Milman & Kennet Surgery Also known as Milman Road Health Centre

Updated 3 July 2017

Milman Road Surgery - Dr Mittal(also known as Milman Road Health Centre) provides primary care GP services to approximately 15000 patients in the South Reading area. The practice has a large catchment area and contains some of the most deprived wards in Reading, meaning many patients are affected by social and economic depravity locally. In comparison to other areas, Milman Road Surgery - Dr Mittal has a higher proportion of patients of working age and a lower than average older population (over 60). Although the majority of the patients are white British, the practice has recognised established ethnic minorities of South Asian and Nepalese descent.

The practice is located in a residential street with clearly signed entrance. The reception areas are located on both ground and first floors. The first floor is accessed via a lift or stairs. There is car parking available on site and in some surrounding streets.

The practice staff list has two partners (one male GP and one senior manager), six salaried GPs (three male, three female), a Nurse Practitioner (female), two practice nurses (female), two health care assistants (female), one midwife (female), two senior managers, one reception manager and nine receptionists.

The clinical staff operate from 9 consulting rooms and 5 treatment rooms, which are located on both ground and first floor. There are two reception areas with access to the consultation and treatment rooms and toilet facilities including baby change and disabled toilet. The practice has recently undergone major expansion and refurbishment.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments are varied to allow greater flexibility to patients. The practice offers appointments at the following times;

• Mondays from8am to 1pm in the morning and 2.30pm to 6pm in the afternoon.
• Tuesdays from 7.00am to 12.40pm in the morning and 2.30pm to 5.30pm in the afternoon.
• Wednesdays from7.00am to 12pm in the morning and 2.30pm to 6pm in the afternoon.
• Thursdays from 8.30am to 1pm in the morning and 1.30pm to 6pm in the afternoon.
• Fridays from 7.00am to 1pm in the morning and 1pm to 5.30pm in the afternoon.

Extended surgery hours are offered on Tuesday, Wednesday & Friday mornings from 7am and one rotational evening session is available each week until 8pm. In addition, the practice is open every Saturday from 8am until 12.30pm with both pre-bookable appointments and walk-in appointments available.

The practice does not offer out of hours cover out of these times. This service is covered by Westcall as part of the NHS 111 service.

All services are provided from: Milman Road Health Centre, Milman Road, Reading, Berkshire, RG2 0AR

Updated 3 July 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Milman Road Surgery- Dr Mittal on 26 January 2016. The overall rating for the practice was good. The full comprehensive report on the January 2016 inspection can be found by selecting the ‘all reports’ link for Milman Road Surgery – Dr Mittal on our website at www.cqc.org.uk.

The practice registered an additional 5000 patients on 1 April 2017 following the closure of another practice in the same building. The practice that closed had a breach of regulation identified during their inspection in September 2016. CQC had also received information of concern regarding Milman Road Surgery – Dr Mittal that required follow up.

This inspection was an announced focused inspection, carried out on 23 May 2017, to follow up the issues of concern and verify that the practice systems in place supported the rapid increase in registered patients. This report covers our findings in relation to these issues and the information of concern we had received. We have not reviewed the existing ratings following this inspection.

Our key findings were as follows:

• The practice provided information in languages other than English to support patients whose first language was not English.
• Clinical audit was undertaken to improve outcomes for patients and an audit plan was in place.
• There was a system in place to manage requests for home visits and telephone consultations.
• The practice demonstrated an effective process for dealing with repeat prescription requests and issue of urgent prescriptions.
• There was a system in place to record and take action upon medicine and product alerts. Minutes of meetings showed that these were discussed and actions taken when appropriate. The GP we spoke with identified medicine alerts and the action taken when they were relevant to the practice.
• There was a portable hearing loop available for use at both reception desks to assist patients that used hearing aids.
• Automated doors were provided and a lift was available to assist patients with mobility problems.

The practice had systems in place that complied with regulations and supported the care of all registered patients. These systems addressed the breaches that had affected the practice whose patients transferred upon closure of the next door practice on 31 March 2017. The practice also demonstrated systems were in place to address the concerns CQC had received since the last inspection.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 March 2016

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

• GPs had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Data related to diabetes care were mixed. For example, 71% of diabetic patients had received a blood test result within set targets, compared to the national average of 78%. 92% of diabetic patients had received a foot examination compared to the national average of 88%.

• 58% of patients under 65 with long term conditions had received a seasonal flu vaccination compared to the national average of 55%.

• 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 GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 24 March 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 higher than the CCG average for all standard childhood immunisations.

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  Patients told us that children and young patients were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• 68% of females aged 25-64 had a record of a cervical smear test within a target period compared to the CCG average of 70% and national average of 74%.

• 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.

Immunisation rates for the standard childhood immunisations were above the CCG average, with the exception of Hepatitis B which was below the CCG for children under 24 months old.

Updated 24 March 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.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• 71% of patients aged 65 or over had received a seasonal flu vaccination which was comparable to the national average of 73%.

• Nationally reported data showed that outcomes for patients for conditions commonly found in older patients were mixed. For example, 89% of patients with COPD had a review undertaken (including relevant breathing assessments) compared to the national average of 90%. However, 78% of patients with high blood pressure (BP) had a recorded BP check within set parameters compared to the national average of 84%.

Updated 24 March 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 online services as well as a full range of health promotion and screening that reflects the needs for this age group.

• The practice offered seven hours of extended hours surgeries which is above the required contractual obligation to provide four hours.

Updated 24 March 2016

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

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  92% of patients diagnosed with severe mental health conditions who had their care reviewed in a face to face meeting in the last 12 months, which was better than the CCG average of 81% and national average of 77%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had signposted patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 24 March 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 patients, travellers and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with multi-disciplinary teams 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.