Archived: Broadway Surgery

Updated 26 January 2017

Broadway Surgery is located in the Whitehawk area of Brighton and provides primary medical services to approximately 2402 patients.

There are two GP partners, one male and one female. There are two practice nurses, a health care assistant and a phlebotomist. There is a practice manager, an administrator and four receptionists.

Data available to the Care Quality Commission (CQC) shows the practice serves a higher than average number of patients aged between 5 and 29 when compared to the national average. The number of patients over the age of 75 is below the national average. The practice population has a significantly higher than average income deprivation score. There is also a higher than average number of patients with long standing health condition and with health related problems in daily life.

The practice is open on Monday, Tuesday Wednesday and Friday from 9am to 1pm and 3pm to 6pm and on Thursday from 9am to 1pm. The practice is open on a Wednesday evening from 6.30pm until 7.45pm for extended hour’s appointments. It is closed on a Thursday afternoon. Between 8am until 9am and 6pm until 6:30pm Monday to Friday and on Thursdays from 1pm to 6.30pm calls to the practice are taken by an out of hours provider (Integrated Care 24). Appointments can be booked over the telephone, on line or in person at the surgery. Information on how to access the out of hours service is provided on the practice’s answer phone message, their website and in the practice information leaflet.

The practice runs a number of services for its patients including; chronic disease management, asthma and diabetes reviews, new patient checks, and holiday vaccines and advice. Welfare and benefits advice is provided at the practice twice a week by the Citizens Advice Bureau.

Updated 26 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Broadway Surgery on 19 October 2016. Overall the practice is rated as good.

Broadway Surgery was subject to a previous comprehensive inspection in February 2016 where the practice was rated as inadequate and was placed into special measures. Following our inspection of the practice in February 2016, the practice sent us an action plan detailing what they would do to meet the regulations. We undertook this second comprehensive inspection on 19 October 2016 to check that the provider had followed their action plan and to confirm that they now met the regulations. We found that the practice had made significant improvements since our previous inspection. The practice is now rated as good overall.

Our key findings across all the areas we inspected were as follows:-

• There was now an open and transparent approach to safety and an effective system in place for reporting and recording significant events. We saw evidence these were investigated and that learning was shared with staff.
• Risks to patients were assessed and well managed. This included arrangements for managing medicines, including emergency drugs, vaccines and the prescribing of high risk medicines.
• Arrangements were now in place to manage the care and treatment of patients with long term conditions. Practice performance against the quality and outcomes framework (QOF) had significantly improved as a result.
• Immunisation rates were now relatively high for all standard childhood immunisations.
• 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. This included up to date training on basic life support, safeguarding, infection control and the role of the chaperone.
• Patient satisfaction had improved. Seventy six per cent of respondents to the national GP patient survey stated that they would recommend their GP surgery to someone. This was now in line with the national average of 80%.
• Patients commented that they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice now had a website and Information about services and how to complain was available, easy to understand and available in other languages. 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.
• A clear leadership structure was now in place and staff felt supported by management.
• An active patient participation group had been established and 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 must make improvements are:-

• Address areas of lower than average patient satisfaction with opening hours and the ability to get an appointment.

The areas where the provider should make improvement are:

• Identify the number of carers registered with the practice so that measures can be taken to ensure they receive appropriate support.
• Ensure practice performance continues to improve in areas that have been identified as falling below the national and local averages. For example, improving outcomes for people with diabetes and severe and enduring mental health problems,
• Put measures in place to increase the uptake of national screening programmes including cervical screening and screening for breast and bowel cancer.

I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by this service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 26 January 2017

The practice is rated as good for the care of people with long-term conditions.

• The practice had employed an additional practice nurse which had enabled the nursing team to take the lead role in chronic disease management.
• Practice performance against the diabetes indicators in the quality and outcomes framework had improved and was now above the local and national averages. For example, the percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the last 12 months) was 140/80 mmHg or less was 78% compared to the clinical commissioning group (CCG) average of 77% and the national average of 78%.
• Nationally reported data showed that outcomes for patients diagnosed with conditions commonly found in older patients had improved. For example, 55% in 2014/2015. This had increased to 82% in 2015/2016, which was comparable to the clinical commissioning group average of 86% and below the national average of 90%.
• Longer appointments and home visits were available when needed.
• All these patients had a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the practice worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 26 January 2017

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.
• The percentage of patients who had had an asthma review in the preceding 12 months that included an assessment of asthma control had improved from 51% in 2014/2015 to 72% in 2015/2016. This was comparable to the clinical commissioning group (CCG) average of 71% and the national average of 76%.
• The number of women aged between 25 and 64 who attended cervical screening in 2014/2015 was 73% which was lower than the clinical commissioning group average of 79% and the national average of 82%.
• The practice had developed a website with specific information for teens and young people and links to and advice on sexual health and counselling services.
• 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.

Updated 26 January 2017

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 was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The practice hosted a volunteer who worked as a ‘community navigator’, helping patients with complex needs to access the various community resources that were available.

Updated 26 January 2017

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. For example, extended opening hours operated on a Wednesday evening from 6.30pm until 7.45pm.
• The practice now had a website and patients could now book appointments and order repeat prescriptions on-line.

Updated 26 January 2017

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

• 100% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was above the clinical commissioning group (CCG) average of 77 % and the national average of 84%.
• The percentage of patients with a severe and enduring mental health problem who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months (04/2014 to 03/2015) was 50% compared to the CCG average of 76% and the national average of 89%. The practice told us that all of the fourteen patients on the mental health register had been invited for an annual review but that half of them either declined or did not attend for their appointment. The GPs had contacted the patients personally by telephone to encourage them to attend and undertook home visits if that made it easier for the patient.
• The practice regularly worked with multi-disciplinary teams in the case management of patients 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.
• 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 26 January 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice maintained a register of patients with learning disabilities.
• The practice offered longer appointments for patients with a learning disability or complex needs.
• The practice offered home visits and 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.