ISSA Medical Centre - Dr Z H Patel

Updated 26 September 2023

ISSA Medical Centre is housed in a purpose-built two storey building in the Deepdale area of Preston, this is also known as ISSA @ Deepdale and is located at;

73 St Gregory Road

Deepdale

Preston

PR1 6YA.

There is also a branch location which occupies the ground floor at the Fatima Medical Centre, this is known at ISSA @ Fulwood and is located at;

228 Garstang Road

Fulwood

Preston

PR2 9QB.

The provider is registered with CQC to deliver the regulated activities;

• Diagnostic and screening procedures
• Maternity and midwifery services
• Treatment of disease, disorder or injury
• Surgical procedures
• Family planning

The practice is situated within NHS Lancashire and South Cumbria Integrated Care Board (ICB) and delivers General Medical Services (GMS) to a patient population of about 33,958. This is part of a contract held with NHS England.

The practice is part of a wider network of GP practices called the Preston North and East Primary Care Network (PCN) with other local practices.

Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the higher decile (3 of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 57% White, 37% Asian, 3% Mixed, 1.5% Black and 1% Other.

The age distribution of the practice population is 0-18 Years 25%, 18-64 Years 63% and 65 years and over 12%.

There is a clinical team of 15 GPs, 30 clinical staff including advanced nurse clinicians, physicians associate, clinical pharmacist, paramedic-in-practice, specialist nurses, practice nurses and health care assistants. The clinical team was supported at the practice by a team of 66 administrative, reception and secretarial staff. Managerial support was provided by 2 practice managers, a business manager, 3 assistant practice managers, 3 department managers and 3 supervisors.

The practice offers training and support to year 1 and 2 physician associates from the University of Central Lancashire and medical students from Manchester University. The practice also takes paramedic and student nurse placements.

The practice is open between 8am to 6.30pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

Extended access is provided through PCN arrangements on Tuesday to Friday evenings from 6.30pm to 8pm at ISSA Medical centre and on Monday 6.30pm to 8pm at another hub practice. Weekend access is provided at ISSA Medical Centre on Saturdays alternating from mornings 8am to 12pm to a longer day from 9am – 5pm the following week. Out of hours services are provided by NHS 111 and through an arrangement with an out of hours provider.

Updated 26 September 2023

We carried out an announced inspection at Issa Medical Centre on 18 July and 10 August 2023. Overall, the practice is rated as good.

We rated each key question as follows:

Safe - Good

Effective - Good

Caring - Good

Responsive - Good

Well-led – Good

Following our previous inspection on 5 and 6 April 2022, the practice was rated requires improvement overall. It was rated requires improvement for the key questions safe, effective and well led and rated good for the caring and responsive key questions.

At this inspection, we found that those areas previously highlighted as requiring improvement had been improved. The practice is therefore now rated good for providing safe, effective, caring, responsive and well led services and good overall.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for The Issa Medical Centre on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection to follow up breaches of regulation from a previous inspection. It was a full comprehensive inspection looking at all five key questions.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing and face to face discussions
• Requesting written feedback from staff and patients
• Completing clinical searches on the practice’s patient records system and discussing findings with the provider
• Reviewing patient records to identify issues and clarify actions taken by the provider
• Requesting evidence from the provider
• A site visit.

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We found that:

• Our clinical record searches identified that all issues from the previous inspection had been addressed.
• The practice now had oversight of the monitoring of high-risk medicines and disease modifying anti-rheumatic drugs (DMARDs). We saw that appropriate monitoring was in place and there was evidence that blood test results were checked before medicines were issued.
• Systems to monitor performance of clinical staff had been formalised and documented.
• The audit and quality assurance processes had been improved.
• Actions from audits, meetings and where issues were identified were followed up and monitored through action plans.
• Infection prevention and control processes and procedures were in order.
• Shortfalls in staff capacity had been addressed.
• Flagging of vulnerable patients, such as those who may be at risk, were highlighted appropriately.
• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

Whilst we found no breaches of regulations, the provider should:

• Improve the documentation of medication reviews undertaken. The records should include detail of the discussion that took place including the efficacy and suitability of medicines taken as part of the monitoring of the patient’s medication.
• Update the recruitment policy so that it reflects the requirements of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
• Continue with the plan to audit DNACPR records to provide assurance of regular review, documentation and record keeping, especially around mental capacity assessments and best interest decision making where appropriate.
• Progress plans to improve cervical, bowel and breast screening uptake.
• Consider reviewing the practice business plan to include a review of the strategic vision and plan for future years.
• Continue ongoing work around annual clinical and non-clinical audit programme and centralise audit streams.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care