Dr Jasjeet Dua

Updated 26 February 2018

Dr Jasjeet Dua, 75 Russell Road, London W14 8HW, http://www.kensingtonpark.co.uk provides primary medical services through a General Medical Services (GMS) contract within the London Borough of Kensington Chelsea.  The services are provided from a single location to around 7000 patients. The local population is diverse in terms of levels of deprivation and affluence, ethnicity and household income with overall average life expectancy being higher than the national average. The practice population is young with a high proportion of 20-49 year olds. 

Updated 26 February 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection 8 July 2015 – Good)

The key questions are rated as:

Are services safe – Good

Are services effective – Good

Are services caring – Good

Are services responsive – Good

Are services well-led - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Dr Jasjeet Dua Surgery on 13 December 2017 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Continue to implement processes to increase their numbers of identified carers in order for them to receive appropriate care and support.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 December 2015

The practice is rated as good for the care of people with long-term conditions. The practice team included doctors and nursing staff with a range of skills, specialist interests and further qualifications, for example, in diabetes care. Clinicians were assigned responsibility for specific long term conditions and took the lead for monitoring practice performance and providing advice and support to other staff and trainees in relation to relevant guidelines.

Patients were reviewed in line with published guidance or more frequently as required. Patients at risk of hospital admission were identified as a priority and were given same-day access to the service. Longer appointments and home visits were available when needed. Alerts were set up on the electronic records system to remind staff and patients when repeat reviews, blood tests or medicines reviews were due. The practice had focused clinical audit and records reviews on its management of long term conditions, for example recently reviewing the prescribing of antiepileptic medicines.

The clinical team were aware of relevant community based services and provided health promotion advice tailored to people’s needs. The practice referred and signposted patients to other sources of support where appropriate, for example referring patients with diabetes to the “X-PERT programme” which aims to educate patients about successfully self-managing their condition. The practice was achieving good outcomes for patients with diabetes and had taken opportunities to share its experience and good practice with other practices in the area.

Updated 17 December 2015

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.

All children known to be at risk or in local authority care had an alert added to their medical records and their cases were regularly reviewed by the safeguarding lead GP, practice manager and cases reviewed at the weekly clinical meeting.

The premises were suitable for children and babies. The practice had a same day access policy for young children and appointments were available outside of school hours. We saw good examples of joint working with health visitors. For example when new patients registered with the practice, the practice notified the health visitors of all children under five in the household and discussed patients of concern at regular multidisciplinary meetings.

Immunisation rates were high for all standard childhood immunisations. The practice carried out regular searches of the electronic patient records system to monitor immunisation uptake. Missed immunisation appointments were followed up the same day with the family. The practice had also run a birthday card scheme for the past four years, sending cards at birth, one year and four years of age with a reminder about immunisations. The practice was a recognised high performer in relation to immunisation uptake and had been asked to present its experience and learning with other GP practices in the area.

Updated 17 December 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs.

The practice systematically identified older patients with complex needs and at raised risk of admission to hospital and requiring support of multiple agencies. Reception staff also contributed to this process as the receptionists sometimes had more frequent and regular contact with patients and could be the first to spot changes in patients they knew. At-risk patients were assigned a named GP and offered a care plan. The practice had implemented an automatic reminder system to ensure that the responsible GP always contacted patients following hospital discharge to discuss their care and make any appropriate changes to their care plan.

Older patients requiring ongoing case management were discussed at weekly clinical practice meetings and monthly multidisciplinary team (MDT) meetings. MDT meetings involved the community matron, social workers and district nurses as well as practice staff.

The practice hosted a “primary care navigator”, that is a worker funded through the clinical commissioning group who had responsibility for patients over 55. The navigator signposted patients to other sources of community support and was able to see patients at the surgery or visit patients at home.

The practice carried out enhanced assessments of patients over 85 years who live alone and used the electronic records system to run automated searches to identify older patients who would benefit from vaccination against flu, pneumonia and shingles. The practice operated a call/recall system to follow up patients for vaccination and had achieved higher than average uptake levels.

Updated 17 December 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). The practice had a high proportion of patients of working age and had developed a range of services to meet the health needs of this group, such as family planning services (including long acting reversible contraception) and minor surgery.

The practice made use of remote imaging technology to discuss complex cases with hospital specialists in relation to minor surgery and dermatology. This avoided the need for patients to attend an additional outpatients appointment.

The practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. The practice offered early morning, lunchtime and evening appointments. The practice also participated a local scheme to offering primary care appointments on Saturdays and Sundays at a nearby practice on a walk-in basis. The practice staff provided sessions to the weekend service on a rota basis.

The practice offered online appointments, prescription requests and access to summary records. SMS messaging is used to confirm appointments and also to provide results of investigations, to advise patients to pick up reports or referral letters when ready and health promotion/recalls. The GPs also offered telephone consultations at set times every day.

Updated 17 December 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). People experiencing poor mental health received an extended annual health check covering both their mental and physical health. The practice referred patients experiencing mental health problems including dementia to local multi-disciplinary teams and were familiar with local “pathways” to care including those for patients experiencing a mental health crisis.

The GPs had experience and a special interest in providing primary care to patients whose health was complicated by mental health and substance misuse problems. The practice provided counselling services on site with access to talking therapies, a Farsi speaking counsellor and provide longer appointments for patients with complex mental health problems or those requiring an interpreter.

The practice hosted a primary care navigator who followed patients up and provided wider support including help with housing applications. The practice also hosted an on-site community psychiatric liaison nurse who could assess patients with more severe or complex mental health issues. The practice proactively identified older patients at risk of dementia and added an alert to their records prompting clinicians to inquire about any memory concerns.

Updated 17 December 2015

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 recognised the vulnerability of patients at particularly difficult times in their lives, for example following bereavement.

The practice had carried out recent annual health checks of all patients on its learning disability register. The practice offered longer appointments for people with a learning disability.

The practice staff liaised with local homeless hostels to encourage people to register with the practice. The practice offered enhanced physical and mental health checks for homeless people and assigned patients a named GP for continuity of care.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It signposted patients to 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.