Archived: Dr Rameshchandra Manilal Shah Also known as Thorns Road Surgery

Updated 14 December 2016

Dr Rameshchandra Manilal Shah’s practice at Thorns Road Surgery is a long established practice located in the Brierley Hill area of the West Midlands. There are approximately 3560 patients of various ages registered and cared for at the practice. 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 a male GP and a female practice nurse. The practice also employs a regular locum GP. The GP and the practice manager form the practice management team and they are supported by a team of seven staff members who cover secretarial, administration, reception and practice management support duties.

The practice is open between 8am and 8:30pm on Mondays and between 8am and 6:30pm on Tuesdays, Thursdays and Fridays. On Wednesdays the practice is open between 8am and 1pm.

Appointment times are available between 8:30am to 10:30am and between 4pm to 6pm during weekdays except for Wednesdays, when appointments available until 10:30am. Appointment until a later time of 8pm on Mondays during extended hours.

Nurse appointments are available between the times of 8:30am, up to 1:30pm during weekdays. Nurse appointments are also additionally available between 3:30pm to 6:30pm on Mondays, Tuesdays and Thursdays.

There are arrangements to ensure patients receive urgent medical assistance when the practice is closed, there is a GP on call between 8am and 8:30am and when appointments are closed during weekdays. There are also arrangements to ensure patients receive medical assistance during the out-of-hours period.

Updated 14 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Rameshchandra Manilal Shahs practice (Thorns Road Surgery) on 14 October 2015. 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.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• Some risks to patients who used services were assessed. However we found that risk assessments were not in place to assess a number of risks across the practice.
• The practice had an up to date fire risk assessment and completed weekly fire alarm tests. However, staff we spoke with confirmed that regular fire drills had not taken place.
• The practices recruitment checks were not robust, the practice did not complete a disclosure and barring check (DBS) for their nurse.
• The practice did not correctly monitor the temperature of the vaccination fridges and therefore adherence to cold chain procedures was not robust.
• 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.

• 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.

• 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.

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

The areas where the provider must make improvements are:

• Assess and manage risks associated with legionella and to assess the risk of not having disclosure and barring checks (DBS) for the practice nurse and for staff that chaperone.
• Ensure fridge temperatures are recorded correctly, in line with national guidance, to ensure robust maintenance of the cold chain.

The areas where the provider should make improvement are :

• Ensure regular fire drills take place within the practice.
• Analyse feedback from external and internal surveys to ensure patient needs are listened to and used to drive improvements to the quality and safety of services.
• Assess and manage risks in the absence of emergency medical equipment that reflects national standards

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 December 2015

The practice is rated as good for the care of people with long-term conditions. The nurse had a lead role 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 patients with long term conditions had a named GP and a structured annual review to check that their health and medication needs were being met. 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.

Updated 17 December 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. Immunisation rates were relatively high for all standard childhood immunisations. 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. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 17 December 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. The practice offered proactive, personalised care to meet the needs of the older people in its population. The practice 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.

Updated 17 December 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 and provided extended hours to ensure these were accessible, flexible and offered continuity of care. The practice was proactive in offering online services as well as a full range of health promotion and comprehensive screening programmes that reflects the needs for this age group.

Updated 17 December 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). 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 had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. The practice also supported patients by referring them to a gateway worker from the local mental health trust who provided counselling services on a weekly basis in the practice. The gateway worker also attended and contributed to the monthly multi-disciplinary team meetings at the practice. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

Updated 17 December 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, travellers and those with a learning disability. It had carried out annual health checks, offered longer appointments and offered appointments at quieter times for people with a learning disability.

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.