Archived: Dr Mohan and Associates

Updated 1 October 2015

Dr Mohan and Associates is a practice located in the London Borough of Barking and Dagenham. The practice is part of the NHS Barking and Dagenham Clinical Commissioning Group (CCG) which is made up of 40 practices. It currently holds a Personal Medical Service (PMS) contract and provides NHS services to 7982 patients. The practice is a teaching practice.

The practice serves a diverse population with many patients attending where English is not their first language. The practice does not have a large older population (6%) and 22.8% of the population is under the age of 14. The practice is situated within a purpose built health centre which it shares with another GP practice. The practice has lift access to meeting rooms and all consulting rooms are on ground level. Staffing comprised six GP’s (three male and three female), a GP registrar, two practice nurses, administrative staff and a practice manager.

The practice is open between 8.00am to 6.30pm on each week day except Thursday when it is open from 8.30am to 1.30pm. The practice is open until 8pm on a Tuesday. Appointments are available from 9am to 1pm for the morning session and then 4.30pm to 6.30pm in the afternoon. Extended hours appointments are available between 6:30pm and 8pm on a Tuesday.

Telephone consultations, and home visits are also offered. The practice opted out of providing an out of hours service and refers patients to the local out of hours service or the ‘111’ service.

The service is registered with the Care Quality Commission to provide the regulated activities of diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and the treatment of disease, disorder or injury.

The practice provides a range of services including child health and immunisation, minor illness clinic, smoking cessation clinics and clinics for patients with long term conditions. The practice also provides health advice and blood pressure monitoring.

Updated 1 October 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Mohan and Associates on 13 May 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing well-led, effective, caring, safe and responsive services. It was also good for providing services for the care provided to older people, people with long term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable, and people experiencing poor mental health (including people with dementia).

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.
• 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.
• Patients said they were treated with compassion, dignity and respect and that they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• 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.

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

Importantly the provider should:

• .Ensure water safety through legionella testing
• Ensure the practice business continuity plan is regularly reviewed and updated.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 1 October 2015

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. 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 example, the practice had undertaken annual reviews for 65% of patients on the chronic obstructive pulmonary disease (COPD) register. Thirty five percent of patients on the COPD register had a self-management care plan documented in their records. 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. The practice also ran diabetic and heart failure clinics for patients.

Updated 1 October 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. The practice had a dedicated member of staff to manage this. Immunisation rates were relatively high for all standard childhood immunisations. For example the practice vaccinated 81.7% of children with the MMR vaccination. No comparative data was available from the Clinical Commissioning Group (CCG). 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 and the premises were suitable for children and babies, this included baby changing facilities. We saw good examples of joint working with midwives and school nurses. Joint working with the community health visiting team was limited due to the availability of the team.

Updated 1 October 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 For example 60.6% of patients had received a flu vaccination. All patients had a named GP and this was recorded within their notes 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 met regularly with the community matron team to discuss the on-going needs of the older patients on the practice register.

Updated 1 October 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 practice was proactive in offering online services including online booking of appointments. The practice provided a full range of health promotion and screening that reflects the needs for this age group. Support was given to those working people who became ill through the use of medical certificates and the fit note system.

Updated 1 October 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). Seventy eight percent of patients on the mental health register had an agreed care plan. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia.

The practice advised patients experiencing poor mental health how to access support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E) who may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs including dementia.

Updated 1 October 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 eight of the 45 patients on the learning disability register. It offered longer appointments for people with a learning disability and those who required interpreting services.

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. The GP also provided a report for the transition of young people in social services care to adult services.