The Care Quality Commission
  • Doctor
  • GP practice

ISSA Medical Centre - Dr Z H Patel

Overall: Good read more about inspection ratings

73 St Gregory Road, Deepdale, Preston, Lancashire, PR1 6YA (01772) 798122

Provided and run by:
ISSA Medical Centre - Dr Z H Patel

All Inspections

18 July and 10 August 2023

During a routine inspection

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

05/04/2022

During an inspection looking at part of the service

We carried out an announced inspection at ISSA Medical Centre on 5th and 6th April 2022. Overall the practice is rated as Good.

The key question ratings are as follows:

Safe - Requires improvement

Effective - Requires improvement

Caring – Previously rated- Good

Responsive - Previously rated- Good

Well-led - Requires improvement

Why we carried out this inspection

This inspection was a focused inspection to check the provider was complying with the regulations under the Health and Social Care Act 2008. We inspected three key questions to determine if the service is safe, effective and well led. We also collected evidence around access to the service in the responsive key question.

We undertook this inspection at the same time as CQC inspected a range of urgent and emergency care services in Lancashire and South Cumbria. To understand the experience of GP Providers and people who use GP services, we asked a range of questions in relation to urgent and emergency care. The responses we received have been used to inform and support system wide feedback.

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 was with consent from the provider and in line with all data protection and information governance requirements.

This included

  • Completing remote 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 and branch 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;
  • information from the provider, patients, the public and other organisations.

We have rated this practice as Good overall

We found that:

  • The practice had some systems in place to deliver safe care in a way that kept patients safe and protected them from avoidable harm. However we found not all these systems were working as intended, which presented risk.
  • Patients received effective care and treatment that met their needs. However, there were shortfalls in staff capacity to effectively deliver some screening programmes.
  • Caring was not inspected as part of the inspection.
  • The practice was responsive to patients in terms of of access to appointments, however access to the building was restricted to patients until 8.30am.
  • The practice’s governance systems were limited, quality assurance processes were lacking structure, learning, outcomes and discussions were not documented. We found structured supervision for non- clinical prescribers and healthcare assistants were not standardised but more informal and tasked based.

We found one breach of regulations. The provider must:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

We also found the provider should:

  • Review extended families on the safeguarding register and flag other residents of the household where appropriate.
  • Complete the MHRA alert process to documents outcomes and actions.
  • Review risk assessment documentation to ensure they fully reflect identified risks and mitigating actions taken..

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

5 August 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at ISSA Medical Centre on 5 August 2016. Overall the practice is rated as good.

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

  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events, although actions taken as a result of these events were not systematically reviewed.
  • Risks to patients were assessed and well managed although references for new practice staff were not always sought, as per the practice’s recruitment policy.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Protocols and policies for managing blank prescription forms were in place, however staff using loose prescription forms did not log them in and out and prescriptions were left in prescription printers overnight.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • The practice had good policies and procedures although these were not easily available to staff and there was no structured programme for their review.
  • The practice had good facilities and was well equipped to treat patients and meet their needs. Patients we spoke with praised the practice environment.
  • There was a clear leadership structure and 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.

We saw one area of outstanding practice:

  • The practice had recognised the needs of Muslim patient families and had been the first practice in the area to work in partnership with the coroner and the Muslim burial committee. The practice had facilitated timely access to these services particularly out of working hours. This led to families being able to satisfy the needs of their religion and bury their relatives within appropriate timescales. This service was then rolled out to other practices in the area.

The areas where the provider should make improvement are:

  • The practice should consider that systems are put in place to check that actions identified by significant event reports are effective.
  • The practice should minimise the risks that may be associated with the security of blank prescription forms.
  • The practice should follow its recruitment policy and obtain references for all new staff employed.
  • The practice should make policies and procedures easily available to all staff and review them systematically.


Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

18 July 2014

During a routine inspection

Issa Medical Centre operates from purpose built premises opened in 2009. It has grown rapidly since then adding approximately 1000 patients each year since opening. The practice currently serves over 12,600 patients and continues to grow.

Issa Medical centre is registered with the Care Quality Commission (CQC), as responsible for providing primary care, which includes: access to GPs, family planning, maternity and midwifery services, treatment for disease, surgical procedures, disorder and injury and diagnostic and screening services.

The medical centre offers NHS care and is a teaching practice for GPs. Issa Medical Centre has two GP trainees.

Patients told us that they were very satisfied with the services they received and they told us that the clinical staff working at the medical centre were all held in high regard by the wider community.

The practice works collaboratively with other health and social care providers locally in order to offer a ‘joined up’ service to patients.

The practice evidenced its efforts to be responsive to a broad community by the way in which it gave support to the patients participation group (PPG).

The patients speak a number of languages and clinical healthcare professional staff in addition to speaking English, were fluent in, Bengali, Hindi, Punjabi, Urdu and Gujarati. There were systems in place to access translation services for other languages as necessary.

The values and visions of the practice were clearly demonstrated and the patients said that they enjoyed a respectful and compassionate service delivered by caring staff who were mindful of a wide range of cultural needs of patients.