Background to this inspection
Updated
23 July 2021
St Peter’s Medical Centre Medical Centre is located in a central location in the city of Brighton.
30-36 Oxford Street
Brighton
East Sussex
BN1 4LA
The provider is registered with the CQC to provide the regulated activities; Treatment of disease, disorder or injury; Surgical procedures; Diagnostic and screening procedures; Maternity and midwifery services and Family planning.
The practice is situated within the Brighton and Hove Clinical Commissioning Group (CCG) and delivers general medical services to a patient population of 14,178. This is part of a contract held with NHS England.
The practice is part of a wider network of GP practices, which includes two other local practices. These are Park Crescent Health Centre and Wellsbourne Health Centre. The total patient population of this network is about 33,000.
Information published by Public Health England shows that deprivation within the practice population group is in the fourth lowest decile (4 of 10). The lower the decile, the more deprived the practice population is relative to others.
According to the latest available data, the ethnic make-up of the practice area is 88% White, 4.5% Asian, 4.2% Mixed, 1.8% Black and 1.4% Other.
Data available to the Care Quality Commission (CQC) shows the number of patients from birth to 18 years old served by the practice is below the national average. The number of patients who are working age is above CCG and national averages, particularly those aged 25 to 55.
There are four partners (two GPs, a nurse and the business manager) and 10 salaried GPs. There is one advanced nurse practitioners, two nurse practitioners, four practice nurses, and one health care assistant. GPs and nurses are supported by the business manager, the practice manager, patient care advisor managers and a team of reception/administration staff.
Due to the enhanced infection prevention and control measures put in place since the pandemic and in line with the national guidance, most GP appointments were telephone or video consultations. Patients are offered a face-to-face appointment if the GP needs to see them.
St Peter’s Medical Centre is open from Monday to Friday between 8am and 6:30pm. The practice offers extended opening on Tuesday evenings until 8pm and on Saturdays from 8:30am to 11:30am.
When the practice is closed patients are asked to call NHS 111, which is a free 24-hour helpline to help patients access the appropriate out of hours care. The out of hours service offers appointments from 6am to 8am on weekday mornings and throughout the day and evening during weekends. Alternatively, patients can see a doctor or nurse 7 days a week at the walk-in clinic at the Brighton Station Health Centre. The Centre is open from 8am to 8pm every day of the year.
Updated
23 July 2021
We carried out an announced inspection of St Peter's Medical Centre on 29 June 2021 because breaches of regulation were found at our previous inspection.
Following our previous inspection on 15 October 2019, the practice was rated good overall but requires improvement for providing safe services. The practice was rated good for providing effective, caring, responsive and well led services. All population groups were rated good.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for St Peter's Medical Centre on our website at www.cqc.org.uk.
Why we carried out this inspection
This inspection was a focused inspection to confirm whether the provider now met the legal requirements of regulations and to ensure enough improvements had been made.
At our last inspection, we rated St Peter’s Medical Centre as requires improvement for providing safe services because:
- Staff files did not always contain evidence that appropriate recruitment checks had been completed.
- The practice did not demonstrate that staff records were held for all recommended vaccinations.
- The practice could not demonstrate there was an effective system for the production of Patient Specific Directions (an instruction to supply and/or administer a medicine, written and signed by a prescriber, to individually named patients).
We also identified areas where the provider should make improvements. These were:
- Review and update the chaperone and recruitment policies regarding disclosure and barring (DBS) check requirements.
- Review and strengthen the training provided to staff on sepsis and serious infection.
- Strengthen the systems to monitor and track blank prescriptions through the practice.
- Continue to explore options to ensure all leaders receive regular appraisal.
- Continue to monitor and take action to improve performance for areas that are not in line with targets or England and local averages, including the GP patient survey results, patients prescribed dependency forming medicines and the uptake of childhood immunisation and cervical screening.
How we carried out the inspection
Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.
This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.
This included:
- Requesting evidence from the provider.
- Reviewing patient records to identify any issues and clarify actions taken by the provider.
- A short site visit.
- Speaking with staff both on and off site.
Our findings
We based our judgement of the quality of care at this service on a combination of:
- what we found when we inspected
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations.
The practice continues to be rated good overall and is now rated good for providing safe services.
We found that:
- The practice had effective processes to ensure that pre and post employment checks were completed. This included DBS checks for chaperones.
- The practice had improved their monitoring and recording of staff vaccinations.
- There were systems and processes to ensure that Patient Specific Directions were produced appropriately.
- All staff received annual training to recognise the symptoms of serious infection or sepsis.
- The practice ensured all staff received an annual appraisal.
- Blank prescriptions were kept securely and there were systems to monitor their use, including when distributed throughout the practice.
- Improvements to practice performance was seen for GP patient survey results.
- The number of patients prescribed dependency forming medicines, the uptake of childhood immunisation and cervical screening continued to be outside of the expected range. However, we saw evidence of positive and proactive work by staff to improve performance in the future.
Whilst we found no breaches of regulations, the provider should:
- Continue to monitor and take action to improve performance for areas that are not in line with targets or England and local averages, including the number of patients prescribed dependency forming medicines, and the uptake of childhood immunisation and cervical screening.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care