Archived: Dr B. B. Roy & Partner Also known as Dr. B. B. Roy & Partner

Updated 30 July 2015

Dr B. B. Roy and Partner is located in Stanford Le Hope, Essex. The practice is situated in a residential house that has been adapted to meet the needs of patients. The practice is one of 34 GP practices in the Thurrock Clinical Commissioning Group (CCG) area. The practice has a general medical services (GMS) contract with the NHS. There are approximately 2700 patients registered at the practice.

There are up to three GPs working at the practice (one male and one female) and one of them is a partner. A third GP is available to cover GP absences. On most days only one GP is working at the surgery except on Wednesday afternoons when there are two. The GPs are supported by two nurses who work a total of one and a half days each week. There is a practice manager and six receptionists who share the role throughout the week.

The surgery is open Monday to Friday between 8am and 6pm and GP surgeries run in the mornings and afternoons at various times. The practice is closed Thursday afternoons. There are three late nights until 7pm on Mondays, Tuesdays and Fridays. The practice works closely with three other practices in the local area to provide weekend appointments for working patients on a shared basis on Saturday and Sunday mornings. Patients can pre-book appointments and have to travel to one of the other practices for consultations.

The practice has opted out of providing 'out of hours’ services which is now provided by the  contractor commissioned by NHS England. However on Thursday afternoons between 1pm and 6.30pm when the practice is closed, patients can contact the South Essex Emergency Doctor Service in an emergency. Patients can also contact the non-emergency 111 service to obtain medical advice if necessary.

Updated 30 July 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr B. B. Roy and Partner on 29 May 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well-led services. It was also good for providing services for the all of the population groups we looked at.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• The practice pro-actively monitored patients to identify adult and child safeguarding issues.
• The practice identified learning and took action in response to significant events but this was not always recorded.
• Risks to patients were assessed and well managed. Staff recruitment procedures were robust.
• Performance was being monitored, areas for improvement were being identified and action was taken to achieve progress.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received appropriate training for their roles and further training needs had been identified and planned.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice notes of patients receiving a multidisciplinary package of care were not always updated with the most recent care and treatment decisions, although they were recorded on the relevant register.
• Information about services and how to complain was available and easy to understand.
• Patients generally found the appointment system met their needs but had experienced difficulties getting an appointment of their choice with the GP and nurses.
• The practice provided 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.
• The practice had not undertaken a patient survey to seek the views of patients.

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

Importantly the provider should;

• Undertake a patient survey to seek a broader view of the services provided.

• Update patient notes when changes to care and treatment have been discussed and agreed at multidisciplinary meetings.

• Implement a system to regularly review medicine alerts.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 30 July 2015

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 had received appropriate training. Patients at risk of hospital admission were identified as a priority and their condition monitored. Chronic disease clinics were in place to monitor patients’ conditions. Longer appointments and home visits were available when needed. The practice was pro-active in undertaking regular health reviews. Patients with complex health needs received continuity of care and the practice worked with relevant health and care professionals to deliver a multidisciplinary package of care. Patients in need of same day appointments due to their long-term condition or with urgent health care needs were prioritised. Patients’ mental health was monitored in relation to anxiety and stress caused by their condition. Monthly palliative care meetings took place with other healthcare professionals. A phlebotomy service was available at the practice for patients on anti-coagulation medicines.

Updated 30 July 2015

The practice is rated as good for the care of families, children and young people. There were systems in place to identify and follow up children identified as ‘at risk.’ All clinical staff had received an appropriate level of safeguarding training. The attendance of children who had a high number of A&E attendances was monitored. Immunisation rates were high for all standard childhood immunisations as compared with other practices in the local area. Patients told us that children and young people were treated in an age-appropriate way. Appointments were available outside of school hours and the premises were suitable for children and babies. Children under the age of five were seen on the same day. Staff were aware of consent legislation in relation to children and young persons. Contraception and sexual health services were available for patients to access. Cytology testing was available and patients were pro-actively encouraged to attend appointments for screening. Six week baby checks and post-natal examinations took place to ensure young children’s health was being monitored effectively.

Updated 30 July 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. Same day appointments, telephone consultations and home visits were available for the elderly or house-bound. Longer appointments were available if required. Patients over 75 received a structured health assessment and had a named GP. Medicines could be delivered directly to their home address. Multidisciplinary meetings took place with other healthcare professionals to identify the most appropriate care and treatment to avoid unplanned hospital admissions. The practice worked with community health services so that care could be provided in patient’s homes if required. Frail patients had care plans in place and falls were being monitored and referrals made when necessary. The practice offered proactive, personalised care to meet the needs of older patients with dementia or requiring end of life care. Flu vaccinations were available and patients were contacted if they had not attended the practice. Joint injections were available for patients.

Updated 30 July 2015

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. Online services were available to book appointments and order repeat prescriptions. Extended opening hours were available through the week and appointments available on Saturday and Sunday mornings. The practice provided health screening for working age people to check on their health. Return to work advice and fitness guidance was available to patients returning to work after illness.

Updated 30 July 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice identified patients with dementia and provided consultations, advice, annual health reviews and they were monitored through the use of a register. The practice took a multidisciplinary approach to patients and involved them in identifying the most appropriate care and treatment that met their needs. The practice advised patients experiencing poor mental health about how to access various support groups and voluntary organisations. The practice worked with a dementia crisis support centre. There was a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia. Dementia care support was offered and referrals made to a dementia memory service. The use of medicines used by patients suffering with poor mental health was monitored regularly.

Updated 30 July 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. Staff were pro-active in identifying patients at risk of abuse. Staff had received additional training to support patients with learning disabilities. Longer appointments were available for vulnerable patients if required. Patients could be referred to advocacy services if advice and support was required. The practice held a register of patients living in vulnerable circumstances including travellers and those with a learning disability. Patients with a learning disability received an annual health check or sooner if required. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. Vulnerable patients were signposted to various support groups and voluntary organisations. 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. The practice had access to sign language interpreters for patients with hearing or speech problems.