Archived: Dr Pattara and Dr Raja Also known as The Surgery Horndon-on-the-Hill

Updated 11 July 2016

This practice is also known as ‘The Surgery Horndon-on-the-Hill’.

The practice is situated at the top of a hill on the High Road and is opposite the Bell Inn Public House. Car parking is either on the High Street outside the practice or there is some parking at the Bell Inn.

The practice register patients from all over Thurrock, the Lower Dunton Road, Bulphan, Dry Street, parts of Laindon and Basildon.

It is a dispensing practice. This means that patients who do not have a dispensing chemist within a 1.6km radius of their house can get their prescribed medicines dispensed from the practice.

The current list size of the practice is 2615. There are two male GP partners who cover 10 sessions a week between them. There are two female practice nurses.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments are from 8.30am to 12pm every morning and from 2pm to 6.30pm every afternoon. Extended hours are offered Mondays 6.30pm to 8pm. The practice is closed at 1pm on the second Tuesday of every month for staff training.

Thurrock Clinical Commissioning Group (CCG) has recently launched a weekend system called ‘Thurrock Health Hubs’. Patients are able to book through the practice to see either a doctor or a nurse between 9.15am and 12.30pm at the weekend, at one of four ‘hubs’.

When the practice is closed patients are advised to call 111 if they require medical assistance and it cannot wait until the surgery reopens. The out of hours service is provided by IC24.

The practice area demographic comprises of mainly white British, with other nationalities including French, Italian and Polish. There are fairly low levels of income deprivation affecting children and older people.

Updated 11 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Pattara and Dr Raja on 28 April 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment. Where staff needed to refer to other professionals this was completed in a timely manner.
• Patients spoken with said they were treated with compassion, dignity and respect. They told us they were involved in their care and decisions about their treatment.
• Results from the national GP patient survey published in January 2016 showed patients had a high level of satisfaction with the practice.
• Information about services and how to complain was available, clearly displayed and easy to understand. No written or verbal complaints had been made in the last 12 months.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day and routine within a few days.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff were well supported by management. A new practice manager was in post and there was a programme of improvements being implemented. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Ensure ensure all new medicines dispensing staff receive supervision in line with guidelines set out in the Dispensary Services Quality Scheme regarding trainee dispensers.
• Undertake infection control audits.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 July 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had a lead role in chronic disease management and ensured that they kept up to date with latest developments through peer support and training sessions and other training opportunities.
• Nationally reported data showed that outcomes for patients with long-term conditions were comparable or slightly higher than other practices nationally. For example, numbers of patients with long-term conditions, such as diabetes, receiving appropriate reviews were comparable or slightly higher than the local and national average.
• 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 GP or practice staff met regularly and worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 11 July 2016

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.
• We saw evidence to confirm that children and young people were treated in an age-appropriate way and were recognised as individuals.
• Nationally reported data showed that outcomes for patients for uptake of cervical smears were higher than other practices locally and nationally.
• The practice made a room available for a maternity clinic, held by a midwife, every two weeks on a Friday morning from 9.30am to 11.30am.
• Appointments were available outside of school hours. Premises were suitable for children and babies, although there was no baby changing facilities.

Updated 11 July 2016

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

• The practice staff were familiar with the majority of its patients due to the size of the practice and used this knowledge to ensure that patients received proactive, personalised care which met individual’s needs.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• Nationally reported data showed that outcomes for patients for conditions commonly found in older people were in line with or better than compared to the local and national average. For example, the numbers of patients with a diagnosis of hypertension having an annual review was comparable with other practices locally and nationally.
• The practice told us that following discharge from hospital older patients were contacted by the GP for a review.

Updated 11 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, those recently retired and students 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 extended hours on a Monday evening until 8pm for working patients who could not attend during normal opening hours.
• If patients were unable to attend the practice during the week there was a service available, that was bookable through the practice, where a patient could be seen at a ‘hub’ at the weekend. This including appointments for doctors, nurses or health care assistants.
• The practice was proactive in offering online services, such as repeat prescriptions and online booking, as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 11 July 2016

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

• The percentage of patients diagnosed with dementia who had had their care reviewed in a face to face meeting in the last 12 months, was in line with the local and national average.
• The percentage of patients, on the practice register, with a diagnosis of schizophrenia, bipolar affective disorder or other psychosis, that had an agreed care plan documented in their records, was less with the national average. However the data was affected by the small numbers of patients in the practice population and on the register.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.
• The practice had information regarding various support groups and voluntary organisations displayed in the waiting area.
• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

Updated 11 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 those with a learning disability.
• The practice offered longer appointments for patients with a learning disability, and for other vulnerable patients on a case by case basis.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice informed 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. Posters displaying this contact information were readily available to staff.