Archived: Dr Hamid Dathi Also known as Golborne Medical Centre

Updated 17 December 2015

Dr Dathi’s practice (also known as the Golborne Medical Centre) is located in a residential area of west London, in the second most deprived borough. The practice is co-located in premises which are shared with another GP practice, with wheelchair access and all patient areas are on the ground floor. There is limited space within the current building, but there are plans for reconfiguration of the existing space for clinical consultation. The practice has a total patient list size of approximately 2533 patients; the practice population has a slightly lower percentage of over 65s at 12.7% compared to national average.

The practice has a GP (male) he is the partner, who worked full time and was supported by two sessional GPs (female). There was one practice nurse, a practice manager, a phlebotomist, as well as reception and administration staff. The practice has a PMS (Personal Medical Services)

contract with NHS England and is also signed up to a number of local and national enhanced services. Since 2014, Golborne Medical Centre has been a teaching practice for undergraduate students.

The practice is open between 8.30am to 6.30pm Monday to Friday, with an extended hour’s service between 9.00am to 12pm on Saturday. The extended hour service on Saturday is by appointment only. Surgery times for booked appointments are from to 9.30am to 11.30am every morning. Afternoon appointment times are varied, Monday and Tuesday 4pm to 6pm, Wednesday 2pm to 5pm, Thursday 2pm to 4pm and Friday 4pm to 6pm. The practice belongs to the Kensington Chelsea and Westminster GP Cooperative out of hour’s service, patients requiring GP services outside of these hours are directed to the out-of-hours service. Details of how to access this service is displayed on the website, and in the reception area.

Updated 17 December 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Hamid Dathi on 17 September 2015. Overall the practice is rated as good.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
• Of the patients who were placed on the urgent two week referral pathway, 75% of all new cancer diagnosis were picked up by the practice. This was higher than the CCG rate of 40% and the national average of 48.8%.

• The practice worked in collaboration with other health and social care professionals to support patients’ needs and provided a multidisciplinary approach to their care and treatment.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice provided appropriate support for end of life care and patients and their carers received good emotional support.

• Information about services and how to complain was available and easy to understand.
• 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.

However there were areas of practice where the provider needs to make improvements.

The provider should:

• Ensure serial numbers of prescriptions were recorded in accordance with practice policy to have a robust system to monitor their use.
• Ensure recruitment arrangements include all necessary employment checks for all staff, including a written record of an induction programme for non-clinical staff being kept.

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 used the electronic clinical system to monitor patients with long term conditions, with a separate alert and recall system. During consultations motivational interviewing was used to empower patients to be involved in their care and decision making. Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care

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. Immunisation rates were relatively high for all standard childhood immunisations. We saw good examples of joint working with health visitors. 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. Appointments were available outside of school hours. Patient views on the service through feedback, had resulted in a project by medical students designing an antenatal pack specifically for this population group.

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 worked with a Primary Care Navigator for home visits and clinic appointments to support and guide patients to services, including social services if needed. There was rapid access appointments for those with enhanced needs to be seen in a timely manner. Clinicians had undertaken the ‘Gold Standards Framework’ training to support patients requiring end of life care.

Updated 17 December 2015

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 extended hour service on Saturday was accessdible by booked appointments.The practice was proactive in offering online services for repeat prescriptions as well as booking and cancelling appointments. Patients were also able to access telephone consultations with the GP or nurse. There was a full range of health promotion and screening that reflects the needs for this age group. The practice targeted those aged 40-65 years for health checks, this included follow ups if risk factors were identified. Of the patients who were placed on the urgent two week referral pathway, 75% of all new cancer diagnosis were picked up by the practice. This was higher than the CCG rate of 40% and the national average of 48.8%.

The team were proactive in offering this service opportunistically for patients to maximise uptake of the service.

Updated 17 December 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice screens for dementia and refers high risk patients to a Memory Clinic. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The practice were supporting a sessional GP to become the local Champion of Mental Health, which included dementia care. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

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. It had carried out annual health checks for people with a learning disability. It offered longer appointments for people with a learning disability. The practice employed a system to follow up vulnerable patients who did not attend for appointments. They offer a flexible time for patients to attend providing longer appointments for screening, immunisations, mental health and any identified health and social needs. One GP had undertaken specialist training for working with homeless people.

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