Dr Agha & Siddique Also known as Thorpe Bay Surgery

Updated 29 October 2018

Dr Agha & Siddique provides a range of primary medical services from its premises at Thorpe Bay Surgery, 99 Tyrone Road, Thorpe Bay, Southend-On-Sea, Essex, SS1 3HD. The practice has a registered manager in place. (A registered manager is an individual registered with CQC to manage the regulated activities provided).

The practice serves a population of approximately 7,099 and is a teaching and training practice. The area served is less deprived compared to England as a whole. The practice population is mostly white British with South Asian and Central and Eastern European communities. The practice serves an above average population of those aged 50 years and over. There is a lower than average population of those aged from 0 to 9 years and 20 to 44 years.

The clinical team includes two GP partners (one male and one female), two salaried GPs (one male and one female), two female trainee GPs, one nurse prescriber, one practice nurse and one healthcare assistant. The team is supported by a practice manager and seven other secretarial, administration and reception staff. The practice provides services under a General Medical Services (GMS) contract (a nationally agreed contract with NHS England).

The emergency phone line is open from 8am to 8.30am daily. The practice is open from 8.30am to 6.30pm Monday to Friday. Between 1pm and 3pm daily the doors are closed but the phone lines remain open. There is extended opening every Monday until 8pm.With the exception of Tuesdays from 1pm when there is no surgery, in general appointments are available from 9.30am to midday and 4pm to 6.30pm Monday to Friday, with slight variations depending on the doctor and the nature of the appointment.

An out of hours service for when the practice is closed is provided by Integrated Care 24 (IC24).

Updated 29 October 2018

This practice is rated as Good overall. (Previous rating 04/10/2017 – Good)

We carried out an announced comprehensive inspection at Dr Agha and Siddique on 4 October 2017. The overall rating for the practice was good, with requires improvement for safe. The full comprehensive report on the October 2017 inspection can be found by selecting the ‘all reports’ link for Dr Agha and Siddique on our website at www.cqc.org.uk.

The key question at this inspection is rated as:

Are services safe? – Good

We carried out an announced focused inspection at Dr Agha & Siddique on 26 September 2018 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulation that we identified in our previous inspection on 4 October 2017. We inspected the key question safe as this area related to the breach of regulation.

This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

At this inspection we found:

• A legionella risk assessment had been carried out and there was a legionella management policy in place at the practice. There were processes in place to monitor and control the risk of legionella.
• Prescription stationery was stored securely and there was system in place to monitor its distribution throughout the practice.
• The practice had identified 2.2% of the patient list as carers. The practice offered support to carers, including annual health reviews and information packs.
• The Patient Participation Group (PPG) was led by the patients.

• There was a system in place to monitor training that had been identified by the practice as mandatory for all staff. The records showed that most training was up to date and organised for the future where required.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Updated 31 October 2017

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.
• 75% of patients on the asthma register had their care reviewed in the last 12 months. This was similar to the CCG average of 74% and the national average of 76%.
• Performance for diabetes related indicators was similar to the CCG and national averages. The practice achieved 86% of the points available with 9% exception reporting compared to the CCG average of 80% with 10% exception reporting and the national average of 90% with 12% exception reporting.
• All newly diagnosed patients with diabetes were managed in line with an agreed pathway.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GPs worked with relevant health and care professionals to deliver a multi-disciplinary package of care.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

Updated 31 October 2017

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 may be 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 child 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.
• The practice’s uptake for the cervical screening programme in 2015/2016 was 77% which was similar to the CCG and national average of 81%.
• Appointments were available outside of school hours and the premises were suitable for children and babies. Same day appointments were available for children.
• There were six week post-natal checks for mothers and their children.
• A range of contraceptive and family planning services were available. Chlamydia testing kits were available at the practice.

Updated 31 October 2017

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

• The practice offered proactive, personalised care to meet the needs of the older people in its population.
• The practice was responsive to the needs of older people and offered home visits and urgent appointments for those with enhanced needs.
• Older people had access to targeted immunisations such as the flu vaccination. The practice had 1,783 patients aged over 65 years. Of those 998 (56%) had received the flu vaccination at the practice in the 2016/2017 year. We spoke with staff about the low uptake of the flu vaccination among the practice’s population aged over 65 years. They told us that many patients now chose to receive their flu vaccinations at local pharmacies that offered the service.
• There were two care or residential homes in the practice’s local area. The GPs visited on a regular basis and when required to ensure continuity of care for those patients.
• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.

Updated 31 October 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
• The practice offered online services such as GP appointment booking (this was not yet available for nurse appointments) and repeat prescriptions as well as a range of health promotion and screening that reflects the needs for this age group.
• The practice sent patients text message reminders of appointments which included the facility for patients to cancel their appointments by return text.
• The practice operated a phone triage system every morning and afternoon to assess urgent need and ensure all those patients who required a same day consultation were seen.
• The practice provided an electronic prescribing service (EPS) which enables GPs to send prescriptions electronically to a pharmacy of patients’ choice.
• There was some additional out of working hours access to appointments to meet the needs of working age patients. There was extended opening every Monday until 8pm.
• 59% of the practice’s patients aged 60 to 69 years had been screened for bowel cancer in the past 30 months compared to the CCG average of 52% and the national average of 58%.
• 66% of female patients aged 50 to 70 years had been screened for breast cancer in the past three years compared to the CCG average of 62% and the national average of 73%.

Updated 31 October 2017

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

• 73% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months. This was similar to the CCG average of 81% and the national average of 84%.
• Performance for mental health related indicators was similar to the CCG and national averages. The practice achieved 94% of the points available with 8% exception reporting compared to the CCG average of 87% with 10% exception reporting and the national average of 93% with 11% exception reporting.
• The practice regularly worked with other healthcare professionals in the case management of people experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice had told patients experiencing poor mental health about how to access support groups and voluntary organisations.
• The staff we spoke with had a good understanding of how to support patients with mental health needs and dementia.
• There was a GP lead for mental health.

Updated 31 October 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 including those with a learning disability. There were 28 patients on the practice’s learning disability register at the time of our inspection. Of those, 11 had been invited for and six (21%) had accepted and received a health review since April 2017. Senior staff told us all of these patients would be invited for a review by March 2018 (within a 12 month period).
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other healthcare professionals in the case management of vulnerable people.
• The practice had some information available for vulnerable patients about how to access 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.
• The practice had identified 166 patients on the practice list as carers. This was approximately 2.4% of the practice’s patient list. Of those, 27 had been invited for and 12 (7%) had accepted and received a health review in the past 12 months. Senior staff at the practice were aware of the low rate of offering carers an annual health review and could demonstrate they were responding to it.