Archived: Churchwood Medical Practice

Updated 14 January 2016

Churchwood Medical Practice offers personal medical services to the population of St Leonards On Sea. There are approximately 5,784 registered patients.

Churchwood Medical Practice is run by two partner GPs. The practice is also supported by a salaried GP, two practice nurses, two healthcare assistants, a phlebotomist, a team of receptionists, administrative staff, a practice manager and a deputy practice manager. There are two male GPs and one female GP. The practice is a training practice and currently has two GP registrars. These are qualified doctors who are undergoing further specialist training in general practice and hospitals with a view to becoming GPs.

The practice is open between 8am and 6pm Monday to Thursday and 8am to 5pm on Friday. Appointments are from 8.30am to 12am every morning and 3pm to 5pm in the afternoon. Extended hours surgeries are offered between 6.30pm to 8pm one Thursday a month and 9am to 10.30am on three Saturdays a month which are for pre-bookable appointments only.

When the practice is closed cover is provided by IC24 Ltd and is accessed via NHS111

Patients can be seen in general clinics which can include health checks, annual reviews for patients suffering from chronic diseases including amongst others, coronary heart disease, previous stroke, hypertension, mental health issues, chronic kidney disease, asthma and diabetes. Dressings, anti-coagulation, spirometry and smoking cessation clinics are also offered.

Child immunisations are held throughout the week.

Well person checks are available with the nurses and this can include a smear test for women if indicated.

Sexual health advice and investigations are offered in confidence to patients even if not registered with the practice.

Nurses also offer dietary advice and advice on exercise and weight loss and run travel clinics.

Some minor surgical procedures such as steroid joint injections and cryotherapy are also available following GP referral.

Annual flu vaccination clinics are held in October, November and December some of which are held on Saturdays.

Community midwives hold a weekly clinic at the practice on Thursday mornings.

The practice has a slightly higher than average population of 5-24 year olds and 45-69 year olds and slightly less than the national average population of 25-45 year olds. The percentage of registered patients suffering deprivation (affecting both adults and children) is higher than average for England.

Updated 14 January 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Churchwood Medical Practice on 3 November 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. Staff understood and fulfilled their responsibilities to raise concerns and report significant events. Such information about safety was recorded, monitored, reviewed and appropriate action taken.

• 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. They received training appropriate to their roles.

• 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.

• Urgent and some booked appointments were available on the 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 very well 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 show improvement are:

Ensure that PAT testing is carried out.

Ensure that a Legionella risk assessment is completed.

Continue to assess and respond to feedback from patients and staff in respect to access to appointments and customer service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 14 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. Longer appointments and home visits were available when needed. All these patients had a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the GP team worked with relevant health and care professionals to deliver a multidisciplinary package of care and host monthly multidisciplinary team (MDT) meetings which included a range of service providers including social care, a local voluntary agency specialising in mental health and one specialising in dementia, as well as community nursing and palliative care teams. The practice also worked closely with the community matron to ensure that patients with long term conditions and requiring extra support received additional input.

The clinical team worked closely with other service providers and referred to, or encouraged patients to attend, local support programmes such as ESTER, a hospital based scheme which provides additional advice for patients with Type 2 diabetes, and Rebalance which provides advice and support on weight loss.

Updated 14 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. All children under child protection procedures were coded appropriately on the clinical system and highlighted by an alert when their notes were accessed. There was a robust child safeguarding policy in place and all staff had been appropriately trained. Letters were sent to parents of any children who had missed a hospital appointment to encourage them to return to the practice for re-referral. This was because the practice recognised that they may feel uncomfortable at having missed an appointment or may be expecting to be sent a new hospital appointment automatically. Immunisation rates were relatively high for all standard childhood immunisations. Appointments were offered outside of school hours and the premises were suitable for children and babies.

There was a midwifery service available once a week on the premises. The cervical screening results were that the percentage of women aged 25 or over and who have not attained the age of 65 whose notes record that a cervical screening test had been performed in the preceding 5 years (net of exceptions) was 85% which was1.1% above the clinical commissioning group (CCG) average and 3.2% above the national average.

Updated 14 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. Those living alone were identified and with their consent the practice worked closely with family members to ensure their needs were met. It was responsive to the needs of older people, and offered home visits for the housebound. Patients in care homes were dealt with as a priority and any phone calls or faxed information were passed directly to the on-call GP for appropriate action, including home visits or liaising with other health professionals. The practice had identified patients over 75, with enhanced needs, that were at risk of unplanned hospital admission and regularly reviewed them. Hospital admissions and discharges were reviewed on a live dashboard daily to ensure a prompt and appropriate response when the patient returned home.

Updated 14 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 offered extra booked appointments for three Saturday mornings and one Thursday evening a month. These additional clinics included both practice nurse and health care assistant (HCA) appointments alongside GP appointments. GPs also offered advice by telephone each day for those patients who had difficulty attending the service. Patients could book or cancel appointments using an online booking system via the practice web page.

It was also possible to order repeat prescriptions online, update personal details or clinical records and sign up to receive the practice newsletter by email. The practice was proactive in offering a full range of health promotion and screening that reflects the needs for this age group including an in-house smoking advisor. There was a sexual health clinic available which is also offered to patients not registered with the practice.

Updated 14 January 2016

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

Of people diagnosed with dementia, 96.7% had received a review of their care in a face to face meeting in the last 12 months (14.9% above the CCG average, 12.7% above the national average) and 91.4% with severe mental health needs had a comprehensive care plan documented in the record in the last 12 months (1.2% below CCG average, 3.1% above national average). Staff had a good understanding of how to support people with mental health needs and dementia, for example all staff members had attended an in-house dementia awareness workshop. Reception staff would phone patients with dementia (or if appropriate a carer) to remind them of an appointment. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. The MDT included members of local groups working with people with mental health issues and dementia. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations having implemented a referral pathway in conjunction with the Community Wellbeing Service. 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. They hosted a local agency working with patients with mental health issues and a counselling service for adults who have been victims of abuse in childhood.

Updated 14 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 with a learning disability. Each patient had an annual review either by one of the GPs or the practice nurse and the team worked closely with the patient’s carers and residential home managers to complete the reviews in their familiar surroundings. Longer appointments were offered for people with a learning disability and where possible at the beginning or end of a surgery when the waiting room was quieter.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. 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 were aware that their local population included a high level of income deprivation and were actively involved in the Reducing Health Inequalities programme which was planning to develop a multi service provider centre to improve access to a range of support services.