Dr R Sigurdsson & Partners

Updated 23 January 2017

Dr R Sigurdsson & Partners is a GP practice located in the town of Herne Bay, Kent. It provides care for approximately 16,000 patients. It is the main part of a larger practice, with a branch surgery approximately 2.5 miles away in Broomfield Road, Herne Bay. The two sites are referred to as the Parks and the Broomfield surgeries. All 16000 patients are cared from both surgeries.

There are five GP partners.There are seven salaried GPs in total four male and eight female GPs. There are eight practice nurses and a healthcare assistant all female. Practice management is spread across a range of disciplines including; a practice manager, a human resources and patient liaison manager, a finance manager and an information technology manager. The practice is supported by a full range of administrative and reception staff.

The demographics of the population the practice serves is more complex than the national averages. There are fewer patients under the age of 20 to 40 years. There are more patients aged over 55 years. There is a significant increase, over the national averages in the numbers of patients in all the age groups from 65 to 85 plus years, particularly in the age groups 65 to 75 and over 85 years of age.

The majority of the patients describe themselves as white British. Income deprivation and unemployment are marginally below average. Although the practice as a whole is not in an area of deprivation there are pockets of deprivation within it.

The practice has a personal medical services contract with NHS England for delivering primary care services to local communities. The practice offers a full range of primary medical services. The practice is a training practice.

The practice is open between 8am and 6.30pm Monday to Friday. Extended hours appointments were offered between 6pm and 8pm each Monday, Tuesday and Wednesday and between 7.30am and 8am every weekday.

Both the surgeries are two story buildings with consulting and treatment rooms on the ground floor.

Services are provided from

The Park Surgery

116 Kings Road,

Herne Bay,

Kent.

CT6 5RE

and

Herne and Broomfield Surgery

38 Broomfield Road,

Herne Bay,

Kent.

CT6 7LY.

We visited both sites during our inspection.

The practice has opted out of providing out-of-hours services to their own patients. This is provided by Primecare through the NHS 111 service. There is information, on the practice buildings and website, for patients on how to access the out of hours service when the practice is closed.

Updated 23 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr R Sigurdsson & Partners on 16 November 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 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 the experience, and had been trained to provide them with the skills and knowledge, to deliver effective care and treatment.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• 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.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. 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.

We saw areas of outstanding practice:

• There was an over age 75’s health check and frailty assessment offered in the patient’s home. These checks were carried out by health care assistants. The practice said that this helped with the early identification of patients who were becoming confused, frail or socially isolated.
• There was a quarterly governance report which summarised complaints, complements and significant events and the learning from them

There is one area where the provider should make improvements:

• The practice should review the systems used to identify patients who are caring for others so as to develop a carers’ register which is more reflective of the patient population.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 January 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.
• The indicators for the best management of diabetes showed that the practice achieved 97% which is 3% above the clinical commissioning group (CCG) and 7% above the 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 named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• There was a nurse home visiting service for anti coagulation monitoring and influenza vaccinations for housebound patients.

Updated 23 January 2017

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

• There were systems 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 accident and emergency (A&E) attendances. Immunisation rates were relatively high for all standard childhood immunisations.
• There was nurse led walk in family planning clinic from 4pm – 6pm every Wednesday, no appointment was required.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.
• The practice’s uptake for the cervical screening programme was 83%%, which was comparable to the clinical commissioning group (CCG) and national average of 82 %.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 23 January 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.

• In partnership with the other three practices in Herne Bay the practice operated a visiting paramedic practitioner service for the over 75s considered at risk of hospital admission.
• There was an over 75 health check and frailty assessment offered in the patient’s home. These checks were carried out by health care assistants. The practice said that this helped with the early identification of patients who were becoming confused, frail or socially isolated.
• GPs from the practice carried out a daily (Monday - Friday) ward round at the local community hospital. The ward has step down beds for discharge from the acute trust. Recently the ward round had been conducted jointly with consultants specialising in the health care of older people.

Updated 23 January 2017

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 was proactive in offering online services and 17% of practice patients were registered to use this service.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 23 January 2017

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

• Seventy six percent of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the local average (80%).
• The percentage of patients with specific diagnosed mental health problems who had had an agreed care plan was 92% which is 2% above the CCG and 3% above the national average.
• The practice regularly worked with multi-disciplinary teams in the case management of patients 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 various support groups and voluntary organisations.
• The practice had a system to follow up patients who had attended A&E where they might have been experiencing poor mental health.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 23 January 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 homeless people and those with a learning disability. There were alerts on the clinical system to identify vulnerable patients for example, child protection, domestic abuse and vulnerable adults
• The practice offered longer appointments for patients with a learning disability.
• 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.