Sheerness Health Centre

Updated 19 September 2017

Sheerness Health Centre is situated in Sheerness town centre. There are three separate GP practices housed in the purpose built premises. The practice was newly registered as a provider in April 2015. All patient areas are on the ground floor and are accessible to patients with reduced mobility, as well as parents with children and babies. There is parking available for patients with a disability who attend the practice and unrestricted on street parking and local transport.

The practice consists of two GP partners, both male, a practice nurse and HCA, both female and a regular locum GP who works each Wednesday, who is male. The clinical team are supported by a practice manager and an administration and reception team.

There are approximately 4200 patients on the practice list. The practice age range population profile is close to national averages. However, the practice has more young patients registered from 0 to 9 years, and less working age people than the national average. The practice is situated in an area that is considered to be more deprived. It is rated as 2 on the Indices of Multiple Deprivation (IMD) scale, with one being the most deprived and 10 being the least deprived. The practice patient population is mainly white, with 2% being identified as Asian or other ethnicity. 47% of patients are identified as being in paid work or full time education compared with the clinical commissioning group (CCG) average of 59% and the national average of 63%.

The practice is open from 8.30am to 6.30pm Monday to Friday. The phone lines are maintained by the out of hours service between 8am and 8.30am and the GP will be contacted if there is an emergency. There was an extended hours clinic on Tuesday evenings from 6.30pm to 8pm. GP appointments were offered daily from 9.30am to 11.30am, 3.30pm to 5.30pm and from 6.30pm to 7.40pm on Tuesday evening. The practice offers pre-bookable appointments as well as urgent on the day appointments for patients that needed them.

An out of hour’s service is provided by MedDoc, outside of the practices normal opening hours and there is information available to patients on how to access this in the practice information leaflet and on the website.

Services are delivered from:

250 – 262 High Street, Sheerness, Kent, ME12 1UP.

Updated 19 September 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Sheerness Health Centre name on 25 July 2017. 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 a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with 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 proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 September 2017

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

• GPs and nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.
• The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) was 140/80 mmHg or less was 91% compared with the clinical commissioning groupand national average of78%. This was marked in CQC data as a positive variation.
• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.
• The practice had a system for monitoring repeat prescribing for patients with long term conditions. For example, there was a rollingdisease modifying anti-rheumatic drugs (DMARD) audit which monitored the repeat prescribing of medicines such as Methotrexate.
• All these patients had a named GP and there was a system to recall patients for a structured annual review to check their health and medicines needs were being met. Where a patient was unable to attend the practice for their annual review the GP carried out home visits to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 19 September 2017

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

• From the sample of documented examples we reviewed we found there were systems to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of accident and emergency (A&E) attendances.
• The practice had a process to follow up on any children who missed outpatient appointments by telephoning the parent/carer.
• Immunisation rates were relatively high for all standard childhood immunisations.
• Patients told us, on the day of inspection, 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 provided post-natal checks and child health surveillance clinics.

Updated 19 September 2017

The practice is rated as good for the care of older people.

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice offered proactive, personalised care to meet the needs of the older patients in its population.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.
• Where older patients had complex needs, the practice shared summary care records with local care services. For example, the practice used ‘Your wishes’ an IT system to record information about terminally ill patients which was shared with the out of hours service, to help ensure continuity of care.
• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible.

Updated 19 September 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example, extended opening hours.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 19 September 2017

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

• The practice carried out advance care planning for patients living with dementia.
• 97% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is higher that the CCG average of 83% and national average of 84%.
• The practice specifically considered the physical health needs of patients with poor mental health and dementia.
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs. For example, there was a rolling audit which monitored the repeat prescribing of medicines such as Lithium.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 94% compared to 93% at CCG level and 89% as a national average.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• Patients at risk of dementia were identified and offered an assessment.
• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.
• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 19 September 2017

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 homeless people and those with a learning disability.
• The practice provided care and treatment for the residents of a care home for people living with a learning disability and for three patients in a nursing home.
• Patients with learning disabilities were flagged on the IT system so that the appropriate level of care and length of appointment time could be offered.
• Annual reviews were carried out for patients with a learning disability and care plans which demonstrated updates to care and treatment were seen.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.