Kumar Medical Centre

Updated 9 December 2016

Kumar Medical Centre is situated in Slough within a converted premises. All patient services are offered on the ground and first floors. The practice comprises of three consulting rooms, one treatment room, a patient waiting area, a reception area, administrative and management office.

The practice has core opening hours from 8am to 6.30pm Monday to Friday. The practice offers a range of scheduled appointments to patients every weekday from 9am to 6.10pm including open access appointments with a duty GP throughout the day. The practice offers extended hours appointments Monday to Friday from 6.30pm to 7pm at the premises. In addition, the practice offers extended hours appointments Monday to Friday from 6.30pm to 8.30pm and every Saturday and Sunday from 9am to 1pm at Crosby House practice (funded by Prime Minister’s Access Fund).

The practice has a patient population of approximately 4,670 registered patients. The practice population of patients aged between 0 to 9 and 15 to 39 years old is higher than the national average and there are a lower number of patients over 40 years old compared to national average.

Ethnicity based on demographics collected in the 2011 census shows the patient population is predominantly Asian and 64% of the population is composed of patients with an Asian, Black or mixed background. The practice is located in a part of Berkshire with the average levels of income deprivation in the area.

There are two GP partners, and two salaried GPs at the practice. Three GPs are male and one female. The practice employs a practice nurse and a clinical pharmacist. The practice manager is supported by an assistant practice manager, a team of administrative and reception staff. Services are provided via a General Medical Services (GMS) contract (GMS contracts are negotiated nationally between GP representatives and the NHS).

Services are provided from following location:

59 Grasmere Avenue

Slough

Berkshire

SL2 5JE

The practice has opted out of providing out of hours services to their patients. There are arrangements in place for services to be provided when the practice is closed and these are displayed at the practice, in the practice information leaflet and on the patient website. Out of hours services are provided during protected learning time by East Berkshire out of hours service or after 6:30pm, weekends and bank holidays by calling NHS 111.

Updated 9 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Kumar Medical Centre on 31 October 2016. Overall the practice is rated as good.

Specifically, we found the practice good for providing safe, effective, caring, responsive and well led services.

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 assessed and well managed.
• 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.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• 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 we spoke to on the day of inspection informed us they were able to make an appointment with a named GP, 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 and complied with the requirements of the duty of candour.

We saw an area of outstanding practice:

• The practice had responded to the needs of ethnic minority diabetic patients and developed ‘The South Asian Lifestyle Intervention Programme’ in collaboration with other practices in the local clinical commissioning group (CCG). The project was aimed at improving the outcomes for diabetic patients. In addition, the practice was offering other health promotion activities, such as, group discussions and yoga classes at the premises. The practice informed us they were one of the best performing practices in managing diabetes in Slough CCG. We noted the positive impact on prescribing rates. For example, the practice had over all lowest prescribing rates (-11%) compared to other practices in the local clinical commissioning group (CCG) and reduced the prescribing of antibiotics by 40%.

The areas where the provider should make improvements are:

• Ensure all staff are aware that a translation service is available and information about a translation service is displayed in the reception areas.
• Review and monitor the system in place to continue with improvements and encourage the uptake for the bowel screening programme.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 December 2016

The practice is rated as outstanding for the care of patients with long-term conditions.

• There were clinical leads for 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 patients with long term conditions had a named GP and the practice carried out a structured annual review to check that their health and medicines needs were being met.
• Data from the Quality and Outcomes Framework (QOF) showed the practice had achieved excellent outcomes for the care of patients with long-term conditions. For example, performance for diabetes related indicators was better than the CCG and national average. The practice had achieved 100% of the total number of points available, compared to 90% locally and 90% nationally.
• The practice had responded to the needs of ethnic minority diabetic patients by taking part in developing a ‘The South Asian Lifestyle Intervention Programme’ in collaboration with other local practices and data showed that patient outcomes had improved.
• We also noted the positive impact on prescribing rates because patients were self managing their long term conditions better due to improved lifestyles.
• A clinical pharmacist was employed to carry out medicines reviews for complex cases patients with long term conditions.
• The practice had a dedicated member of staff to place reminders on the practice’s computer system to ensure all reviews were done in a timely manner.
• The practice was organising monthly ‘health and well-being social club’, weekly yoga classes and offered group discussions to patients with long term conditions at the premises.
• 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 9 December 2016

The practice is rated as good for the care of families, children and young patients.

• 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 patients who had a high number of A&E attendances.
• Immunisation rates were high for all standard childhood immunisations.
• Patients told us that children and young patients were treated in an age-appropriate way and were recognised as individuals.
• The practice’s uptake for the cervical screening programme was 82%, which was same as the national average of 82%.
• The practice offered weekly smoking cessation clinic at the premises.
• 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.
• We noticed that a GP partner was working as a primary care strategy lead in Slough CCG. A GP partner had led a project at CCG level designed to educate young children early about health promotion messages with the added effect of cascading these influencing messages to parents and extended family members. 

Updated 9 December 2016

The practice is rated as good for the care of older patients.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.
• It was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• There was a register to effectively support patients requiring end of life care.
• There were good working relationships with external services such as district nurses.
• The premises was accessible to those with limited mobility. However, the practice did not have a low level desk at the front reception.

Updated 9 December 2016

The practice is rated as good for the care of working-age patients (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 extended hours appointments Monday to Friday from 6.30pm to 7pm at the premises. In addition, the practice offered extended hours appointments Monday to Friday from 6.30pm to 8.30pm and every Saturday and Sunday from 9am to 1pm at Crosby House practice (funded by Prime Minister’s Access Fund).
• 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.
• We noted the practice was offering telephone consultations.

Updated 9 December 2016

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

• Data from 2015-16 showed, performance for dementia face to face reviews was above the CCG and national average. The practice had achieved 88% of the total number of points available, compared to 85% locally and 84% nationally.
• 85% of patients experiencing poor mental health were involved in developing their care plan and health checks.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice had told patients experiencing poor mental health how to access various support groups and voluntary organisations.
• Systems were in place to follow up patients who had attended accident and emergency, when experiencing mental health difficulties.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 9 December 2016

The practice is rated as good for the care of patients whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability.
• It offered annual health checks for patients with learning disabilities. Health checks and care plans were completed for 28 out of 35 patients on the learning disability register.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• 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.