Queens Park Health Centre Also known as Dr Khokher & Partners

Updated 17 November 2016

The practice is based over two sites, the Queens Park Health Centre, at 23c Carlisle Road, Bedford, MK40 4HR and a branch site based at The Medical Centre, 8 Honeysuckle Way, Goldington, Bedford, MK41 0TF.

All patients can access services from either of these sites. Both of these sites were visited as part of this inspection. Throughout our report, when we refer to ‘the practice’, we are including both sites, unless specifically mentioned by name.

Queens Park Health Centre provides a range of primary medical services from its premises which were built, as purpose built health centre in 1969. The branch in Goldington is based in a modern purpose built premises, built in 2009.

The practice has approximately 8500 patients in Bedford and the surrounding villages. Staff at the practice speak a number of languages including English, Punjabi, Urdu, Hindi, Gujarati and Swahili.

The practice is based in an urban area of Bedford, with the area’s deprivation level recorded as being in the fourth most deprived decile. Life expectancy for males, at 78 years, is two years less than CCG average and one year less than national average. Life expectancy for females, at 83 years, is the same as both the CCG and national averages.

The practice age profile differs from that of the England national profile, with younger patients under the age of 18 year and fewer patients over the age of 65 year of age, than both local CCG and national averages.

For example, 28% of the patients were under 18 years of age, with local CCG average of 22% and a national average of 21%. Similarly, only 10% of patients were 65 years or older, compared to 17% in the local CCG and nationally.

The clinical team includes three male GP partners and two female salaried GPs, three practice nurses, a health care assistant and minor illness practitioner. The team is supported by a practice manager and a team of administration, reception and secretarial staff. The practice provides services under a General Medical Services (GMS) contract (a nationally agreed contract).

The opening times for each site is as follows;

• Queens Park Health Centre is open Monday to Friday from 8.15am until 6.30pm. There is extended opening on Monday, until 7.20pm and Friday until 8pm. The centre closed for lunch between 1pm and 2pm each day.

• The Medical Centre at Goldington is open on Monday to Friday from 8.15am to 1pm. Afternoon opening times is 2pm, with a flexible closing time depending on patient need and availability of staff. The centre closed for lunch between 1pm and 2pm.

An out of hours service, for when the practice is closed, is provided by NHS 111 service. Information about the service is provided on the practice website, the practice leaflet and is displayed on notices boards at each site.

Updated 17 November 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Queens Park Health Centre on 19 April 2016.

Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were systematically assessed and appropriately managed.
• 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.
• Patients were positive about the standard of care they received and about staff behaviours. They said staff were attentive, kind, thorough and helpful. They told us that their privacy and dignity was respected and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was readily available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Feedback from patients indicated access to appointments was sometimes difficult, particularly with a named or preferred GP. However, it was also reported that there was continuity of care, with urgent appointments available when required.
• 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 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.

The practice should take action in the following areas:

• Continue to investigate options to ensure improvement to patient survey outcomes.

• Identify an effective escalation process to pursue when they need to follow up progress relating to building maintenance.

• Ensure effective systems are in place for staff appraisals.

• Consider a formal documented business plan to evidence the practice vision and strategy plans

• Continue to encourage patients to attend breast and bowel screening programmes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 November 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.
• 76% of patients on the asthma register had their care reviewed in the last 12 months. This was comparable to the local CCG average of 77% and national average of 75%.
• All newly diagnosed patients with diabetes were managed in line with an agreed pathway.
• 77% of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months was less than the local CCG average of 90% and 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 GPs worked with relevant health and care professionals to deliver a multi-disciplinary package of care.

Updated 17 November 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 may be at risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were comparable to other practices in the local area 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 81% which was comparable to the local CCG average of 83% and national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• There were six week post-natal checks for mothers and their children.
• A range of contraceptive and family planning services were available.

Updated 17 November 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 access to targeted immunisations such as the flu vaccine. The practice had approximately 900 patients aged over 65 years.
• Patients over 75 years of age had a named GP and any patients discharged from hospital were contacted to check on their situation.
• Health checks were provided to patients over 75 years of age, with 220 checks delivered in the preceding 12 months.

Updated 17 November 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 offered online services such as appointment booking and repeat prescriptions as well as a full range of health promotion and screening that reflects the needs for this age group.
• There was additional out of working hours access to meet the needs of working age patients, where the Queens Park Health Centre offered extended opening hours until 7.20pm on Monday and 8pm on Friday evenings and early morning appointments from 8am on Mondays.

Updated 17 November 2016

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

• 90% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months. This was higher than the local CCG average and the national average of 84%.
• 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.
• Staff had a good understanding of how to support patients with mental health needs and dementia.
• There were named clinical leads for mental health and dementia.

Updated 17 November 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 those with a learning disability.
• The practice offered longer appointments for patients with a learning disability and there was a GP lead for these patients.
• 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.
• 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.
• Additional information was available for patients who were identified as carers and there was a nominated staff lead for these patients.