Stone Cross Surgery Also known as Stone Cross, Pevensey Bay and Westham Surgery

Updated 11 May 2016

Dr Bansel & Partners is situated in East Sussex. It comprises of three locations. The main location is:- Stone Cross Surgery,

Mimram Road

Stone Cross

East Sussex

BN24 5DZ

There are two branch surgeries:-

Pevensey Bay Surgery

10 Richmond Road

Pevensey Bay

BN24 6AQ

Westham Surgery

Church Bailey

Montague Way

Westham

BN24 5NQ

All three locations are managed from Stone Cross Surgery and they have a shared patient list. During our inspection we visited Stone Cross Surgery.

The practice serves a population of 11,803 patients, consisting predominantly of patients who are working or in full time education and older patients. Patients over the age of 65 account for 25.9% of the patient population in comparison with the national average of 16.7%. Patients who are working or in full time education account for 53.5% of the patient population compared with the national average of 60.2%.

The practice has a General Medical Service (GMS) contract. The practice provides enhanced services which include childhood immunisation and vaccination and on-line services.

The practice team consists of Six GP Partners. Four are male and two are female.

In addition there are six practice nurses; three health care assistants a phlebotomist; a practice manager and administrative staff.

The practice is a training practice for GP trainees (registrar) with 1 GP being trainer. At the time of our inspection one GP registrar was being supported by the practice.

Stone Cross Surgery is open between 8.30am and 6.00pm Monday to Friday. Appointments are from 8.30am to 12 noon every morning and 2.30pm to 5.30pm daily. Extended surgery hours are offered on Thursday mornings from 7.00am to 8.00am and on Saturday mornings from 8.00 to 1pm.

The practice has opted out of providing Out Of Hours services to their own patients. Information on the surgery website informs patients how to access medical attention when the surgery is closed. IC24 provides emergency care between the hours of 8am to 8.30 am and 6 to 6.30pm. Patients can access NHS 111 at all other times of the day.

Stone Cross Surgery is fully accessible for wheelchair users. There is a lift available.

Updated 11 May 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Bansel & Partners (Stone Cross Surgery) on 26 January 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.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make appointments and that there was continuity of care. Urgent appointments were available on the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• 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:

• Establish an auditable system for the monitoring and recording of all decision making, action taken, outcomes and lessons learned in relation to significant events

• Ensure that the Infection Control Audit includes the checking of all single and Central Sterile Supplies Department (CSSD) instrumentation.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 May 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. This included patients living with chronic respiratory disease and asthma.

• GPs provided care plans and a structured annual review for all patients with a Long Term Condition to check that their health needs were being met.

• Patients with the most complex needs were managed by a named GP working with relevant health and care professionals to deliver a multidisciplinary care package.

• Patients on a recognised list of those requiring urgent care were given priority for telephone calls with a GP and were also contacted following hospital admission.

• The percentage of patients with diabetes, on the register, in whom the last IFCC-HbA2c was 64 mmol/mol or less in the preceeding12 months was 81.68% in comparison to the national average of 77.54%

• Longer appointments and home visits were available when needed.

• Flu vaccines were routinely offered to patients with long term conditions to help protect them against the virus and associated illness.

Updated 11 May 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 comparable to the Clinical Commissioning Group (CCG) and national averages 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.

• The practice assessed the mental capacity of young patients using recognised and approved guidelines (Gillick and Fraser)

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

• The practice offered pre-natal, neo-natal and six-week baby checks managed by the GP’s and Practice Nurse.

• The practice offered childhood Immunisations and were current with new vaccines issued by Public Health.

• The practice offered appointments outside of school hours and the premises were suitable for babies and small children. Baby changing facilities were available.

• The practice recognised the need for and offered offer sexual services for young people as there was no drop in centre directly in the area. The practice also offered contraceptive implants and emergency contraception.

• The practice worked jointly with midwives, health visitors and school nurses.

• There was a system in place to notify practice staff of any child at risk.

Emergency processes were in place and referrals could be made for children and pregnant women whose health was at risk.

Updated 11 May 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 and actively sought out those patients that would benefit from home visits in order to optimise their health.

• The practice offered enhanced care in the format of a one-stop shop to manage all outstanding medical needs including flu vaccines, blood pressure checks and blood test reviews.

• The practice offered preventative immunisation for Flu/Pneumonia/Shingles as appropriate.

• The practice offered health reviews to all patients over 75.

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

Updated 11 May 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 a full range of health promotion and screening that reflects the needs for this age group, including dietary and lifestyle advice, and smoking cessation advice, with further referral for specialist support.

• Extended opening hours were offered on a Thursday between 7.00am – 8.00am and also on Saturday mornings from 8.00am to 1.00pm to meet the needs of working patients. Telephone appointments were available.

• The practice offered online services to book appointments and re-order medicines

Updated 11 May 2016

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

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  The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption had been recorded in the preceding 12 months was 97.8% compared to the national average of 89.55%

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

• The practice offered a choice of specialist services to patients experiencing poor mental health, including charities that provide support and also hospital based mental health services.

• 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.

• Staff were caring and compassionate and trained to respond to the needs of those patients living with poor mental health.

Updated 11 May 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 living with a learning disability.

• The practice offered longer appointments when needed.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients. The practice held monthly Multi-Disciplinary Team meetings at which vulnerable patients were discussed.

• 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.

• Translation services were available.

• The practice was fully accessible to those patients with limited mobility and wheelchair users.

• The practice supported patients who were registered as a carer and provided advice for these patients.

• The practice was responsive to people in vulnerable circumstances with poor access to primary care and a system was in place to ensure these patients were afforded priority access to the surgery and its services.

• The practice identified a GP lead for adult safeguarding and worked closely with the district nursing and palliative care teams.