Brow Medical Centre

Updated 29 March 2017

Brow Medical Centre is a GP practice located in the town of Burgess Hill, West Sussex. It provides care for approximately 6,500 patients.

There are three GP partners. There are four other GPs, either salaried or regular locum, in total seven female and one male GP. There are three practice nurses and two healthcare assistants all female. The practice is supported by a full range of administrative and reception staff including two care co-ordinators and a practice manager.

The demographics of the population the practice serves is more complex than the national averages in that the male and female population profiles are significantly different. There are more males between the age of 10 and 19, though fewer between the age of 20 and 54, than the national average. There are fewer women between the ages of 20 and 35 but more women over the age of 45 through to the age of 85 and over. In fact there are a significant number of women over 85 years, about 50% more than average, in the population group.

The majority of the patients describe themselves as white British. Income deprivation and unemployment are significantly below average. Although the practice as a whole is not in an area of deprivation there are pockets of deprivation within it.

The practice has a general medical services contract with NHS England for delivering primary care services to local communities. The practice offers a full range of primary medical services. The practice is a training practice.

The practice is open between 8am and 6.30pm Monday to Friday. There are extended hours surgeries on Monday, Tuesday and Wednesday evenings until 9.30pm.

The surgery building is a single storey purpose built health centre building with consulting and treatment rooms on the ground floor.

Services are provided from

The Brow

Burgess Hill

West Sussex

RH15 9BS

The practice has opted out of providing out-of-hours services to their own patients. This is provided by Primecare through the NHS 111 service. There is information, on the practice buildings and website, for patients on how to access the out of hour’s service when the practice is closed.

Updated 29 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Brow Medical Centre on 10 November 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 been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice placed a strong emphasis on addressing the wider social and lifestyle and community aspects of their patient’s health and worked closely with other organisations and with the local community to do this.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group (PPG). For example, the practice provided a Saturday morning and weekday evening flu clinic for working patients in response to patient feedback. Vaccines needed by students were also available at this time.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available 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 practice had strong and visible clinical and managerial leadership and governance arrangements.
• The practice recognised that the patient’s emotional and social needs were as important as their physical needs.
• Staff were motivated and inspired to offer kind and compassionate care and respected the totality of their needs.
• The practice had taken action on areas identified as having lower than average satisfaction within the national GP Survey. This included improved reception staffing during busy times.
• There is a strong collaboration and support across all staff and a common focus on improving quality of care and people’s experiences.
• The practice raised money, through patient and staff contributions, to buy Christmas hampers for vulnerable patients such as older people living alone.

We saw one area of outstanding practice:

• The practice had worked in partnership with the ambulance service following an audit on unplanned admissions. The first cycle examined 120 such admissions over a four month period. The findings were discussed in a clinical meeting and in particular what category of admission might have been better served by a paramedic attending. As a result of the changes made there were 36 such admissions over a similar period, a 70% reduction.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 29 March 2017

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.
• There are 11 indicators for the management of diabetes, these can be aggregated. The aggregated practice score for diabetes related indicators was 100% compared with the CCG average of 96% and the national average of 90%.
• 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 participated in a tier 2 weight management programme and were co-creators, with their local district council, of a pre-diabetes prevention programme.
• The practice was part of a local pilot scheme “tailored health coaching” which aimed to help patients to understand their long term conditions developing their knowledge and skills so as to give them the confidence to self-manage their condition more fully.

Updated 29 March 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 accident and emergency (A&E).
• Immunisation rates were high for all standard childhood immunisations and the practice followed up with patients who did not attend to maximise uptake.
• 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.
• 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 community mid wife held clinics within the practice.

Updated 29 March 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 supported the PPG members to hold coffee morning one day a week in the practice. This so that people who were socially isolated, such as some older patients, could have the opportunity for contact.
• There were weekly visits to residential homes to assess older patients.
• The practice raised money, through patient and staff contributions, to buy Christmas hampers for vulnerable patients such as older people living alone.
• The practice held monthly meetings with the community multi-disciplinary team and a care co-ordinator to assess and develop support plans to enable patients to remain independent at home for longer.

Updated 29 March 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 a full range of health promotion and screening that reflects the needs for this age group.
• The practice’s uptake for the cervical screening programme was 92%, compared with the CCG average of 84% and the national average of 81%.
• The practice offered coil fitting and other contraceptive services.
• There was a text message service to remind patients of their appointments, patients could also cancel using this service.
• The practice offered telephone and web GP (web GP is a platform that allows patients to consult with their own GP by completing an online form).
• The practice offered Saturday morning and weekday evening flu vaccinations.

Updated 29 March 2017

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

• 94% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was better than both the CCG average of 85% and the national average of 84%.
• The percentage of patients with schizophrenia and other psychoses who had a comprehensive care plan in the preceding 12 months, agreed between individuals, their family and/or carers was 94%. This was similar to both the CCG average of 92% and the national average at 89%.
• The practice held monthly Mini Dementia clinics in partnership with The Alzheimer’s Society. The practice was recognised as a Dementia friendly practice.
• 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.
• Patients could self-refer to Improving Access to Psychological Therapies (IAPT) services. IAPT services provide evidence based treatments for people with anxiety and depression.
• The community psychiatric nurse held clinics within the practice.

Updated 29 March 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.
• The practice raised money, through patient and staff contributions, to buy Christmas hampers for vulnerable patients.
• The practice employed two care co-ordinators to work with patients and enable them to receive support and benefits.
• The practice facilitated weekly coffee mornings for patients that could be socially isolated including older patients and new mothers.
• The practice undertook patient assessments with both a GP and care co-ordinator to ensure holistic care could be delivered. These appointments were of one hour duration.