Archived: Dr Andreas Sampson

Updated 21 July 2016

The Dr Andreas Sampson surgery is located in the London Borough of Haringey, North London. The practice has a patient list of six NHS patients. We were told that all patients were aged between 20 and 70 and that four were male and two were female. Two patients had long term conditions and none of the patients were identified as carers. This could not be confirmed by a review of patient records.

The services provided by the practice include immunisations and management of long term conditions.

The staff team comprises Dr Sampson whom we were told had undertaken approximately six to seven consultations in the previous six months. Dr Sampson holds a General Medical Service (GMS) contract with NHS England.

The practice’s opening hours are:

Monday-Friday 9:15am – 11:30am and 4:45pm–7pm

Appointments are available at the following times:

Monday: 8:30am-1:30pm, 2:30pm-6:30pm

Tuesday: 8:30am-12:30pm, 3:30pm-6:30pm

Wednesday: 8:30am-1pm, 3:30pm-6pm

Thursday: 8:30am-12:30pm, 2:30pm-6pm

Friday: 9am-12:30pm, 3:30pm-6pm

Outside of these times, cover is provided by Dr Sampson via mobile phone, by triaging the patient and advising on the best course of action. We were told that this service is provided seven days per week including holidays; and that there is an informal arrangement in place with a nearby GP practice when Dr Sampson is unavailable. We were not able to confirm this arrangement.

The practice is registered to provide the following regulated activities which we inspected:

Diagnostic and screening procedures and Treatment of disease disorder and injury.

Updated 21 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Andreas Sampson (also known as the ‘The Surgery’) on 10 March 2016 and 24 March 2016. Overall the practice is rated as inadequate.

At the time of the inspection, the practice’s patient list consisted of six NHS patients. The staff team consisted solely of Dr Andreas Sampson.

We were advised that the practice did not participate in the national GP patient survey or QOF (a system intended to improve the quality of general practice and reward good practice). We were shown a range of policies and procedures; and shown a patient survey completed in 2015 as part of Dr Sampson’s annual appraisal. We were told that all patient records were paper-based.

However, we were declined access to patient records and the opportunity to ask patients (via comment card or in person) for their views about care and treatment; although we explained our rationale for looking at patient records. This hindered our lines of enquiry such that we were unable to provide a rating for the six population groups.

Our report is therefore based upon Dr Sampson’s feedback and upon a review of the available policies; and has not been corroborated by a review of patient records.

We have not been able to assure ourselves that people were being protected from avoidable harm, that people’s care and treatment was optimised and that people were being treated with care and compassion.

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

• There was no evidence of recording and learning from significant events. For example, we had previously inspected the location in 2014 and identified infection prevention and control (IPC) concerns. There was no record of the concerns having been logged as a significant event or of learning being shared with a GP provider based in the same building which shared IPC processes. No significant events had been recorded since July 2014.

• There were inadequate plans in place to manage risks associated with emergency situations. For example, we were told that the GP had access to the emergency medicines of the GP provider based in the same building but the provider’s staff told us that no such arrangement was in place.

• Patient outcomes were hard to identify. For example, there was little reference made to quality improvement and there was no evidence that the practice was comparing its performance to others; either locally or nationally.

• Two clinical audits had been undertaken in the last two years but it was unclear how they had been used to drive improvements to patient outcomes. They were not completed audit cycles.

• Some people who used the service had concerns about how they were treated. For example, NHS Choices feedback was not positive regarding levels of compassion and dignity.

• Governance arrangements were unclear. For example, the practice had a list of policies and procedures used to govern activity but some lacked sufficient detail.

The areas where the provider must make improvements are:

• Ensure that there are appropriate systems in place to review governance arrangements including systems for assessing and monitoring risks and the quality of the service provision.

• Ensure that clinical equipment is regularly checked.

• Ensure that the GP undertakes annual basic life support training.

• Undertake a risk assessment of the range of emergency medicines carried on home visits.

In addition the provider should:

• Review systems in place for receiving and acting on patient safety alerts.

• Review the chaperone policy to ensure that is fit for purpose.

• Review arrangements for out of hours cover.

• Ensure that the practice’s safeguarding policy contains details of how to contact relevant agencies in normal working hours and out of hours.

• Install a privacy curtain in its consulting room to maintain patients’ privacy and dignity during examinations, investigations and treatments.

• Provide information to help patients understand the services available to them.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 21 July 2016

Updated 21 July 2016

Updated 21 July 2016

Updated 21 July 2016

Updated 21 July 2016

Updated 21 July 2016