Park Crescent Health Centre

Updated 21 January 2016

Park Crescent Health Centre offers general medical services to people living and working in the Lewes road area of Brighton and Hove. It is a practice with five GP partners (male and female). There are three salaried GPs and four practice nurses, two healthcare assistant, phlebotomist, and an assistant practice manager and a team of administrative staff. The practice had an interim practice manager in post who provided consultancy input as they had experienced difficulties appointing a permanent practice manager. There are approximately 13300 registered patients.

The practice runs a number of services for its patients including asthma clinics, child immunisation clinics, diabetes clinics, new patient checks, travel advice and weight management support.

Services are provided from:

1 Lewes Road, Brighton, Brighton and Hove, BN2 3HP

The practice has opted out of providing Out of Hours services to their patients. There are arrangements for patients to access care from an Out of Hours provider (IC24/111).

The practice population has a slightly higher than average number of patients aged 0 to 4 years and a below average number of patients aged 65 and over. The practice has a higher deprivation score compared to the national average and a significantly higher percentage of patients in paid work or full time education.

Updated 21 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Park Crescent Health Centre on 28 October 2015. 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 the skills, knowledge and experience to deliver effective care and treatment.
• Patients told us they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. However, we saw from results of the national GP patient survey than the practice was performing below the CCG and national average in patients feeling involved in their care.
• Patients told us they were able to get appointments when they needed them and were generally able to see their GP of choice. However, results from the national GP patient survey showed that patient’s satisfaction with how they could access care and treatment and getting to see their preferred GP was below local and national averages.
• Information about services and how to complain was available and easy to understand and the practice evidenced learning from complaints they had received.
• Patient feedback was mixed in relation to finding it easy to make an appointment with a named GP, with patients we spoke with on the day saying they hadn’t experienced any difficulties although results of the GP patient survey were lower than average in this area.
• Patients we spoke to told us 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 and complied with the requirements of the Duty of Candour.

The areas where the provider should make improvement are:

• To review national GP patient survey results and include areas of lower than average patient satisfaction in the practice action plan for the year.
• To address the needs of patients’ experiencing difficulty making an appointment with a named GP.
• To address the needs of patients’ experiencing difficulties getting through by phone.
• To address the needs of patients not satisfied with the convenience of their appointment and their overall experience of making an appointment.
• Take action to ensure that patients feel involved by their GP in their care.
• To ensure that a permanent practice management structure is in place moving forwards.
• To review the use of extended hours access appointments to ensure they are meeting the needs of all groups of patients including those of working age.
• To review the function of the PPG and work together with them to ensure they are active and their views are used to contribute to the development of the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 January 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.
• Performance for diabetes related indicators was better than the CCG and national average at 97.7%, 8.2% above the CCG average and 8.5% above the national average.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• Specific initiatives included an in-house citizens advice bureau service and a free telephone call service in the reception area to local community services where patients can get help and advice.

Updated 21 January 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.
• 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 practice’s uptake for the cervical screening programme was 73.9%, which was comparable to the CCG average of 72.4% and the national average of 76.7%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw good examples of joint working with midwives, health visitors and school nurses.
• The practice provided sexual health drop in clinics for teenagers.
• The practice offered STI screening, cervical smears and family planning, including coil insertion and contraceptive advice.

Updated 21 January 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.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• Specific initiatives to include an in-house citizens advice bureau service and a free telephone call service in the reception area to local community services where patient s can get help and advice.
• The practice held regular frailty meetings where to review patients who were considered frail and requiring additional support. They also held bi-monthly palliative care meetings and were involved in a CCG led proactive care initiative.

Updated 21 January 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 healthcare assistant provided a comprehensive smoking cessation service using a 12 week programme.
• Telephone consultations were available for patients who found it difficult to attend the surgery during work hours.

Updated 21 January 2016

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

• 80.8% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, this was higher than both the national and CCG averages.
• Performance for mental health related indicators was better than the CCG and national average at 100%, 10.5% above the CCG average and 7.2% above the national average.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• It 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.
• It 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 people with mental health needs and dementia.

Updated 21 January 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 homeless people, travellers and those with a learning disability and undertook comprehensive learning disability checks.
• It offered longer appointments for people with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• It had told 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.
• The practice had a dedicated carer link worker who provided support and access to carer services.
• The practice provided substance misuse clinics.