Health inspectors have now formally warned a GP he must make urgent improvements or he could be fined and even be forced to close, after a third inspection found a dirty patient toilet.

The Care Quality Commission (CQC) has issued multiple warnings to Dr Mujib ul Haq Khan of Granville Road Surgery, in Southfields, after he failed to protect patients.

During an inspection, in January this year, out-of-date drugs were discovered, an empty first aid box and inadequate supplies of oxygen.

The CQC warned him action was needed in multiple areas however, in the follow-up inspection in June, the surgery failed to improve in the areas required and the CQC declared enforcement action would be taken against the surgery.

During an unannounced follow-up visit, in August, inspectors found he was failing to meet five of the six national standards inspected.

Despite some improvements, four of the standards inspected in June were still not being met in August.

The CQC has now issued five warning notices after finding out of date medicines, incorrectly stored patient records and inadequate arrangements for medical emergencies.

The most recent report said: "The practice manager had completed weekly checks of the environment, but these checks had not identified there was dust on the doors and screens and the dirt on computer keyboards and telephones.

"The patient toilet was not clean.

"The doctor's bag was not included in the cleaning schedule, we found the inside of the bag was not clean and the foam inside was disintegrating, making the cleaning of the bag and its contents impossible."

Your Local Guardian:

Our front page story exposing the surgery last month 

The CQC can issue fines, place conditions on surgeries and ultimately remove their registration – forcing them to close.

Sarah Seaholme, CQC’s deputy chief inspector of GP’s in London, said: “We have previously issued formal warnings to Dr Khan because he has consistently failed to protect the health, safety and welfare of people using this service.

“This multiple shortfall against national standards is unacceptable and we have warned Dr Khan that immediate improvements must be made.

“We will return unannounced to check that Dr Khan has made the changes require to provide people with high quality care.

"If we find that this service is not making the required progress we will consider using our legal powers further to protect the people who live here.”

Got a story? Call Sophia Sleigh on 020 8722 6344 or email ssleigh@london.newsquest.co.uk