Archived: Eastbourne Station Health Centre

Updated 19 October 2016

The Eastbourne Station Health Centre holds an Alternative Personal Medical Services (APMS) contract with the Hastings and Rother Clinical Commissioning Group (CCG) and offers general practice services to the people of Hastings. There are approximately 3,670 registered patients. Additionally the practice offers a GP led walk-in centre and will accept all patients, whether registered at the practice or not, for one off consultations between the hours of 8am and 8pm Monday to Sunday. The population of the Eastbourne area which the walk in centre covers is 180,000 although this figure increases during the summer period.

The Eastbourne Station Health Centre is run by Integrated Care 24 (IC24) a non-profit making social enterprise organisation that provides Out of Hours services, NHS 111 services and GP services across central and southern England. The practice has three salaried GPs whose hours equalled two and a half whole time equivalents (three male). One of the GPs was the designated Medical Services Director. The GPs are supported by three practice nurses all of whom are nurse prescribers, a long term locum Advanced Nurse Practitioner and one health care assistant. The practice team also includes a team of receptionists and administrative staff, the Head of Primary Care, Walk In Centres and Pharmacies and the Patient Services Manager. There is also a Clinical Nurse Lead. The practice have also appointed a clinical pharmacist. The provider IC24 also provides services at a walk in centre at Hastings and the medical services director, clinical nurse lead and head of primary care also manage that centre. There are plans in progress to use the nursing staff with specialist skills across both sites. The practice also uses locum GPs who have to undergo vetting and ongoing performance review and they ensured that a female locum GP or the Advanced Nurse Practitioner were available if requested.

All patients on the practice list have a named GP although the GPs operated a shared list system so patients could choose which GP they saw.

The practice runs a number of services for its patients including chronic obstructive pulmonary disease (COPD) and asthma clinics, child immunisations, contraception advice, diabetes clinics, new patient checks, travel health checks and vaccinations, smoking cessation advice and weight advice.

Services are provided at

Eastbourne Station

Terminus Road

Eastbourne

East Sussex

BN21 3QJ

The entrance to the practice is on the concourse of Eastbourne Railway Station and can only be accessed via the concourse.

The building is owned and maintained by landlords.

The practice is open between 8am and 8pm Monday to Sunday and access to the walk in service is available to both registered and non registered patients during those hours. Booked appointments for registered patients are available from 8am to 6.30pm daily including weekends. In addition to pre-bookable appointments that can be booked up to four weeks in advance, booked urgent appointments are also available for registered patients that need them. Additionally registered patients can use the walk in service from 8am to 7.50pm Monday to Sunday.

The practice are contracted to see 18,000 patients via the walk in centre per year. In the year 01 January 2015 to 31 December 2015, they saw 17,837 walk in patients.

There is a diverse mix of ethnicities amongst the patients of the practice with 30% not having English as their first language.

The practice has a high turnover of patients, between 01 January 2015 and 31 December 2015, 709 patients joined the practice list and 557 deregistered.

The percentage of registered patients suffering deprivation (affecting both older people and children) is higher than average for England. The practice population has a much lower number of patients who are 65 or over than the national average (93% are under 65 years) and a higher than average group of patients in the 20 to 45 years age group. There are also a lower number of patients under 18 years than the national average, with a slightly higher than average number of patients below four years of age. There are a lower than average number of patients with a long standing health conditions compared with the national average and a slightly higher than average number of patients with a caring responsibility. There is a higher than average number of patients in paid work or full time education and an average number of unemployed patients.

Updated 19 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Eastbourne Station Health Centre on 28 July 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.
• Some risks to patients were assessed and well managed. However we noted that there was no Legionella risk assessment available and the practice did not have a clear system of assessing that electrical equipment had been checked and was considered safe to use.
• 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.
• Medicines and prescribing were generally managed in a safe and effective way, however there was no effective system in place for following up patients when repeat prescriptions had not been picked up by the patient.
• 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.
• The practice provided both general practice services with a list of patients registered to the practice and also a GP led walk in service open to unregistered as well as registered patients.
• The practice was open from 8am to 8pm and saw all patients that presented during that time.
• The practice saw 95% to 99% of patients using the walk in service within two hours.
• Patients registered with the practice 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. Registered patients could also use the walk in service.
• 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 and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

To liaise formally with the local fire service to consider and action ways of carrying out fire evacuation rehearsals.

To continue to assess ways of improving the uptake of national screening programmes by eligible patients.

To monitor the effectiveness of their new system for dealing with repeat prescriptions that have not been collected.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 October 2016

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 patients at risk of hospital admission were identified as a priority. Nurse led clinics were offered to patients with multiple conditions.

• The percentage of patients with diabetes, on the register, in whom the last blood pressure reading is 140/80 mmHg or less was 86% (clinical commissioning group average (CCG) average 81%, national average 78%).

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review 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 October 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 living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations. We saw that all patients where there was a safeguarding concern were registered as an alert on the system and these were cross referenced with other members of the household whose notes were also tagged with an alert.

• The local safeguarding lead nurse was informed of the attendance at the walk in centre of any children under 17 years of age. Parents were made aware of this when they registered the child and could speak to a clinician if concerned.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The percentage of women aged 25 or over and who had not attained the age of 65 whose notes recorded that a cervical screening test had been performed in the preceding five years was 74% (clinical commissioning group average 82%, national average 82%).

• 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 19 October 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.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 19 October 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.

• 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.

• The practice was open from 8am to 8pm to walk in service patients. Registered patients could also use this service if they wished.

Updated 19 October 2016

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

• 100% of patients diagnosed with dementia (five patients out of five) had had their care reviewed in a face to face meeting in the last 12 months, which was better than the CCG average of 79% and national average of 84%.

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive care plan documented in the record was 100%, (14 patients out of 18 with four reported as exceptions). The CCG average was 90% and national average 88%. (Exception reporting is the removal of patients from calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of side effects.)

• 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 had told patients experiencing poor mental health about 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 19 October 2016

The practice is rated as good for the care 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. Homeless patients could be registered using the practices’ address as their correspondence address. Telephone numbers for organisations that help the homeless were displayed in the waiting room.

• The practice offered longer appointments for patients with a learning disability.

• The practice would take vulnerable patients who accessed them through the walk in service on to their registered patient list.

• Some patients who were known to be vulnerable had access directly to the practice via a separate telephone number.

• The practice regularly 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 in normal working hours and out of hours. We saw examples of where the practice had made appropriate safeguarding referrals.