Drs Mitchell and Ahmad

Updated 14 January 2016

Ballards Walk Surgery provides services to approximately 7570 patients. Recently the surgery has experienced an increase in patients registering with the practice. The practice is owned and managed by three GP partners and supported by practice nurses, health care assistants and administrative team overseen by the practice manager. There are three male GPs and patients can access a female GP via the GP Hub Service. The GP Hub Service provides patients from 15 practices within Basildon and Brentwood Clinical Commissioning Group with access to clinical services outside normal practice hours. Monday to Friday they operate from 6.30pm to 8pm and every Saturday and Sunday from 8am to 8pm. Patients can pre-book appointments with GPs, practice nurses and healthcare assistants or walk in and wait to be seen.

The practice holds a contract a General Medical Services contract.

The practice was open between 8am and 6.30pm Monday to Friday. Consultations were conducted between 8.30am to 12noon and 4pm to 6.30pm. The practice operates as a GP hub clinic providing patients with access to clinical services (GP, practice nurses and healthcare assistants) from 6.30pm to 8pm and 8am to 8pm on a weekend, both Saturday and Sunday. After 8pm patients are diverted to the NHS 111 who provide advice and make referrals to the out of hours provider commissioned by Basildon and Brentwood CCG; IC24.

The practice offers an online GP service where advice, guidance and consultations may be held and treatments discussed and approved.

The practice has a comprehensive website. It provides its patients with access to online appointments and prescriptions. It provided details on their patient participation group and specific services and community support networks.

Updated 14 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs Mitchell and Ahmed, also referred to as Ballards Walk Surgery on 9 December 2015. Overall the practice is rated as good.

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 with all staff undergoing security checks.
• The practice was clean and tidy. Staff had received training on infection prevention control and annual infection control risk assessments had been conducted. Where actions had been identified, they had been addressed and appropriately resolved.
• 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 they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients told us they sometimes experienced difficulties making an appointment. This was acknowledged by the practice who had commissioned a new call management system to improve patient experiences. Urgent appointments were available the same day.
• The practice was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported and valued by management. The practice proactively sought feedback from staff and patients, which it acted on.

However there were areas of practice where the provider should make improvements:

• The practice should formalise a business plan.

Professor Steve Field

CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 14 January 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. The practice offered regular consultations, medicine reviews and follow ups. Flu and pneumococcal vaccinations were offered to all patients with a chronic disease. Longer appointments, home visits and evening and weekend appointments 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 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 14 January 2016

The practice is rated as good for the care of families, children and young people. The practice offered a range of clinics working in partnership with community services. For example the health visitor attended the practice twice monthly, the midwife attended twice weekly and ante and post natal checks were conducted weekly lead by a GP.

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 and the premises were suitable for children and babies.

Updated 14 January 2016

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 and had a range of enhanced services, for example, patients over 65 years with chronic disease were invited for the flu, pneumococcal and age relevant shingle vaccine. The practice was responsive to the needs of older people, conducting regular multidisciplinary meetings working with the dementia care team, social services, community teams, occupational health and the ambulance services. In addition, the practice had access to a social worker, who worked in partnership with the GPs and care coordinator. The practice offered home visits, including evening and weekend appointments and rapid access appointments for those patients with enhanced needs.

Updated 14 January 2016

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. The practice offered a range of appointments that included face to face, and telephone consultations, early and late appointments, online and web GP advice and guidance. The practice had an electronic prescribing service, providing patients with the convenience of collecting their prescription at their elected pharmacy. The practice was proactive in providing a full range of health promotion and screening that reflected the needs for this age group.

Updated 14 January 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). People experiencing poor mental health had received an annual physical health check. In addition, where appropriate, medication was prescribed weekly or two weekly to manage individual patient risks. Regular appointments were scheduled with patients where required and at short or no notice. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia such as the Crisis Support Teams and Memory Clinics. They offered access to counsellors who attended the practice weekly; patients were invited and supported to self-refer. The practice 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. 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.

Updated 14 January 2016

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 those with a learning disability. It had carried out annual health checks for people with a learning disability overseen by a lead GP. It offered longer appointments for people with a learning disability. Non attendance by the patients was followed up.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people and conducted regular medicine reviews. 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.