Hove Polyclinic

Updated 8 August 2014

We inspected Hove Polyclinic on 21 May 2014 as part of our comprehensive inspection of Brighton and Sussex University Hospitals NHS Trust.

Hove Polyclinic provided a safe and caring service, but required improvement in being responsive to patients and being well-led.

Our key findings were as follows:

• We found the outpatient department to be safe, accessible, well-maintained and fit for purpose. The outpatient department had sufficient essential equipment.
• Guidance from the National Institute for Health and Care Excellence (NICE) was speciality-based within the speciality of the division. We saw copies of the relevant guidance for staff to access in the nurse manager’s office in the outpatient department.
• Nurses had received additional training to enable them to run nurse-led clinics. For example, Parkinson’s disease and cystic fibrosis clinics. Extended roles for nurses were in place in the pain management service.
• Each patient attended the outpatient clinic for long-term management of their clinical condition. On the inpatient notes, we saw the running records that demonstrated how patient care and support had been managed and how patients were involved in the care planning process.

However, there were also areas of poor practice where the trust needs to make improvements.

Importantly, the trust must:

• Ensure that effective systems are in place through the Hub, so that patients needing urgent referrals for assessment or treatment are dealt with promptly.

In addition the trust should:

• Ensure that there are systems in place to communicate necessary performance data to relevant clinic staff to enable them to more effectively manage the outpatient service at Hove Polyclinic.
• Ensure that there is feedback and communication from the medical records department to Hove Polyclinic.
• Ensure that Hove Polyclinic is part of a wider clinical governance framework for outpatient services across the trust.
• Ensure that staff are supported to attend appropriate internal and external training courses and are provided with time and resources that are fair and equitable to the individual staff member, the department and the trust as a whole.
• Ensure that Hove Polyclinic reviews the directional signage in relation to people who are visually impaired.

Professor Sir Mike Richards

Chief Inspector of Hospitals

Updated 8 August 2014

Clinic staff were aware of how to report incidents, and while there were few incidents, we saw that these were investigated. Patients told us they felt the outpatient department was cleaned to a high standard. The nurse manager checked the cleanliness of the outpatient department every morning before patients arrived for their outpatient treatment. We found the outpatient department to be safe, accessible, well-maintained and fit for purpose. The outpatient department had sufficient essential equipment. We saw all nursing and support staff were meeting their mandatory training requirements. For example: fire, manual handling, resuscitation and infection control.

Each patient attended the outpatient clinic for long-term management of their clinical condition. We saw that in the inpatient notes, the running records demonstrated how patient care and support had been managed and how each patient had been involved in the care planning process.

A significant number of concerns had been received from patients attending the outpatient department. Incident reports had been completed by the nurse manager and sent to the Hub (a centralised booking system). We noted clinics had been cancelled, or the wrong appointments had been sent to patients.

Local clinical governance arrangements were in place, but there was no overarching clinical governance framework in place for outpatient services. Staff had not been engaged in the implementation of the Hub and there were no formal systems to enable the nurse manager to be involved in leading improvements in outpatient services. Incident reports had continued to be received around the risks to patients caused by delays in referral and treatment times. Plans were in place to address the service shortfalls.