. All practice staff had completed dementia friends training and one of the reception staff had completed training to be the dementia champion for the practice. The practice planned to develop this role to support meeting the needs of patients diagnosed with dementia and their carers..

Updated 2 June 2016

The practice is rated good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients with a learning disability. The practice worked regularly with the local specialist learning disability nurses to ensure it carried out annual health checks for people with a learning disability. An easy read (pictorial) letter was sent to patients with a learning disability inviting them to attend the practice for their annual health check.

Staff had been trained 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. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations.