Dr Sims & Partners

Updated 25 July 2016

Dr MA Sim's Practice (also known as Dr Sims and Partners) holds a general medical services contract and is situated in a shared premises occupied by three other GP surgeries. It neighbours extensive housing developments. The practice has an estimated 7102 patients on their list. There are three GP partners (two female GPs and a male GP) and two salaried female GPs. They are supported by three practice nurses (two of whom are nurse prescribers) and two healthcare assistants. The reception and administrative staff are overseen by the practice manager.

The practice is open between 8am and 7.30pm on Monday and 8am to 6.30pm Tuesday, Wednesday, Thursday and Friday. Appointments on a Monday are from 9am to 11.20am and 3.30pm and 7.40pm. On Tuesday, Wednesday, Thursday and Friday appointments are available from 9am to 11.50am and 3.30pm to 5.45pm. Extended hours appointments are offered Monday evenings 6.30pm to 7.30pm. In addition to pre-bookable appointments can be booked two weeks in advance for a GP. Urgent appointments are available for people that needed them. Patients benefit from access to the GP hub a local commissioned service operating out of hours Monday to Friday 6.30pm to 8pm and Saturday and Sunday 8am to 8pm.

The practice does not provide out of hours cover. Patients are advised to call the national 111 service. IC24 are currently commissioned to provide out of hours services for Basildon and Brentwood Clinical Commissioning Group.

The practice serves an ageing patient group with higher representation amongst their patients aged 65years and over than the national averages. Deprivation levels for children and older people are higher than the local and national averages. Both male and female patients have a lower life expectancy then the local and national averages.

The practice has a clear and comprehensive website providing patients with a menu of options how they may contact the surgery, access to additional health services and information sites.

Updated 25 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr MA Sims' Practice on 22 June 2016 also known as Dr Sims and Partners. Overall the practice is rated as good.

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

• Staff knew and were confident reporting significant events. These were investigated, responded to and lessons learnt identified. Staff were provided with training and support where appropriate.
• Patient safety and medicines alerts had been appropriately reviewed and actioned. However, they would benefit from revisiting the searches to ensure good safe prescribing practices are embedded within their practice team.
• Staff understood and were confident in safeguarding children and vulnerable adults. The practice had a large number of children known to social services and all children who failed to attend hospital appointments were contacted.
• The premises were found to be clean and tidy and staff had undertaken training in infection control.
• Medicines were managed safely and regular checks were conducted to improve prescribing behaviour.
• Newly appointed staff had received appropriate recruitment check prior to being appointed.
• The practice demonstrated adherence to relevant and current evidence based guidance and standards, including National Institute for Health and Care Excellence (NICE) best practice guidelines.
• The practice had achieved 99.6% of the total number of QOF points available.
• The practice did not conduct multidisciplinary meetings but communicated with partner services tasking one another through the patient record system.
• The practice promoted national screening programmes and had higher than the national average for their patient’s uptake of cervical screenings.
• Data from the national GP patient survey showed patients rated the practice similar to the local and national averages for several aspects of care.
• Staff treated patients with kindness and respect.
• The practice provided a range of face to face, telephone and online consultations with GPs, practice nurses and healthcare assistants.
• Patients were happy with the practice opening hours, but experienced difficulties getting through on the phones.
• Complaints were appropriately recorded, investigated and responded to. Lessons were learnt, apologises made and staff had received training to improve standards of care.
• The partners regarded it as a privilege to be a GP and care for their patients. They met monthly to discuss practice performance and plans for the future of the service.
• There was an overarching governance framework supporting the delivery of services. Staff had appointed roles and responsibilities and covered for colleagues during planned and unplanned absence.
• The practice were active within their Clinical Commissioning Group and participated in national thematic research and local audits to inform the delivery of services.

The areas where the provider should make improvement are:

• Ensure regular medicine searches are conducted to ensure good safe prescribing practices are embedded within the practice prescribing team.
• Ensure palliative care patients receive regular reviews, utilising template data and reference to the Gold Standard Framework.
• Ensure meetings are minuted. Where actions are assigned these are clearly documented in the meeting minutes. They should also include completion or review dates and be revisited at subsequent meetings to ensure actions are progressed and finalised.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 July 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. The practice screened patients for potential chronic diseases.
• Phlebotomy services were provided at the practice every morning and during normal clinics.
• The practice participated in the admission avoidance programme and ensured care plans were in place for their patients.
• 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 their health and medicines needs were being met.
• For patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• The practice had conducted an audit on their prescribing of specific medicines to diabetic patients. They had reviewed the outcomes and amended their practice to improve patient care.

Updated 25 July 2016

The practice is rated as good for the care of families, children and young people.

• Priority on the day appointments were given to children 5 years and under.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• Staff are trained in child safeguarding and the practice worked in partnership with parents, carers and other health and social care professionals such as physiotherapists, health visiting team, wellbeing services (child and adolescent mental health services) and schools.
• 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 were known to social services.
• Immunisation rates were 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.
• Sex education and contraception services were available through appointments and the monthly contraception clinic.
• The practice’s uptake for the cervical screening programme for 25-64year old women was 76%, which was above the national average of 74%.
• The practice benefits from the attendance of a weekly midwifery clinic.

Updated 25 July 2016

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

• The practice serves an ageing population with 137 patients currently residing in residential, nursing or care homes.
• They offered personalised care, encouraging regular health reviews and providing home visits to those who required them.
• The practice worked in partnership with other health professionals such as pharmacy to identify and respond to patients whose health was deteriorating (including depression).
• The practice works with nursing and care homes to develop admission templates to identify immediate medical needs.

Updated 25 July 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 have been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
• The practice provides GP face to face appointments, nursing and health care assistant appointments every morning. Telephone appointments were available with GPs and practice nurses and the practice conducted symptom screening via WebGP patient questionnaire enable them to prioritise call backs.
• Extended surgery appointments were offered on a Monday evening 4.30pm to 7.30pm.These had proven popular with families and shift workers unable to attend during normal hours.
• Out of hours appointments could be booked from 6.30pm to 8pm every weekday evening and 8am to 8pm weekends.
• Online appointments, electronic prescribing services and online access to test results.

Updated 25 July 2016

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

• The practice maintained a register of those of patients with severe mental health conditions. They encouraged patients to have yearly health checks and provided additional consultation time during appointments.
• Patients may be signposted to support services such as Therapy for you or the Child and Adolescent Mental Health Services (CAMHS).
• Patients experiencing deterioration in their memory may be referred to the memory clinic for early diagnosis and Help for Carers a support service.
• Dementia patients received annual reviews. The practice had achieved higher than the national average for the percentages of their patients diagnosed with dementia receiving a face to face review within the preceding 12 months. They achieved 98% in comparison with the national average of 84%.
• Where patients with dementia experienced deterioration in their behaviour multiagency working may be conducted in partnership with the community psychiatric nurse, dementia crisis team and the dementia intensive care team.
• Quiet waiting facilities were available to patients to wait separate for the main areas.
• Patients discharged from hospital with mental health needs were contacted and invited to attend for an appointment.
• Patients on high risk medicines were regularly reviewed by GPs and senior prescribing nurses.

Updated 25 July 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 homeless people, travellers and those with a learning disability. These were appropriately flagged on their patient record system.
• The practice offered longer appointments for patients with a learning disability such as when they conducted their annual health checks.
• The practice regularly worked with other health care professionals (social worker, counsellor, occupational therapist and specialists) in the case management of vulnerable patients.
• 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.
• Patients at risk of misusing their medicine were prescribed medicine daily or weekly.
• Patients with substance misuse dependence were referred to partner services to support them such as Open Road, a drop in service.
• The practice participated in local pilot programmes such as social prescribing, informing vulnerable patients about how to access various support groups and voluntary organisations.
• Carers were encouraged to attend the practice and talk about concerns with the clinical team.