Archived: Tangmere Medical Centre

Updated 1 July 2016

Tangmere Medical Centre is located in the village of Tangmere near Chichester. It provides primary medical services and a dispensing service to approximately 4,507 patients.

The practice is owned by one female GP who employs one male salaried GP. There are three practice nurses, and one health care assistant. There is a practice manager and a team of four whole time equivalent administrators/receptionists and a secretary. There is also a dispensary manager and three dispensing staff.

Data available to the Care Quality Commission (CQC) shows the practice serves a population that has a higher proportion of working adults and children than most practices in the clinical commissioning group area and the lowest percentage of patients aged over 65.

The practice is open 8.00am to 6.30pm Monday to Friday. Extended hours appointments are offered every Monday from 6.30pm to 7.20pm. Appointments can be booked over the telephone or in person at the surgery. Patients are provided with information on how to access the duty GP or the out of hour’s service by calling the practice.

The practice runs a number of services for its patients including; chronic disease management, contraception, smoking cessation, travel advice, vaccinations and immunisations.

The practice provides services from the following location:-

Tangmere Medical Centre

Malcolm Rd

Tangmere

Chichester

West Sussex

PO20 2HS

At the time of the inspection the practice had not formally notified us that they were operating as a sole provider. This was because they were in the process of recruiting a GP partner. The practice was in the process of submitting the relevant applications.

Updated 1 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Tangmere Medical Centre on 31 March 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was a system in place for reporting and recording significant events. However, there were some inconsistencies in the recording and sharing of significant events and near misses.
• The practice did not have effective arrangements in place for the safe management of medicines.
• 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.
• 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. 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 sought feedback from staff and patients, which it acted on.

The areas where the provider must make improvements:

• Put arrangements in place to ensure the safe management of medicines.

The areas where the provider should make improvements:

• Ensure significant events and near misses in the dispensary and the practice are consistently recorded and shared. Include non-clinical events so that learning opportunities are maximized.

• Ensure accurate recuitment records for all staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 1 July 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 with diabetes, on the register, who had had an influenza

  immunisation in the preceding 1 August to 31 March (04/2014 to 03/2015) was 100% compared to the clinical commissioning group (CCG) average of 96% and the national average of 94%.

• Longer appointments and home visits were available when needed.

• All these patients had a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the practice worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 1 July 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 relatively high for all standard childhood immunisations.

• The percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years (04/2014 to 03/2015) was 91% which was above the CCG and national average of 82%.

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

• The practice held a weekly midwifery clinic and a weekly health visitor clinic

Updated 1 July 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.

• Patients over the age of 75 had a named GP.

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

• The practice worked closely with other health and social care organisations to ensure care was planned and co-ordinated for elderly patients at risk of hospital admission.

Updated 1 July 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 offered a full range of health promotion and screening that reflected the needs for this age group.

Updated 1 July 2016

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

• 98% of patients diagnosed with dementia that had their care reviewed in a face to face meeting in the last 12 months, which was higher than the CCG average of 81% and the national average of 84%.

  94% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record, in the preceding 12 months (04/2014 to (03/2015) which was higher than the CCG average of 89% national average of 88%.

• 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 screening for patients at risk of dementia.

• Counselling services were provided on the practice premises on a weekly basis.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 1 July 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 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.