Portslade Health Centre Medical Practice

Updated 17 December 2015

Portslade Health Centre Medical Practice offers general medical services to approximately 12,200 registered patients within the Portslade area of Brighton and Hove. The practice occupies a purpose built building which is owned by Sussex Community NHS Trust. A local pharmacy is situated at the front of the building and local community speech therapy and chiropody services also use the building.

The practice delivers services to patients in each of the defined aged groups, for example patients under the age of 18 years, patients over the age of 65 years and patients over the age of 85 years, in numbers which mirror the national averages for those age groups. Care is provided to patients living in residential and nursing home facilities and a local hospice. Data available to the Care Quality Commission (CQC) shows the number of registered patients suffering income deprivation is slightly higher than the national average.

Care and treatment is delivered by seven GP partners, one associate GP and one salaried GP. Six of the GPs are female and three are male. The practice employs a team of four practice nurses, one healthcare assistant and one phlebotomist. GPs and nurses are supported by the practice manager, an assistant practice manager and a team of reception and administration staff.

The practice was subject to a previous inspection on 21 May 2014. At this inspection we found that the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008. The practice did not receive a rating for its services following this inspection.

The practice is a GP training practice and supports undergraduates and new registrar doctors in training. The practice also provides support for undergraduate nurses.

The practice is open from 8.00am to 6.30pm on weekdays.

Services are provided from:

Portslade Health Centre, Church Road, Portslade, East Sussex, BN41 1LX.

The practice has opted out of providing out of hours services to its own patients and uses the services of a local out of hours service.

Updated 17 December 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Portslade Health Centre Medical Practice on 30 September 2015. Overall the practice is rated as good. Specifically, we found the practice to be outstanding for providing well led services. The practice was good for providing safe, effective, caring and responsive services. The practice was also rated as good for providing services for older people, people with long-term conditions, families, children and young people, working age people (including those recently retired and students), people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed. All opportunities for learning from internal and external incidents were maximised.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. 

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met people’s needs.

• The practice team was forward thinking and creative and was part of local and national pilot schemes to improve outcomes for patients in the area. Staff were encouraged to be innovative in their approach to improving outcomes for patients and to meet individual patients’ needs.

• A programme of continuous clinical and internal audit was used to monitor quality and to make improvements. Governance arrangements reflected best practice guidance.

• The practice had a clear vision which had quality and safety as its top priority. High standards were promoted and owned by all practice staff with evidence of team working across all roles. There was a clear leadership structure and staff felt well supported by management.

• Staff had received training appropriate to their roles and any further training needs had been identified and planned. Staff were encouraged to progress and develop within 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 appointments were available on the day they were requested. However, some patients told us that they sometimes had to wait for non-urgent appointments with a named GP.

• The practice proactively sought feedback from staff, patients and members of their patient participation group (PPG), which it acted upon.

We saw areas of outstanding practice including:

• There was a strong focus upon openness, transparency, continual learning and improvement at all levels within the practice. Leaders were highly visible, accessible and effective. The practice team was forward thinking and creative and was part of local and national pilot schemes to improve outcomes for patients.  

• The practice provided a weekly drop in sexual health service for young patients under the age of 24 years. This service was also open to young patients not registered with the practice.

There were areas of practice where the provider needs to make improvements.

The provider should:

• Ensure the practice staff training matrix is updated to reflect the training planned and completed.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 17 December 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 named GP and a structured annual review to check that their health and medicine needs were being met. The practice had identified lead administrators to support the recall of patients with each individual long term condition. 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.

Updated 17 December 2015

The practice is rated as good for the care of families, children and young people. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives and health visitors. 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. Immunisation rates were good for all standard childhood immunisations. A flexible appointment system was offered to promote access to childhood immunisations. 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 practice had taken part in a national Youth Champion pilot which produced a toolkit to support practices in providing optimum primary care services for young people. Young people involved in the project had designed an insert for the practice information booklet on services available to young patients within the practice.

Updated 17 December 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. Elderly patients with complex care needs, for example, dementia and end of life care and those at risk of hospital admission, all had personalised care plans that were shared with local organisations to facilitate the continuity of care. The practice worked closely with the community nursing team who were located within the practice premises. The practice was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. The practice supported residents at local residential and nursing homes and provided regular visits, medicine reviews and physical checks.

Updated 17 December 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. For example, the practice offered a drop in sexual health service for young patients under the age of 24 years. This service was also available to young patients not registered with the practice. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group. Electronic prescribing services enabled patients to request repeat prescriptions and have them sent directly to a pharmacy of their choice. Patients could request to receive text message reminders of their appointments. The practice provided temporary resident’s status for students returning from university and provided pre university vaccinations. Practice staff carried out NHS health checks for patients between the ages of 40 and 74 years.

Updated 17 December 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice had identified a lead GP to support patients experiencing poor mental health. Patients with severe mental health needs had care plans in place and received annual physical health checks. Patients were referred promptly to local memory assessment services. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. A community mental health nurse visited the practice to provide regular support to patients. The practice provided information to patients experiencing poor mental health about how to access various support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health.

Updated 17 December 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. The practice offered longer appointments and carried out annual health checks with a lead nurse for patients with a learning disability. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients. The practice provided information to ensure that vulnerable patients knew how to access various support groups and voluntary organisations. For example, community substance misuse teams provided support to patients on a weekly basis. The practice had identified a lead GP to support patients in substance misuse. 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 worked closely with the clinical commissioning group (CCG) safeguarding team to share information about high risk cases of domestic violence. The practice provided an auditory loop in the surgery for those patients with hearing difficulties.