Silverdale Practice

Updated 26 April 2017

Silverdale Practice is a GP practice based in Burgess Hill in Sussex. The practice provides GP services to 11,780 patients. Services are provided from;

Silverdale Practice, 4 Silverdale Road, Burgess Hill, West Sussex RH15 0EF

And a branch surgery at;

The Avenue Surgery, 283 London Road, Burgess Hill, RH15 9QU

There are six GP partners (male and female) and three salaried GPs (female). The practice is registered as a GP training practice, supporting medical students.

There are three practice nurses and two healthcare assistants (female). GPs and nurses are supported by a practice manager and a team of reception/administration staff.

The practice was open between 8am and 6.30pm Monday to Friday. Pre-bookable extended hour’s appointments were offered between 6.30pm and 8pm on a Monday evening and between 8.30am and midday on a Saturday. In addition to pre-bookable appointments that could be booked up to six weeks in advance, urgent appointments were also available for patients that needed them. Patients are provided information on how to access an out of hour’s service (111) by calling the surgery or viewing the practice website.

The practice runs a number of services for its patients including; chronic disease management, weight management, smoking cessation, maternity services, and holiday vaccines and advice. The practice also hosted a diagnostic ultrasound service onsite at the Silverdale site.

The practice has a higher proportion of patients over the age of 65 when compared with both the CCG and national averages and a slightly lower proportion of patients under the age of 18. In addition the practice had a lower proportion of patients in paid work or education and lower unemployment. The practice is in the least deprived decile, with significantly less deprivation than the national average and slightly less deprivation than the CCG average.

Updated 26 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Silverdale Practice on 20 December 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 a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with 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.
• 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 the requirements of the duty of candour.
• The practice had an overview of performance in relation to patient outcomes and took action to improve these. However, exception reporting was higher than average in relation to asthma and mental health indicators.

The areas where the provider should make improvement are:

• Review QOF exception reporting rates, particularly in relation to asthma and mental health performance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 26 April 2017

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was better when compared to the CCG and national averages. For example 95% of patients with diabetes on the register had a record of having received a foot examination in the preceding 12 months compared with 91% (CCG) ad 89% (national).
• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.
• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.
• All these patients had a named GP and there was a system to recall patients for 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.

Updated 26 April 2017

The practice is rated as good for the care of families, children and young people.

• From the sample of documented examples we reviewed we found there were systems 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) attendances.
• Immunisation rates were relatively high for all standard childhood immunisations.
• Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.
• Appointments were available outside of school hours and the premises were suitable for children and babies. This included late afternoon and Saturday morning clinics for the administration of vaccines.
• The practice worked with midwives, health visitors and school nurses to support this population group.
• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.
• The practice’s uptake for the cervical screening programme was 84%, which was comparable with the CCG average of 84% and the national average of 81%.

Updated 26 April 2017

The practice is rated as good for the care of older people.

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.
• The practice offered proactive, personalised care to meet the needs of the older patients in its population.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.
• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.
• Where older patients had complex needs, the practice shared summary care records with local care services.
• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible. For example in relation to vaccines available to them and support to access other services.

Updated 26 April 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example, extended opening hours and Saturday appointments.
• 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.

Updated 26 April 2017

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

• The practice carried out advance care planning for patients living with dementia.
• 90% of patients diagnosed with dementia that had their care reviewed in a face to face meeting in the last 12 months, which is better when compared to the national average of 84%.
• The practice specifically considered the physical health needs of patients with poor mental health and dementia. For example, annual reviews for patients with dementia were conducted in patient’s own homes to agree a plan to improve health outcomes.
• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.
• Performance for mental health related indicators was similar to the CCG and national averages. For example the percentage of patients with schizophrenia, bipolar affective disorder and other psychoses with a comprehensive care plan documented in the record was 98% compared with the CCG average of 92% and the national average of 89%. However, exception reporting in this area was 14% higher than the CCG average and 20% higher than the national average.
• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.
• Patients at risk of dementia were identified and offered an assessment.
• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.
• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 26 April 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 travellers and those with a learning disability.
• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.
• The practice offered longer appointments for patients with a learning disability and other patients who needed them.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.
• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.