Sedlescombe Surgery

Updated 17 June 2016

Sedlescombe Surgery is run by a partnership of four GPs (three male and one female). They are supported by three practice nurses, two health care assistants, a phlebotomist, six dispensers, a team of receptionists and administrative staff, two office managers and two practice managers.

The GPs run shared lists, so patients can see whichever GP they wish, although all patients on the practice list do have a named GP.

The practice has seen several partnership changes in the past few years. They have recently increased the number of partners from three to four.

The practice has a list size of approximately 6000 patients and operates from two sites. Each site had a dispensary which dispenses medicines to any patients that live more than one mile from a pharmacy.

The practice runs a number of services for its patients including COPD and asthma management, child immunisations, diabetes management, new patient checks and travel health advice amongst others. Intrauterine Contraceptive Devices (IUCDs) can be fitted at the practice.

Joint injections and minor surgery are carried out at the practice.

Services are provided at:

Sedlescombe Surgery, Battle, East Sussex, TN33 0PW

and at

Westfield Surgery, Main Road, Westfield, East Sussex, TN35 4QE

Both sites were visited on the day of the inspection

Sedlescombe Surgery is open from 8.30 am to 7pm on Monday, 8.30 am to 1pm on Tuesday, 8.30am to 5pm on Wednesday and Thursday and 8.30am to 6.30 pm on Friday. On Monday, Wednesday and Thursday the practice is closed between 1pm and 2pm. On Tuesday it is closed from 1pm and on Friday it is closed between 1pm and 2.45pm.

Westfield Surgery is open between 08.30 am and 5pm on Monday, Wednesday and Friday and from 8.30 am to 7pm on Tuesday and Thursday. The practice is closed between 1pm and 2.45pm on Tuesday and Thursday.

A duty doctor can be contacted via the practice telephone number at any time that the practice is closed between 8am to 6.30pm Monday to Friday.

Appointments at Sedlescombe Surgery are from 8.30am to 12.30pm to every morning. Afternoon appointments are from 3pm to 7pm on Monday, 3pm to 5pm on Wednesday and Thursday and 3pm to 6pm on Friday. There are no appointments on Tuesday afternoon.

Appointments at Westfield surgery are from 8.30am to 12.30pm to every morning. Afternoon appointments are from 3pm to 5pm on Monday and Friday and 3pm to 7pm on Tuesday and Thursday. There are no appointments on Wednesday afternoon.

When the practice is closed patients are asked to phone the NHS 111 service who will help them access the appropriate care.

The practice population has a slightly lower number of patients under 18 than the national average. There is also a higher than average number of patients of 65+ years. There are an average number of patients with a long standing health condition and an average number of patients with a caring responsibility. There are a lower than average number of patients in paid work or full time education. The percentage of registered patients suffering deprivation (affecting both adults and children) is lower than average for England.

Updated 17 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Sedlescombe Surgery on 05 May 2016. 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 with the exception that although several action points identified in the fire safety risk assessment had been actioned, not all had been resolved at the time of the inspection.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and 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.
• The practice had identified 4% of its patients as carers.
• 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 ensure that action points identified in the fire risk assessment are completed.

To consider ways of improving the uptake of some childhood immunisations.

To continue to grow, and work with, the new patient participation group.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 June 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.

• The percentage of patients with diabetes, on the register, in whom the last blood pressure reading was 140/80 mmHg or less was 80% (clinical commissioning group average 82%, national average 78%).

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• Consultants attended the practice regularly for teaching purposes and the GPs had attended cardiology clinics to enhance their knowledge.

Updated 17 June 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 living in disadvantaged circumstances, children of substance abusing parents and young carers. Immunisation rates were slightly low for some standard childhood immunisations although the numbers of children eligible to receive vaccinations was also low.

• 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 percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years was 80% (clinical commissioning group average 84%, national average 82%). However more recent unverified data shows that this figure had risen to 82%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives and health visitors.

• Same day after school appointment slots were available for school children.

• A women’s health clinic was available on Monday evenings.

Updated 17 June 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.

• The practice also considered the needs of the carer and the carer’s needs would also be included in discussions at multidisciplinary team and palliative care team meetings.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• All patients had a named accountable GP of their choice.

• Clinicians had meetings with the local consultant in elderly care and the director of the local hospice.

• Patients with complex needs could make longer appointments.

Updated 17 June 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 offered telephone consultations and evening appointments.

• Appointments were monitored and improvements made to the system if required.

• Text reminders of appointments were sent with the agreement of patients.

Updated 17 June 2016

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

• 97% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was better than the national average.

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 100% (Clinical Commissioning Group (CCG) average 93%, national average 88%).

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice 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.

• Counselling services were available in house and organisers of local mental health and counselling organisations met with the practice manager and GPs regularly.

• The practice 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 patients with mental health needs and dementia.

Updated 17 June 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.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed 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 was involved in a new locally commissioned service for vulnerable patients. This was a scheme that encouraged the practice to identify and increase the support for a wider range and number of patients with additional needs.