Dr Sivaranjini Shyamsundar Also known as Lincoln House Surgery

Updated 5 January 2018

Dr Sivaranjini Shyamsundar’s practice is located in a residential area in Birkdale. There were approximately 2094 patients on the practice list and the majority of patients were of white British background.

The practice is a teaching practice managed by an individual female GP who works full time. There is one practice nurse, a practice manager, reception and administration staff. The practice occasionally has regular locum GPs and there is a trainee physician associate. The practice is open 8am to 6.30pm Monday to Friday. In addition there are additional pre bookable evening appointments available until 7pm on Wednesdays.

Patients access the Out-of-Hours GP service by calling NHS 111.

The practice is commissioned by NHS Southport and Formby local clinical commissioning group and has a Personal Medical Service (PMS) contract and also offers enhanced services for example; extended hours.

Updated 5 January 2018

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Sivaranjini Shyamsundar’s practice (also known as Lincoln House Surgery) on 8 September 2017. Overall the practice was rated as good but required improvement for providing safe services. The practice was issued a requirement notice for being in breach of regulations for safety. The full comprehensive report on the on 8 September 2017 inspection can be found by selecting the ‘all reports’ link for Dr Sivaranjini Shyamsundar on our website at www.cqc.org.uk.

This inspection was an announced follow up inspection carried out on 15 December 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulation that we identified in our previous inspection on 8 September 2017. This report includes our findings in relation to those requirements.

Overall the practice is now rated as good for providing services and the requirement notice has been met.

The practice had made significant improvements and addressed the issues identified in the previous inspection. The practice engaged all staff in driving forward improvements.

Improvements included:

• An improved system to review and act on any patient safety and drug alerts.
• A new system to make sure there was an authorisation process for practice nurses to administer vaccinations.
• An improved monitoring system for uncollected prescriptions.
• A system to review any abnormal screening checks for patients.
• A system to record actions taken from any incidents.
• Oxygen was available for medical emergencies.
• An improved system for monitoring fridge temperatures for the storage of vaccinations.

All staff had been made aware of the new systems in place.

In addition:-

• The practice had updated patient information literature regarding who patients can complain to as an alternative to the practice i.e. NHS England.
• The practice had improved the system to monitor verbal complaints.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 October 2017

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

• There was a system to recall patients for a structured annual review to check their health and medicines needs were being met. .
• For those patients with the most complex needs, the GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• The practice had a phlebotomy service onsite for convenience.

Updated 13 October 2017

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

The practice worked with midwives and health visitors to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics and provided immunisations. 

Updated 13 October 2017

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

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.

Updated 13 October 2017

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

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.
• The practice had an additional clinic available once a week in the evening for patients who could not attend during normal working hours.

Updated 13 October 2017

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

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• The practice was able to signpost patients experiencing poor mental health to access various support groups and voluntary organisations.

Updated 13 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.
• 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 had information available for vulnerable patients about how to access various support groups and voluntary organisations.