The Saxonbury House Surgery

Updated 25 February 2016

Saxonbury House Medical Group offers general medical services to people living and working in Crowborough and the surrounding villages. The current patient list is 9371. It is a practice with four GP partners, two male and two female. They are support by one additional salaried GP.

The practice also has three practice nurses, a healthcare assistant and a team of receptionists and administration staff. Operational management is provided by the practice manager.

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

The practice is open between 8.00am and 6.30pm Monday to Friday and 8.00am to 1.00pm on a Saturday.

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.

Services are provided from the following addresses:

Saxonbury House Medical Group

Croft Road

Crowborough

East Sussex

TN6 1DL

At the last inspection of this location we found that the provider’s medicine management procedures did not meet regulations. The provider submitted a plan of action to address this area. At this inspection we found that the provider had taken the appropriate steps as set out in their plan.

Updated 25 February 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Saxonbury House Medical Group on 29 September 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 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.
• Patients we spoke with and most comment card responses said they found it easy to make an appointment with GP. Four of twenty-nine comment cards indicated there were difficulties with getting appointments. All feedback was positive in respect of 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.

There were areas that the provider should make improvements :

The provider should:

• Maintain a record of their regular nurse meetings to demonstrate staff support and assist with future audits.
• Implement and maintain a record to demonstrate that all clinical equipment is cleaned as appropriate.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 February 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 comparable to the CCG and national average. For example: The percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months was 86% compared to the national average of 88%.

• 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.

Updated 25 February 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.
• 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.

Updated 25 February 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.
• Patients discharged from hospital were alerted to the GP on the same day and actions taken to follow up their care.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 25 February 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.
• Evening and telephone consultations were available. Extended hours are provided on Saturdays for patients who find appointments during working hours difficult to attend.

Updated 25 February 2016

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

• It carried out advance care planning for patients with dementia. 78% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months.
• 92% of people schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in the record, in the preceding 12 months.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those 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 25 February 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 those with a learning disability.
• 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 worked closely with a women’s refuge providing healthcare and physiological support.