Archived: Dr Sivakumary Sithirapathy Also known as Wexham Road Surgery

Updated 14 September 2016

Dr Sivakumary Sithirapathy formally known as Wexham Road Surgery is situated in Slough. The premises are wheelchair accessible and although one consulting room is an upstairs room, GPs will see patients on the ground floor if they have difficulties with mobility. There was a hearing loop in place for patients with impaired hearing. Services are provided via a Primary Medical Services (PMS) contract. (PMS contracts are negotiated locally between GP representatives and the local office of NHS England).

There are two GP partners and two locum GPs employed as the practice as well as a locum nurse. The practice uses the same GP locums for continuity of care. Both of the GP partners as well as one of the locum GPs are female. One of the locum doctors is male. The practice also employs a healthcare assistant. The practice employs a practice manager, a business manager, a senior receptionist as well as two receptionists. A secretary is also employed by the practice.

The practice is open between 7.30am and 6.30pm on Mondays, between 8am and 7pm on Tuesdays and Fridays and 8am and 6.30pm on Wednesdays and Thursdays. Appointments are available between these times. Evening and weekend appointments are available on request.

The practice has a patient population of approximately 4,264 registered patients. The practice population of patients aged between 24-44 years old is higher than the national average and there are lower number of patients aged between 49-85 years old compared to national average.

Ethnicity based on demographics collected in the 2011 census shows the patient population is predominantly Asian and British Asian and 13% of the population being White British. The practice is located in an area of Slough where deprivation is similar to the CCG and national average.

Services are provided from the following location:

242 Wexham Road

Slough

Berkshire

SL6 6JP

The practice had opted out of providing out of hours services to their patients. There are arrangements in place for services to be provided when the practice is closed and these are displayed at the practice, in the practice information leaflet and on the patient website. Out of hours services are provided during protected learning time or after 7pm and weekends by calling the NHS 111 provided by South Central Ambulance Service.

Updated 14 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Wexham Road practice on 1 June 2016. Overall the practice is rated as good.

Our key findings were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events. Opportunities for learning from incidents were maximised and learning was shared across local services.

• Risks to patients were assessed and well managed.

• We found that completed clinical audits were driving positive outcomes for patients.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.

• Staff had the skills, knowledge and experience to deliver effective care and treatment.

• Information about services and how to complain was available and easy to read.Results from the national GP patient survey showed the majority of patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment when compared to the local and national averages.

• The majority of patients we spoke with on the day of inspection confirmed this.

• Patients told us they were able to make appointments easily and emergency appointments were available when required.

• Same day appointments were available for children under five and for pregnant women.

• The premises were clean and well maintained. Feedback from patients who used the service was consistently positive.

• There was a clear leadership structure and staff felt supported by management.

• The provider was aware if and complied with the requirements of Duty of Candour.

However there were areas of practice where the provider should make improvements:

• Review the process and systems for engaging patients in cancer screening programmes, in order to improve uptake and patient health outcomes. Specifically, undertake a review of breast cancer and cervical screening.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 14 September 2016

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

• There was a proactive approach to supporting people with long term conditions and specialist clinics and support groups were introduced at the practice. For example, a GP led asthma clinic was introduced to review care plans and promote patient education.

• Patients spoken with during the inspection had direct experience of attending clinics and support groups and they were positive about the success of these in improving and maintaining their health.

• The practice developed care plans for patients who are at high risk of further complication due to long-term conditions.

• Longer appointments and home visits were available when needed.

• Patients with long term conditions such as diabetes were supported to play an active part in managing their condition through patient education.

Updated 14 September 2016

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

• Nationally reported data from 2014/2015 showed that vaccination rates for children were consistently above the average for the CCG.

• There was an after school clinic that was run to allow children and young people to access healthcare at a convenient time.

• Children who were admitted to A & E with asthma were followed up by the GP working in partnership with the paediatric asthma nurse.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice had run Saturday education sessions aimed at parents to teach them how to manage emergencies at home such as allergic reactions, burns and febrile convulsions

Updated 14 September 2016

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.

• There was an on-site falls clinic where patients who were at risk of falls were seen by a physiotherapist.

• Home visits were arranged for patients requiring specific care and treatment to help them to avoid hospital appointments.

• The practice was responsive to the needs of older people and offered home visits and urgent appointments for those with enhanced needs.

Updated 14 September 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.

• Working age patients are prioritised for weekend and evening appointments.

• The practice re-registers students when they return from university for holidays, especially those with chronic conditions, in order to facilitate continuity of care.

• The practice offer early morning ‘commuter clinics’ to meet the needs of patients who are working.

• The practice offers email consultation for patients who work abroad.

• The practice was proactive in health promotion and promoting screening that reflects the needs of this age group.

Updated 14 September 2016

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

• Staff had a good understanding of how to support patients with mental health needs and dementia. This was specific to the patient population. For example, it was identified that patients from particular cultural backgrounds may not respond to some dementia screening tools. Therefore the practice had raised concerns with the local psychiatry team about poor detection rates and helped to introduce a dementia screening tool that was more appropriate for patients from particular cultural backgrounds from within the patient population.

• The practice routinely reviews A & E admissions and will follow up with patients who attended A & E in mental health crisis.

• The practice maintains a register of patients with mental health needs and alerts will be sent to staff when they book appointments and it is therefore possible to prioritise their care.

• Nationally reported data from 2014/2015 showed that 91% of patients with dementia had been reviewed in a face to face meeting in the preceding 12 months (01/04/2014 to 31/03/2015) compared to a clinical commissioning group average of 84.1% and a national average of 84%

• Patients who were experiencing poor mental were signposted to various support groups and voluntary organisations.

• The practice introduced a targeted dementia screening tool that took into account the local population’s cultural background.

Updated 14 September 2016

The practice is rated as good for the care of people whose circumstances make them vulnerable

• Staff knew how to recognise the signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities. They knew who to contact to raise concerns if abuse was suspected and this included who to contact out of hours.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• Patients who may be vulnerable were signposted to various support groups and voluntary organisations. Information was available in the waiting room and staff would liaise with other professionals if they felt additional support was appropriate.