Archived: Dr Haroon Siddique Also known as The Shaftesbury Avenue Surgery

Updated 15 April 2016

Dr Haroon Siddique is located in a refurbished residential dwelling located in a residential area of Southend, Essex. The practice provides services for 2281 patients.

The practice holds a General Medical Services (GMS) contract and provides GP services commissioned by NHS England and Southend Clinical Commissioning Group. A GMS contract is one between GPs and NHS England and the practice where elements of the contract such as opening times are standardised.

The practice population is lower than the national average for younger people and children under four years and higher for older people aged over 65 years. The practice patient list is similar to the national average for long standing health conditions. Life expectancy for men and women is slightly higher than the national average.

Economic deprivation levels affecting children, older people are similar to the practice average across England. The practice population is similar to the national average of working aged people in employment or full time education lower numbers of working age people that are unemployed.

The practice provides the following directed enhanced services:

• Extended opening hours.

• Childhood immunisations and vaccinations.

• Dementia screening.

• Flu vaccinations.

• Unplanned hospital admissions avoidance.

The practice is managed by an individual GP who holds financial and managerial responsibility. The practice employs one salaried GP and two locum GPs. In total one male and three female GPs work at the practice. The practice also employs one practice nurse. In addition the practice employs a management team including a practice manager and a team of receptionists and administrative staff.

The practice is open from 8.30am to 7.30pm on Mondays, 8.30am to 6.30pm on Tuesdays, Wednesdays, Thursdays and Fridays.

Morning appointments are available from 9am to 11.30am on Mondays, Tuesdays and Wednesdays, 9.30am to 12 midday on Thursdays and Fridays. Afternoon appointments are available from 3pm to 5.30pm on Mondays, Wednesdays and Fridays, 4pm to 6.30pm on Thursdays. Late evening appointments are available up to 7.30pm on Mondays. Morning only appointments are available on Tuesdays.

Updated 15 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Haroon Siddique on 9 March 2016. Overall the practice is rated as good.

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

• The practice referred to and used published safety information to monitor and improve safety outcomes for patients. Staff reported concerns about patient safety and when things went wrong these were fully investigated. Learning from safety incidents was shared with staff to minimise recurrences.
• All equipment was routinely checked, serviced and calibrated in line with the manufacturer’s instructions.
• Risks to patients and staff were assessed and managed. There were risk assessments in place for areas including fire safety, health and safety, premises and equipment. There was information available in relation to the Control of Substances Hazardous to Health (COSHH) such as cleaning materials.
• There was a business continuity plan in place to deal with any untoward incidents which may disrupt the running of the practice. However this was not practice specific and did not describe roles and responsibilities and the actions they should take in event of disruption to the services.
• Appropriate checks including employment references and DBS checks were made when new staff were employed to work at the practice.
• Staff received training, supervisions and were supported to carry out their roles and responsibilities.
• There were arrangements in place for managing medicines.
• Emergency equipment and medicines were available. However there were no paediatric pads for use of the defibrillator on children.

• The practice used published guidelines, reviews and audits to monitor how patients’ needs were assessed and the delivery of care and treatment.

• Clinical audits were carried out. However these were not complete and they did not demonstrate improvements in outcomes for patients.

• Patients consent to care and treatment was sought in line with current legislation and guidance.

• Patients said they were treated with respect and care. They said that all staff were helpful and caring.
• Information about how to complain / escalate concerns should patients remain dissatisfied was available. Complaints were investigated and responded to appropriately and apologies given to patients when things went wrong or they experienced poor care or services.
• Patients said they found it easy to make an appointment with their GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had facilities and equipment to treat patients and meet their needs.
• The premises were accessible to patients with disabilities and had step free access, disabled access toilet facilities and a hearing loop.
• Translation services were available as required.
• 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.

However there were areas of practice where the provider needs to make improvements.

The practice SHOULD

• Provide paediatric pads for the use of the defibrillator in children up to 8 years.

• Review and amend the business continuity plan so that it clearly describes roles, responsibilities when dealing with incidents which may disrupt the running of the practice.

• Provide infection control training for non-clinical staff

• Make improvements to the arrangements for conducting clinical audits as a means of improving outcomes for patient treatment.

• Review policies and procedures so that they are practice specific.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 15 April 2016

The practice is rated as good for people with long term conditions.

GPs and nursing staff had lead roles in chronic disease management and provided a range of clinics including asthma and diabetes. The practice performance for the management of these long term conditions was similar to other GP practices nationally.

The practice:

• Offered dedicated appointments for long term conditions, medicine reviews and health screening.

• Offered management support and advice and smoking cessation sessions.

• Referred to and used a range of published guidance to monitor and improve patient care and treatment.

• Provided a range of information to patients about the management of long term conditions including diabetes and heart disease.

Updated 15 April 2016

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

The practice offered same day appointments for children. Appointments were available outside of school hours. Post-natal and baby checks were available to monitor the development of babies and the health of new mothers.

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 similar to other GP practices 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.

Information and a range of sexual health and family planning clinics were available.

Updated 15 April 2016

The practice is rated as good for older people.

Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered a range of health screening and health promotion services for older people including dementia screening. 100% of patients who were diagnosed with dementia had an annual face to face review.

The practice offered proactive, personalised care to meet the needs of the older people including:

• Home visits.

• Access to telephone advice and consultations.

• Longer appointment times.

• Support and advice provided by the practice nurse to patients, families and carers.

• The premises were accessible and adapted to support patients with mobility issues including those who used wheelchairs. The practice had a hearing loop system and disabled friendly toilet facilities.

GPs worked with local multidisciplinary teams to reduce the number of unplanned hospital admissions for at risk patients including those with dementia and those receiving end of life palliative care.

Updated 15 April 2016

The practice is rated as good for 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.

• Appointment availability was reviewed regularly to be flexible with same day and emergency appointments and telephone consultations available each day.

• Appointments were available up to 7.30pm on Mondays.

• The practice offered on-line appointment booking.

• The practice offered a full range of health promotion and screening that reflected the needs for this age group including NHS health checks.

Updated 15 April 2016

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

• The practice reviewed and monitored patients with dementia and carried out face-to-face reviews.

• Patients with mental health conditions were reviewed and had an annual assessment of their physical health needs.

• Longer appointments and home visits were provided as required.

• Information was available about the range of local support and advice services available.

• Patients were referred to specialist services as required.

Updated 15 April 2016

The practice is rated as good for people whose circumstances may make them vulnerable.

• Staff undertook safeguarding training and the practice had a dedicated safeguarding lead.

• The practice held a register of patients living in vulnerable circumstances including patients with a terminal illness and those with a learning disability.

• The practice proactively promoted annual health checks for patients with learning disabilities.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. This helped to ensure that patients whose circumstances made them vulnerable were supported holistically and that patients who were at a higher risk of unplanned hospital admissions were supported to and treated in their home.

• The practice nurse was proactive in offering support and advice to patients, their families and carers.