Rye Medical Centre

Updated 22 March 2017

Rye Medical Centre is a dispensing practice offering general medical services to the population of Rye, Camber, Icklesham, Brede and Peasmarsh in East Sussex. There are approximately 6,900 registered patients. The practice is located within a purpose built property with full access to disabled people. The practice is part of the NHS Hastings and Rother CCG area.

The practice population has a higher number of patients aged between 50-85+ years of age than the national and local clinical commissioning group (CCG) average. The practice population also shows a lower number of patients between the age of 0-44 years of age than the national and local CCG average. There are a comparable number of patients with a long standing health condition in relation to both CCG and national averages. The percentage of registered patients suffering deprivation (affecting both adults and children) is comparable to both the averages for England and local CCG area.

Rye Medical Centre is run by four partner GPs (two male and two female). The practice is also supported by one male salaried GP, three practice nurses (one male and two female), a healthcare assistant a team of administrative and reception staff, five dispensary staff and a practice manager.

The practice provides a number of services for its patients including; asthma clinics, diabetes clinics, anti-coagulation monitoring, minor surgery, child immunisation clinics, new patient checks and holiday vaccinations and advice.

Services are provided from four locations:

Rye Medical Centre, Kiln Drive, Rye Foreign, East Sussex, TN31 7SQ

And three branch surgeries:

The Surgery, Village Hall, Cackle Street, Brede, TN31 6DX. Appointments available on alternate Thursday mornings.

The Surgery, Memorial Hall, Main Road, Icklesham.T36 4BJ. Appointments available Monday and Friday mornings.

The Surgery, Memorial Hall, Lydd Road, Camber. TN31 7RJ. Appointments available Monday, Wednesday and Friday mornings.

The branch surgeries were not inspected during this inspection.

Opening hours are Monday to Friday 8am to 6.30pm. During the times when the practice is closed arrangements are in place for patients to access care from IC24 which is an Out of Hours provider. Access to this service is by calling NHS 111.

Updated 22 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Rye Medical Centre on 8 September 2016. The overall rating for the practice was good but was rated as required improvements within the safe domain. The full comprehensive report on the September 2016 inspection can be found by selecting the ‘all reports’ link for Rye Medical Centre on our website at www.cqc.org.uk.

Following this inspection the practice sent to us an action plan detailing what they would do to meet the legal requirements in relation to the following:

• Implementing a system to monitor hand written and computer printed prescription pads and forms.
• Ensuring that medicines management systems are reviewed to enable all controlled drugs to be dispensed in accordance to legal requirements.

Additionally we had found that:

• The practice needed to review their complaints process to ensure patients are given information on how they can escalate a complaint should they remain dissatisfied.

This inspection was an announced focused inspection carried out on 1 March 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Our key findings were as follows:

• The provider had reviewed their medicines management procedures in relation to dispensing controlled drugs and evidence was seen that these medicines were being dispensed with in accordance to legal requirements.
• A system was now in place to monitor hand written and computer generated prescription pads and forms.
• The provider had reviewed their complaints management system and evidence was seen that patients were given appropriate information so as to allow them to escalate a complaint should they remain dissatisfied.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 October 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.
• Data from 2014/2015 showed the percentage of patients with diabetes, on the register, who had influenza immunisation in the preceding 1 August to 31 March was 96% compared to the clinical commissioning group (CCG) average of 96% and a national average of 94%.
• 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.
• The practice facilitated a healthy living advisor who was available each Thursday to supply advice on a range of topics such as healthy eating.

Updated 20 October 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. Immunisation rates were relatively high for all standard 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 percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding five years was 82% compared to a clinical commissioning group (CCG) average of 84% and a national average of 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.
• The practice provided minor injury care for patients due to the distance of the nearest emergency department.
• The practice was active in a local scheme where condoms could be obtained when a card was shown and there were chlamydia testing kits easily available at the entrance of the practice to enable patients to obtain this without having to enter the main area of the practice.

Updated 20 October 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 was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• Daily visits were undertaken to patients in Rye community hospital, a 19 bed local facility.
• Longer appointments were available for patients with complex needs.

Updated 20 October 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.
• Telephone appointments were available for patients who could not attend the practice.
• The practice undertook the placing of contraceptive implants and coil fitting at the practice.

Updated 20 October 2016

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

• 78% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months which was lower than the national average of 84%.
• Data from 2014/2015 showed the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption had been recorded in the preceding 12 months was 98% which was better than the national average of 90%.
• 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.
• 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.
• The practice facilitated counsellors from the “Health in Mind” service for patients requiring counselling.

Updated 20 October 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 homeless people, travellers and 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 had two “caring for carers” leads who 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.