Background to this inspection
Updated
28 February 2017
Dr Parveen Aggarwal is responsible for providing primary care services to approximately 5,100 patients. The practice has a General Medical Services (GMS) contract and offers a range of enhanced services such as flu and shingles vaccinations and timely diagnosis of dementia. The practice has one GP partner at the time of inspection, three long term locum GPs, three practice nurses, administration and reception staff and a practice manager.
The practice is open from 8am to 6.30pm each day and on Monday and Wednesday they stay open until 7.30pm. Patients can book appointments in person, via the telephone or online. The practice provides telephone consultations, pre-bookable consultations, urgent consultations and home visits. Same day appointments were also available for patients in an emergency. The practice treats patients of all ages and provides a range of primary medical services. Home visits and telephone consultations are available for patients who require them, including housebound patients and older patients. The practice treats patients of all ages and provides a range of medical services. This includes disease management such as asthma, diabetes and heart disease. Other appointments are available for maternity care, mental health and travel vaccinations.
The practice does not provide an out-of-hours service but has alternative arrangements in place for patients to be seen when the practice is closed. For example, if patients call the practice when it is closed, an answerphone message gives the telephone number they should ring depending on the circumstances. Information on the out-of-hours service is available on the practice’s website and in the patient practice leaflet.
The practice is part of the NHS Coventry and Rugby Clinical Commissioning Group (CCG). The practice is located in a very deprived area of the borough area where people experience high levels of unemployment (23% compared to 5.4% nationally) and a high number of the population (40% compared to 54% nationally) who are living with a long-standing health condition.
Updated
28 February 2017
Letter from the Chief Inspector of General Practice
We carried out an announced comprehensive inspection at Dr Parveen Aggarwal on 11 January 2017. Overall the practice is rated as good. We found that;
- On the day of the inspection the practice did not have a defibrillator or oxygen on the premises for use in a medical emergency situation. Proof of purchased was sent to us following the inspection.
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The arrangements for managing medicines, including obtaining, prescribing, recording, handling was safe but the storage of prescription pads required improving.
- 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.
- Feedback from patients about their care was consistently positive. We saw good communication with patients from staff so that they understood their care, treatment and condition.
- Information about services and how to complain was available and easy to understand. We found openness and transparency about how complaints and concerns were dealt with. Lessons were learned from concerns and complaints, and appropriate action taken as a result to improve the quality of care.
- The practice had good facilities and was well equipped to treat patients and meet their needs.
- There was a programme of clinical and internal audit, which was used to monitor quality and systems to identify where action should be taken.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice
People with long term conditions
Updated
28 February 2017
The practice is rated as good for the care of people with long-term conditions. The practice held information about the prevalence of specific long term conditions within its patient population. This included conditions such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. The information was used to target service provision, for example to ensure patients who required regular checks received these. Practice nurses held dedicated lead roles for chronic disease management. Longer appointments and home visits were available for patients with long term conditions when these were required. Patients with multiple long term conditions were offered a single appointment to avoid multiple visits to the surgery.
Families, children and young people
Updated
28 February 2017
The practice is rated as good for the care of families, children and young people. The practice had a reminder system for parents who did not bring children and babies for immunisation, sending these letters out whenever possible. Appointments for young children were prioritised. Staff were aware of safeguarding matters related to children and how to respond to these. We found the practice had regular safeguarding meetings with all professionals to discuss patients at risks and any developments to this. The staff we spoke with had appropriate knowledge about child protection and how to report any concerns. The practice provided a comprehensive and confidential sexual health and contraceptive service delivering the full range of contraceptive services.
Updated
28 February 2017
The practice is rated as good for the care of older people. The practice offered proactive, personalised care and treatment to meet the needs of the older people in its population. The practice had a higher than average number of older people in its population. Up to date registers of patients with a range of health conditions (including conditions common in older people) were maintained and these were used to plan reviews of health care and to offer services such as vaccinations for flu. Nationally reported data showed that outcomes for patients for conditions commonly found in older people were similar to or in some cases better than local and national averages. Monthly multi-disciplinary meetings were held to discuss the care and treatment for patients with complex needs.
Working age people (including those recently retired and students)
Updated
28 February 2017
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. Extended opening hours for patients was in place. 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. The practice had an active website as well as noticeboards in reception advertising services to patients.
People experiencing poor mental health (including people with dementia)
Updated
28 February 2017
The practice is rated good for the care of people experiencing poor mental health (including people with dementia). The practice maintained a register of patients receiving support with their mental health. These patients were mostly known by reception staff and we saw they would call patients to remind them an appointment had been booked for them. Patients experiencing poor mental health were offered an annual review. The practice worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The practice referred patients to appropriate services such as psychiatry and counselling services. The practice had information in the waiting areas about services available for patients with poor mental health. For example, services for patients who may experience depression.
People whose circumstances may make them vulnerable
Updated
28 February 2017
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 in order to provide the services patients required. For example, a register of people who had a learning disability was maintained to ensure patients were provided with an annual health check and to ensure longer appointments were provided for patients who required these. The practice worked with relevant health and social care professionals in the case management of vulnerable people. The practice referred patients to local health and social care services for support, such as drug and alcohol services. 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. Information and advice was available about how patients could access a range of support groups and voluntary organisations.