Archived: Dr PD Gupta

Updated 5 October 2017

Dr PD Gupta’s practice is a long established practice based at the Links Medical Practice (formerly Netherton Surgery) located in the area of Dudley, in the West Midlands. There are two practice locations that form the practice; this consists of the main practice at the Links Medical Practice in Dudley and a branch practice at Hazel Road surgery also situated in Dudley. There are approximately 3,295 patients of various ages registered and cared for across both practice sites and the practice has one patient list. Patients can be seen by staff at both surgery sites and systems and processes are shared across the two sites.

Services to patients are provided under a General Medical Services (GMS) contract with NHS England. The practice has expanded its contracted obligations to provide enhanced services to patients. An enhanced service is above the contractual requirement of the practice and is commissioned to improve the range of services available to patients.

The clinical team includes three GP partners (two male and one female) and a practice nurse (female). The GP partners and practice manager form the management team and they are supported by a team of six support staff who cover reception, secretarial and administration roles. The practice is also an approved training practice and became one of the first training practices in the Dudley area, providing training to medical students from Birmingham University.

The Links Medical Practice is open for appointments between 8am and 6pm during weekdays, except for Thursdays when the practice is open until 6:30pm. The Links Medical Practice is also open for appointments on Saturdays from 9am to 11am.

Hazel Road branch practice is open for appointments between 9am and 11am and then from 5pm until 7pm for extended hours during weekdays, except for Thursday afternoons when the practice closes. On Thursday afternoons patients can be seen at the Links Medical Centre.

There are also arrangements to ensure patients receive urgent medical assistance when the practice is closed during the out-of-hours period.

Updated 5 October 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr PD Gupta’s practice, also known as Links Medical Practice on 20 September 2016. Overall the practice is rated as good.

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

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• We saw that staff were friendly and helpful and treated patients with kindness and respect. Staff spoken with demonstrated a commitment to providing a high quality service to patients.

• The practice was proactive in identifying and managing significant events. There was a structured programme of continuous clinical and internal audit. There was a strong theme of shared learning and emphasis on continuous quality and improvement.

• During our inspection we found that some of the practices emergency medicines had expired and that the practices system for monitoring emergency medicines had not been effective. On identifying this, the practice acted immediately and replaced the expired medicines. Furthermore, the practice strengthened their systems for monitoring emergency medicines.

• There was a strong multidisciplinary approach to patient care. The team met frequently and engaged well with other services through a programme of multidisciplinary team (MDT) meetings. Additionally, patients of concern were discussed in practice every two weeks.

• The practice proactively offered depression and sleep screening to patients with long term conditions and were able to offer them with specific support and make onward referrals to support services and specialist clinics where necessary.

• Patients could access appointments and services in a way and at a time that suited them. The practice offered a choice of extended hours to suit their working age population, with extended hours available four days a week at the branch practice on Hazel Road.

• Local prescribing data highlighted that the practice was performing at the highest level for the CCG area for appropriate prescribing of antibiotics and for overall adherence with the local prescribing formulary.

• By focussing on identifying more carers who were registered at the practice, the practices carers register had increased to 3%. This included young carers to enable the practice to offer them with specific care and support.

• The practice had recognised that they had outgrown their premises at the Links Medical Practice and therefore had plans to move across to the large health centre which was situated across the road during the summer of 2017.

The areas where the provider must make improvements are:

• Ensure that processes for checking aspects of safety are effective to ensure adequate emergency medicine arrangements are in place.

• Maintain appropriate governance of patient group directions (PGDs) and ensure that national guidelines are adhered to.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 31 October 2016

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.

• Performance for overall diabetes related indicators was 95%, compared to the CCG average of 89% and national average of 90%.

• We saw evidence that multi-disciplinary team meetings took place on a monthly basis with regular representation from other health and social care services. We saw that discussions took place to understand and meet the range and complexity of people’s needs and to assess and plan ongoing care and treatment.
• Through use of proactive screening, the practice were able to offer specific support to patients and make onward referrals to support services and specialist clinics where necessary. Data highlighted that 9% of the practices list had received sleep screening and 42% of those who were screened also had a long term condition.

Updated 31 October 2016

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.

• Childhood immunisation rates for under two year olds ranged from 76% to 100% compared to the CCG averages which ranged from 74% to 98%. Immunisation rates for five year olds ranged from 74% to 100% compared to the CCG average of 72% to 98%.

• The practice offered urgent access appointments for children, as well as those with serious medical conditions.
• We saw minutes of meetings to support that the practice worked closely with the Health Visitors and Midwife.

Updated 31 October 2016

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met.

• The practice had effective systems in place to identify and assess patients who were at high risk of admission to hospital. Patients who were at risk of admission to hospital and patients who had been discharged from hospital were also discussed on a fortnightly basis.

• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• Immunisations such as flu and shingles vaccines were also offered to patients at home, who could not attend the surgery. The practices flu vaccination rates for patients aged 65 and over were at 76% compared to the national average of 71%. These rates were based on unverified data provided by the practice.

Updated 31 October 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• Patients could access appointments and services in a way and at a time that suited them.

Appointments could be booked over the telephone, face to face and online.

• The practice offered a choice of extended hours to suit their working age population, with extended hours available four days a week at the branch practice on Hazel Road.

• The practice was proactive in offering a full range of health promotion and screening that reflected the needs for this age group.
• Practice data for 2015/16 highlighted that 582 patients had been identified as needing smoking cessation advice and support; all of these patients had been given advice and 4% had successfully stopped smoking.

Updated 31 October 2016

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

• The practice regularly worked with other health and social care organisations in the case management of people experiencing poor mental health, including those with dementia.

• Performance for mental health related indicators was 100%, with an exception rate of 0%. There were 43 patients on the mental health register, 88% had care plans in place and 91% had received a medication review.

• QOF performance showed that appropriate diagnosis rates for patients identified with dementia were at 100%, with an exception rate of 11%.
• The practice also proactively offered depression screening to patients. Practice data indicated that 267 (8% of the practices list) had been screened for depression. 

Updated 31 October 2016

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

• There were 11 patients on the practices learning disability register, 91% of these patients had care plans in place and 91% of the eligible patients had received a medication review in a 12 month period.

• The practice regularly worked with other health and social care organisations in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations. Additionally, records of fortnightly practice meeting minutes demonstrated that patients of concern and vulnerable patients were discussed in practice every two weeks.

• The practice had 14 patients on their palliative care register. The data provided by the practice highlighted that 100% of these patients had a care plan in place and 93% had received a review in a 12 month period. We also saw that the practices palliative care was regularly reviewed and discussed as part of the multidisciplinary meetings to support the needs of patients and their families.
• The practice had identified 43 patients with drug and alcohol dependencies, these were included in the practice register for vulnerable patients. Practice data highlighted that 95% of these patients received medication reviews within a 12 month period.