Archived: Dr R Miakowski & Partners

Updated 30 May 2017

Dr R Miarkowski and Partners offer primary medical services via a general medical services (GMS) contract to approximately 5,604 registered patients. The practice provides services to a higher number of patients who are aged 0 to 9 years of age and 30 to 39 years of age, when compared with the local clinical commissioning group (CCG) and England average. The practice is in an area with higher deprivation levels compared to the CCG average however the practice is significantly lower than the national average.

The practice clinical staff comprises three GP Partners (two male and one female), a salaried GP (female), two practice nurses (1.32 Whole Time Equivalents (WTE)) and three health care assistants.

The Practice is supported by a team of administration staff including an office manager, a finance administrator, a prescriptions administrator and a reception and secretarial team. Day to day management is undertaken by a practice manager.

The practice runs a number of services for its patients including minor surgery, asthma clinics, child immunisation clinics, diabetes clinics, new patient checks, and weight management support.

Services are provided from:

Dr R Miarkowski and Partners

Park View Health Partnership

Sidney West Primary Care Centre

Burgess Hill

West Sussex

RH15 8HS

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, this is accessed by patients calling NHS 111.

Updated 30 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr R Miarkowski and Partners on 15 March 2016. During this inspection we found breaches of legal requirement and the provider was rated as requires improvement under the safe domain. The full comprehensive report on the March 2016 inspection can be found by selecting the ‘all reports’ link for Dr R Miarkowski and Partners 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:

• Ensuring that all staff who have unsupervised access to patients have undergone a check via the disclosure and barring service (DBS).

• Ensuring records of cleaning, specifically the laundering of material privacy curtains are maintained to demonstrate that these curtains are laundered in line with national infection control guidelines.

Additionally we had found that:

• The provider needed to review appointment accessibility in line with their action plan.

This inspection was an announced focused inspection carried out on 29 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.

Overall the practice is rated as good.

Our key findings were as follows:

• The practice had undertaken DBS checks on staff who required these checks. New staff who had started employment since our last inspection had also undergone an enhanced DBS check.
• The practice had reviewed their procedure for laundering fabric privacy curtains. These had been replaced with disposable curtains and were subject to a six monthly replacement programme.

Additionally:

• The practice continued to keep their appointment availability under review. We saw evidence to demonstrate appointments were available for patients. More appointments had been released each day and could be booked in advance. Urgent appointments were also available for patients. The practice was working collaboratively with other local providers to review the demand for on the day appointments in the area.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 August 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.
• The percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months was 90% which was comparable to the national average of 88%.
• 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.

Updated 16 August 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 high for all standard childhood immunisations.
• 74% of patients diagnosed with asthma, on the register, had an asthma review in the last 12 months which was comparable to the national average of 73%.
• 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 5 years was 84% compared to the 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, health visitors and school nurses.

Updated 16 August 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.
• The practice had worked with local care homes to develop risk assessments and care plans for patients to ensure appropriate healthcare support was delivered.

Updated 16 August 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.
• Extended hours allowed patients to have an appointment after or before work.

Updated 16 August 2016

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

• 84% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, the same as the national average of 84%.
• The practice regularly worked with multi-disciplinary teams in the case management of people 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.

Updated 16 August 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 multi-disciplinary teams in the case management of vulnerable people.
• 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.