Archived: The Ship Street Surgery

Updated 4 August 2017

The Ship Street Surgery is located in East Grinstead, West Sussex. The practice provides services via a General Medical Services (GMS) contract (GMS contracts are a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract). The practice is based in a purpose built premises on two floors. There are nine consulting rooms and three treatment rooms located on the ground floor. The practice is part of NHS Horsham and Mid Sussex Clinical Commissioning Group.

The practice has approximately 11,300 registered patients. The practice has patients from all age groups with a slightly higher proportion of patients aged over 40 compared to other age ranges. The area in which the practice is located is placed in the tenth least deprived decile. In general, people living in more deprived areas tend to have a greater need for health services. According to the Office for National Statistics and information provided by the practice, the practice catchment area has a high proportion of people from a white British background who have English as their main language.

There are five GP partners, three salaried GPs, and one GP trainee. There are three male and six female GPs. GPs provide approximately 62 sessions per week in total which equates to 7.75 whole time GPs. The practice employs two nurses, two health care assistants, and one phlebotomist. The practice manager is supported by a deputy practice manager and team of administrative and reception staff. The practice provides training to medical students and teaching for qualified doctors training to become GPs.

The practice is open and appointments are available between 8am to 8pm on Mondays, 8am to 6.30pm Tuesdays to Thursdays, and 7am to 6.30pm on Fridays. Telephone lines are open between 8am and 6.30pm Monday to Friday. In addition to pre-bookable appointments that can be booked up to eight weeks in advance, urgent appointments are also available for patients that needed them. When the practice is closed patients are referred to the Out of Hours Service via NHS 111 service or emergency services via NHS 999.

Services are provided from the following location

Ship Street Surgery

Ship Street

East Grinstead

West Sussex

RH19 4EE

Updated 4 August 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Ship Street Surgery on 9 December 2016. The practice was rated as requires improvement for providing well led services. The overall rating for the practice was good. The full comprehensive report on the December 2016 inspection can be found by selecting the ‘all reports’ link for The Ship Street Surgery on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 20 July 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 on 9 December 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

We have amended the rating for this practice to reflect these changes. The practice is now rated good for the provision of well led services. Overall the practice remains rated as good.

Our key findings were as follows:

• The practice had reviewed their governance arrangements to reduce risk and improve outcomes for patients.

• The practice had reviewed the monitoring and tracking of blank prescription forms through the practice. A new process was commenced on the day of the previous inspection and logs recording the issue and use of prescriptions were maintained.

• The practice had requested an external contractor to undertake a fire risk assessment. No high risk actions were identified and many medium and low risks were completed or timetabled for implementation.

• The practice had reviewed their systems for receiving and disseminating safety alerts received from the Medical and Healthcare Products Regulatory Agency. A dedicated email address for the alerts had been allocated to designated administration staff and was reviewed daily.

• Recruitment checks were undertaken and documented in line with practice policy.

• Practice data for 2016/17 showed improvement in patient outcomes for long term conditions and childhood vaccines. However, child vaccines were still below the national average and exception reporting for cancer related indicators had risen slightly.

However, there were areas where the practice should make improvements:

• Continue to monitor and improve rates for childhood vaccines and reduce exception reporting for cancer related indicators.

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.

• GPs and nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was 86% which was low compared to the CCG average of 96% and national average of 90%.
• In July 2016 the practice had found that 67% of patients with diabetes had received a pneumococcal immunisation to protect against infection. The practice had sent a letter and emails to patients inviting them for immunisation. Repeat audit in November 2016 showed that 72% of patients had received the immunisation. The practice had identified that patients who could not attend the practice may not receive immunisations, but there was no information in the audit about how to enable these patients to receive immunisation.
• Longer appointments and home visits were available when needed.
• 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.
• There was a self-service machine for patients to measure blood pressure with a privacy screen and clear instructions for use.

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.
• Childhood immunisation rates for the vaccines given were low compared to CCG and national averages. The practice described taking appropriate measures to try and improve immunisations rates. The practice had audited immunisation rates in August 2016 and found that childhood immunisation rates for the vaccines given to under two year olds had improved.
• Children and young people were treated in an age-appropriate way and were recognised as individuals.
• The practice’s uptake for the cervical screening programme for 2015-16 was 81%, which was lower than the CCG average of 84% and similar to the national average of 81%. The practice had conducted four audits of cervical screening rates since 2015 which showed progressive improvement in uptake. Unverified data for October 2016 indicated that cervical screening rates for the practice were 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• There were positive examples of joint working with midwives, health visitors and school nurses.
• Same day appointments were available for children and those patients with medical problems that require same day consultation.

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 provided appointments to patients at residential homes, including routine weekly visits and appointments in response to new concerns.
• There were disabled facilities for people with mobility difficulties.
• The practice supported patients with hearing and visual difficulties to access the service. The practice had invited external organisations for people with visual and hearing difficulties to provide advice on improving building accessibility and training for staff on how to support these patients.

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.
• The practice was proactive in offering online services as well as health promotion and screening that reflects the needs for this age group.
• Patients had access to health checks for new patients. NHS health checks for patients aged 40–74 were not offered at the practice and the practice directed patients to have these at other local services.
• The practice offered early morning and late evening appointments for working patients who could not attend during normal opening hours.

Updated 26 January 2017

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

• 97% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is higher than the CCG average of 85% and national average of 84%.
• Performance for mental health related indicators was 95% compared to the CCG average of 98% and national average of 97%.
• 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. Staff had received dementia training and one GP had completed a dementia fellowship and another GP was in the process of completing this.
• The practice had identified lead GPs who had developed mission statements to promote care for patients with dementia and mental health difficulties.

Updated 26 January 2017

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 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.