Dr Andra Jayaweera Also known as Downhall Park Surgery

Updated 4 April 2016

Dr Andra Jayaweera at Downhall Park Surgery provides GP services to approximately 3265 patients living in Rayleigh, Essex. The practice holds a Primary Medical Services Contract (PMS) with the addition of enhanced services for example; ‘Extended Hours access’, ‘Childhood Vaccination and Immunisation Scheme’, ‘Reducing unplanned admissions’, and ‘Minor Surgery’.

The practice has a team of two doctors; one full-time female GP and one male part time regular locum GP providing choice of clinician gender. There is a nurse who runs a variety of appointments for long term conditions, minor illness and family health. There is a team of four non-clinical, administrative, secretarial, and reception staff who share a range of roles. Patients have access to midwives, health visitors, therapists, and district nurses.

The practice is open from 8.30am to 6.30pm Monday, Tuesday, Thursday, Friday, and 8.30am to 8pm on Wednesdays. GP surgery hours are from 9am to 12 noon Monday, Tuesday, Wednesday, Thursday, Friday and from 5pm to 6.30pm Monday, Tuesday, Thursday, Friday, and 5pm to 7.50pm on Wednesday evenings. Outside of these hours, GP services are accessed by phoning the NHS 111 service. The Out of Hour’s (OOH) service delivery for this practice population is provided by ‘Care UK’ when the practice is closed.                                               

Updated 4 April 2016

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection at Dr Andra Jayaweera on 02 September 2015. At this inspection the practice was good for providing safe, responsive, caring and well led services. They were rated as requires improvement for effective services.

During the inspection on 02 September 2015 we found that;

• Patient treatment reviews were not documented consistently to reflect fully when reviews or patient contacts had taken place.

The practice was issued with a requirement notice for improvement.

To maintain accurate, complete and contemporaneous records in respect of each service user, including the recording of the all care and treatment provided to each service user and of decisions taken in relation to the care and treatment provided.

Following this inspection the practice sent us information that outlined the actions they intended to take to improve, and the date they would be implemented. We were then provided with evidence that the practice had implemented to make the required improvements.

To follow-up on our previous inspection and ensure the practice had made the required improvements, we carried out a desk-based inspection of Dr Andra Jayaweera on 01 March 2016, based on the information they sent us after the inspection.

Our key findings during this desk-based follow-up inspection were as follows:

• The practice provided evidence of their patient documentation procedure.

• They also provided an audit with evidence of good clinical note keeping.

• Further evidence sent showed several audits had been undertaken that reflected that medicine reviews had been carried out effectively.

We were therefore satisfied the provider had made all of the improvements identified as a result of the inspection on 02 September 2015.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 December 2015

The practice is rated as good for providing safe, responsive, caring and well-led services and this includes for this population group. The practice is rated as requires improvement for effective services. The concerns which led to these rating apply to everyone using the practice, including this population group.

Patients with a long-term condition and those at risk of a hospital admission were identified for longer appointments or home visits when needed. The practice offered a number of specialist clinics for asthma, diabetes, chronic obstructive pulmonary disease (COPD), hypertension and dressings. All patients with a long term condition had a named GP and a structured annual review to check their health and medicine requirements were met. For those people with more complex needs, the named GP worked with relevant health and care professionals for example the community and secondary care diabetic clinics to deliver a multidisciplinary care package.

Those patients on the palliative care register in need of care were discussed at the monthly multidisciplinary team meetings.

Updated 24 December 2015

The practice is rated as good for providing safe, responsive, caring and well-led services and this includes for this population group. The practice is rated as requires improvement for effective services. The concerns which led to these rating apply to everyone using the practice, including this population group.

Immunisation rates were relatively high for the standard childhood immunisations and HPV vaccine for teenage girls. Children at risk, for example, children and young people who had a high number of A&E attendances were followed up.

Appointments were available outside school hours for families with school age children and young people. The practice worked closely with midwives, and health visitors. They provided antenatal checks and support for mothers during pregnancy, with baby checks and post-natal checks after confinement. The practice also provided family planning services, signposted young people towards sexual health clinics, chlamydia, and sexually transmitted disease (STD) screening.

Updated 24 December 2015

The practice is rated as good for providing safe, responsive, caring and well-led services and this includes for this population group. The practice is rated as requires improvement for effective services. The concerns which led to these rating apply to everyone using the practice, including this population group.

Nationally reported data showed that outcomes for patients were above those nationally for conditions commonly found in older people.

The practice offered proactive, personalised care to meet the needs of the older people in the practice population and had a range of services, for example; senior health checks, developing care plans as part of the admission avoidance enhanced service for people at risk of an unplanned hospital admissions, multi-disciplinary meetings (MDT) with a neighbouring practice and provision of a named GP for all patients in this population group. The practice offered older people home visits, and urgent appointments to meet their needs.

Updated 24 December 2015

The practice is rated as good for providing safe, responsive, caring and well-led services and this includes for this population group. The practice is rated as requires improvement for effective services. The concerns which led to these rating apply to everyone using the practice, including this population group.

The needs of the working age population, those recently retired and students had been identified and the practice had adjusted their services offered. Extended hours were provided to ensure opening hours were accessible to patients in this population group, and could offer continuity of care. The practice was proactive in offering online appointments and prescriptions as well as a full range of health promotion, screening, and health checks that reflected their needs.

Appointments were available within the practice extended hours for chronic disease monitoring for this group.

Updated 24 December 2015

The practice is rated as good for providing safe, responsive, caring and well-led services and this includes for this population group. The practice is rated as requires improvement for effective services. The concerns which led to these rating apply to everyone using the practice, including this population group.

Analysis of data we held showed the percentage of patients experiencing poor mental health at the practice had received a comprehensive, agreed care plan was 10% higher than the local and national averages. The practice worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

The practice signposted patients experiencing poor mental health to access various support groups and voluntary organisations including cognitive behaviour therapy, crisis intervention team, be-friending service and the drug and alcohol team. Patients in this population group who had attended accident and emergency (A&E) where they may have been experiencing poor mental health were followed up.

Patients receiving certain medicines for their mental health had their levels monitored and adjusted if needed.

Updated 24 December 2015

The practice is rated as good for providing safe, responsive, caring and well-led services and this includes for this population group. The practice is rated as requires improvement for effective services. The concerns which led to these rating apply to everyone using the practice, including this population group.

The practice held a registers of patients living in vulnerable circumstances including those with a learning disability, and those patients assigned to the practice after referral from other local practices.

The practice worked with multi-disciplinary teams in the case management of vulnerable people. Signposting to third sector groups and organisations to access various support was incorporated into the care for vulnerable people.

Staff had received training and knew how to recognise signs of abuse in vulnerable adults and children. They were aware of their responsibilities regarding information sharing and the documentation of safeguarding concerns. Staff knew who the safeguarding lead at the practice was and who to contact with any concerns.

Where necessary frail patients were supported to access a social worker and or a community matrons to maintain their care which was discussed at multidisciplinary meetings.