Mid Downs Medical Practice

Updated 9 October 2018

The practice is situated in the villages of Newick and South Chailey, near Lewes in East Sussex and provides general medical services to approximately 9,270 patients. There are six GPs, three of whom are female. The practice also employs a practice manager, an assistant practice manager, two practice nurses, one health care assistant and administration and reception staff. The practice has been accredited to provide training to GP trainees and is also a teaching practice (hosting medical students from a local University).

The practice has a higher proportion of patients over the age of 65 years compared to the national average and serves a population that has lower deprivation levels affecting both adults and children than the national average.

We visited the practice location at Newick Health Centre, Marbles Road, Newick, East Sussex, BN8 4LR. There is also a branch surgery at South Chailey Surgery, Mill Lane, South Chailey, Lewes, BN8 4PY. We did not visit the branch surgery as part of our inspection.

Opening hours are Monday to Friday 8.30am until 6.30pm at the Newick Health Centre and 8.30am until12.30pm and 3.30pm until 6.30pm Monday to Friday at the South Chailey Surgery. The practice also provides extended opening hours on a Saturday morning from 9.00am until 11.00am at Newick Health Centre for pre booked appointments only.

Updated 9 October 2018

This practice is rated as Good overall. (Previous rating November 2017 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced focused inspection at Mid Downs Medical Practice on 20 September 2018 to follow up on a breach of regulation identified at our inspection in November 2017. At our previous inspection we rated the practice as requires improvement for providing safe services and good for effective, caring, responsive and well-led services.

At this inspection we found:

• The practice had rectified the issue in relation to security of prescription forms by fitting number pad locks to all rooms where these forms were used.
• The practice had ensured they kept emergency medicine to assist patients who may be undergoing a diabetic emergency.
• The practice had improved in the delivery of immunisations to children and had exceeded the target set by the World Health Organisation (WHO).

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Updated 2 July 2015

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. Longer appointments and home visits were available when needed. All these patients had a structured annual review to check that their health and medication 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. For example there was a weekly podiatry clinic at the practice which focused on patients with diabetes and other long term foot conditions.

Updated 2 July 2015

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. Immunisation rates were relatively high for all standard childhood immunisations. Appointments were available outside of school hours and the premises were suitable for children and babies. The practice worked closely with midwives, health visitors and school nurses. The health visiting team was based in the practice premises at Newick which helped promote joint working.

Updated 2 July 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in avoiding unplanned hospital admissions and end of life care. It was responsive to the needs of older people, and was proactive in meeting their needs. For example it provided outreach flu clinic in the local community and offered home visits for vaccinations if required. The practice worked closely with multidisciplinary teams to ensure support was provided to people in their own homes in order to prevent unplanned hospital admissions.

Updated 2 July 2015

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.

Updated 2 July 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). All people experiencing poor mental health were offered an annual physical health check. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried dementia screening on a routine basis. A number of staff had completed on line training to help them understand and support people with dementia. The practice worked closely with the local mental health team which ran clinics from its branch surgery at South Chailey.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

Updated 2 July 2015

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 had carried out annual health checks for people with a learning disability and offered longer appointments for people with a learning disability and visited them in their own homes.

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.