Archived: Dr Senathirajah Sellappah

Updated 7 December 2016

Dr Senathirajah Sellapah's practice is based in Mill Road Surgery. This is a converted two storey detached house in the London Borough of Bexley. It is located within a predominantly residential area of Erith with a small high street nearby. The property has been converted for the sole use as a surgery and now includes one consulting room, one treatment room, a reception area and waiting room and a first floor meeting and administration room. Bexley Clinical Commissioning Group (CCG) are responsible for commissioning health services for the locality.

The practice is registered with the CQC as a sole practitioner. Services are delivered under a Personal Medical Services (PMS) contract. The practice is registered with the CQC to provide the regulated activities of family planning; maternity and midwifery services; treatment of disease, disorder and injury, surgical procedures and diagnostic and screening procedures.

The practice has 2465 registered patients. The practice age distribution is similar to the national average with a slightly lower than average number of patients in the over 65 year age group. The surgery is based in an area with a deprivation score of 6 (with 1 being the most deprived and 10 being the least deprived).

Clinical services are provided by the full-time GP lead (male); two regular locum GPs (male and female) covering 5 sessions per week; one part-time Practice Nurse and two regular locum nurses (0.4 wte) and one part-time trainee Health Care Assistant (0.2 wte).

Administrative services are provided by a Practice Manager (0.8 wte) and five administration and reception staff (2.2 wte).

The practice provides the following Directed Enhanced Services (DES): Childhood Vaccination and Immunisation Scheme; Extended Hours Access; Facilitating Timely Diagnosis and Support for People with Dementia; Improving Patient On-line Access; Influenza and Pneumococcal Immunisations; Learning Disabilities; Minor Surgery; Patient Participation; Rotavirus and Shingles Immunisation and Unplanned Admissions. (Enhanced Services are services which require an enhanced level of provision above what is expected under a core contract).

The surgery reception is open between 8am and 7pm Monday to Friday and 8.30am to midday on Saturday. The surgery is closed on Sunday. Telephone lines are open from 8am to 6.30pm Monday to Friday.

Pre-booked and urgent appointments are available with a GP from 8am to 10am, midday to 1.30pm and 4.30pm to 6.30pm Monday and Tuesday; from 8am to 10am, midday to 1.30pm and 5.30pm to 6.30pm on Wednesday; from 8.30am to 12.30pm and 4.30pm to 6.30pm on Thursday; from 9am to 11am, midday to 2pm and 5.30pm to 6.30pm on Friday and between 9am and 10am on Saturday.

Pre-booked appointments are available with a practice nurse from 10am to 2pm on Monday and Wednesday, from 9am to midday on Tuesday and Saturday and from 3pm to 6pm on Thursday.

When the surgery is closed urgent GP services are available via NHS 111.

A practice website provides details of services provided by the surgery and within the local area.

Updated 7 December 2016

Letter from the Chief Inspector of General Practice​

We carried out an announced comprehensive inspection at the surgery of Dr Senathirajah Sellappah on Wednesday 28 September 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.

• Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

• The practice had identified ten patients as carers (0.4% of the practice list).

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Information about services and how to complain was available and easy to understand.
• Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was 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 sought feedback from staff and patients, which it acted on. A meeting of the Patient Participation Group had not taken place in the 18 months preceding the inspection. However the practice had booked a PPG meeting to take place four weeks after the inspection.

• The provider was aware of and complied with the requirements of the duty of candour.

There were areas where the provider should make improvements.

• The provider should consider proactive strategies to encourage patients to join the patient participation group (PPG) and to re-establish regular meetings of the group.
• The provider should review how patients with caring responsibilities are identified and recorded on the clinical system to ensure information, advice and support is made available to all carers on the practice list.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 7 December 2016

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

• GPs worked closely with practice nursing staff and community specialist nurses in the management of patients with long-term conditions.
• Patients at risk of hospital admission were identified as a priority.
• The practice performance rate for the Quality Outcomes Framework (QOF) diabetes related indicators was comparable to the local and national average.
• Longer appointments and home visits were available when needed.
• Patients with long-term conditions were offered a structured annual review with the GP to check that 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. These patients were discussed at the multi-disciplinary team meetings which took place every two months.

Updated 7 December 2016

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 who were at risk, for example, children and young people who had a high number of A&E attendances.
• Immunisation rates were comparable to local and national averages for all standard childhood immunisations.
• Patients told us that children and young people were treated in an age-appropriate way and we saw evidence to confirm this.
• The percentage of women aged 25 to 64 years who had received a cervical screening test in the preceding five years was comparable to the local and national averages.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives and health visitors.

Updated 7 December 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.
• Quality Outcomes Framework (QOF) performance indicators for conditions found in older people were comparable to local and national averages.
• The practice was responsive to the needs of older people and offered home visits and urgent appointments for those with enhanced needs. This group of patients were also offered a home visit to administer the flu vaccination.

Updated 7 December 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.
• Extended hours appointments were available at the surgery three mornings a week and on Saturday morning.
• The practice was proactive in offering online services. Patients were sent text messages to remind them of appointments.
• A full range of health promotion and screening services were provided that reflects the needs for this age group.

Updated 7 December 2016

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

• 89% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the preceding 12 months. This was comparable to the local average of 81% and national average of 84%.
• 88% of patients diagnosed with a mental health disorder had a comprehensive agreed care plan documented in the preceding 12 months. This was comparable to the local average of 94% and national average of 88%.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health including those with dementia. The practice carried out advance care planning for patients with dementia.
• The practice told patients experiencing poor mental health how to access various support groups and voluntary organisations.
• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 7 December 2016

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 and annual reviews for patients with a learning disability.
• The practice worked with other health care professionals in the case management of vulnerable patients.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies.