Archived: Dr KP Kashyap's Practice

Updated 22 February 2018

Dr KP Kashyap’s Practice is located within a health centre in Romford and is a part of Barking and Dagenham Clinical Commissioning Group. There were 4780 patients registered with the practice.

The practice has one male GP Partner (4 sessions per week), one female GP partner (9 sessions), one sessional male GP (3 sessions), one sessional female GP (4 sessions), one practice nurse (6 sessions) and one health care assistant (3 sessions)..

There is also a practice manager, an assistant practice manager and four admin/reception staff. The practice operated under a General Medical Services Contract (a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract).

The practice is open Monday, Tuesday, Wednesday and Friday 8:30am to 6:30pm with phone lines being open from 8am to 6:30pm. The practice is closed on Thursday afternoon from 1pm.

Appointment times were as follows:

• Monday, Tuesday, Wednesday and Friday: 8:45am to 12:00pm and 4:30pm to 6:30pm.
• Thursday: 8:45am to 12:00pm.

The out of hours provider covers telephone calls made when the practice is closed.

Dr KP Kashyap’s Practice operates regulated activities from one location and is registered with the Care Quality Commission to provide surgical procedures, treatment of disease, disorder and injury, diagnostic and screening procedures and family planning.

Extended hours are not offered by the practice but there are three out of hours hubs that patients can access between 6:30pm and 10pm Monday to Friday, 12pm to 5pm on Saturday and 12pm to 4pm on Sunday.

Updated 22 February 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Good. (Previous inspection September 2016 – Good)

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires improvement

As part of our inspection process, we also look at the quality of care for specific population groups. The concerns raised in Safe and Well Led affect all of the population groups.

The population groups are rated as:

Older People – Requires improvement

People with long-term conditions – Requires improvement

Families, children and young people – Requires improvement

Working age people (including those retired and students – Requires improvement

People whose circumstances may make them vulnerable – Requires improvement

People experiencing poor mental health (including people with dementia) – Requires improvement

We carried out an announced comprehensive inspection at Dr KP Kashyap’s Practice on 16 November 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• The practice had processes and practices to minimise risks to patient safety but these were not always followed prior to the prescribing of some high risk medication.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with 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 facilities and was well equipped to treat patients and meet their needs.
• 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider must make improvements are:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out the duties.

The areas where the provider should make improvements are:

• Carry out regular fire drills.
• Consider implementing DBS checks which are role specific, or risk assesments if a DBS check is not considered necessary.
• Ensure that regular locum staff attend clinical meetings and are included in shared learning outcomes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 29 September 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.

• A diabetes specialist nurse was available once a month for patients with complex needs.

• The percentage of patients on the diabetes register with a record of a foot examination and risk classification within the preceding 12 months was 92% compared with a national average of 88%.

• 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 29 September 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 comparable to local averages for all standard childhood immunisations.

• The percentage of patients aged over six months but under 65 years in the defined influenza clinical risk groups that received the seasonal vaccination within the preceding 12 months was 62% compared with the national average of 58%.

• 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 percentage of women aged 25 to 64 whose notes record that a cervical screening test was performed in the preceding 5 years was 82%, which was the same as the national average.

• 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, health visitors and school nurses.

Updated 29 September 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.

• Patients identified as at risk of a hospital admission are discussed at a multidisciplinary meeting to put a preventative plan in place.

Updated 29 September 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.

• The practice offered evening extended hours appointments and was a part of a local scheme that offers weekday evening and weekend GP appointments for those patients that could not attend during routine opening hours.

• The registration period for the practice was on a Monday and Friday between 10:00am and 12:00pm, which disadvantaged patients that worked during that period.

Updated 29 September 2016

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

• 87% of patients diagnosed with dementia who had had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average of 84%.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive agreed care plan documented in the record in the preceding 12 months was 100% compared to the national average of 88%.

• The practice regularly worked with multi-disciplinary teams in the case management of people 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 29 September 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 and those with a learning disability.

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

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Leaflets were available in a variety of languages.