Warmdene Surgery

Updated 18 January 2017

Warmdene Surgery is situated on the outskirts of Brighton, East Sussex and operates from:

Warmdene Surgery

County Oak Medical Centre

Carden Hill

Brighton

East Sussex

BN1 8DD

The practice has a branch surgery which operates from:

Deneway Surgery

Lionsdene

11 The Deneway

Brighton

BN1 5AZ

The practice provides services for approximately 9,400 patients living within the local area. The practice holds a general medical services (GMS) contract and provides GP services commissioned by NHS England. (A GMS contract is one between the practice and NHS England where elements of the contract such as opening times are standard.) The practice has larger numbers of patients aged 75 years and older and patients aged under 18 years compared to the local and national averages. Deprivation is very low when compared to the population nationally.

As well as a team of five GP partners (three male and two female), the practice also employs three practice nurses and two health care assistants. A business manager, an operational services manager and a quality lead form the management team and there is a team of receptionists and administrative clerks.

The practice is a training practice for foundation level two doctors, medical students and student nurses.

Warmdene Surgery is open between 8am and 6.30pm on weekdays and appointments are available at the main site, Warmdene Surgery, from 8am to 6.30pm Monday to Friday with extended hours appointments available on Mondays and Tuesdays from 6.30pm to 8pm. Appointments are available at the branch site, Deneway Surgery, from 8am to 1pm on Mondays, Tuesdays, Thursdays and Fridays. There is a duty GP each day available for phone appointments and urgent face to face appointments according to patient need. Routine appointments are bookable up to four to six weeks in advance. Patients are able to book appointments by phone, online or in person.

The practice has access to a cluster wide community pharmacist who is available to visit patients at home according to need. The practice runs minor surgery clinics and coil clinics. One of the GPs runs a weekly minor eye surgery clinic from the practice. The practice shares its premises with another GP practice and a pharmacy. Weekly midwifery and regular dermatology clinics are run from the premises. Separate organisations providing musculoskeletal and audiology clinics rent rooms in the same premises.

Patients are provided with information on how to access the duty GP or the out of hour’s service by calling the practice or by referring to its website.

The practice is registered to provide the regulated activities of diagnostic and screening procedures; treatment of disease, disorder and injury; maternity and midwifery services; family planning and surgical procedures.

Updated 18 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Warmdene Surgery on 28 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, well managed and reviewed regularly.
• 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.

• Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were at or above the average national average particularly for patients with severe and enduring mental health problems and patients diagnosed with dementia.

• The National Diabetes Audit showed the percentage of patients with type two diabetes receiving annual checks for the effectiveness of their treatment was the highest within the CCG (84% compared with 57% CCG and 59% nationally).

• 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 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 practice team was forward thinking and part of local pilot schemes and collaborative working with other local practices to improve outcomes for patients in the area.
• The provider was aware of and complied with the requirements of the duty of candour.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 January 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.

• Performance for diabetes related indicators was in line with the clinical commissioning group (CCG) and national averages. For example, the percentage of patients with diabetes, on the register, in whom the last blood glucose level was 64 mmol/mol or less in the preceding 12 months was 73% compared with the CCG average of 72% and the national average of 78%.

• The National Diabetes Audit showed the percentage of patients with type two diabetes receiving annual checks for the effectiveness of their treatment was the highest within the CCG (84% compared with 57% CCG and 59% nationally).

• The practice was involved in piloting the National Diabetes Prevention Programme locally as part of cluster working.

• Longer appointments and home visits were available when needed.

• Patients at risk of hospital admission were identified as a priority.

• 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 had established high quality care plans for patients, including those with diabetes.

Updated 18 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. Immunisation rates were relatively high for all standard childhood immunisations.

• 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 practice’s uptake for the cervical screening programme was 82%, which was similar to the clinical commissioning group (CCG) average of 79% and the national average of 81%.

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

• The practice had a policy of returning urgent calls relating to children under five years old within 30 minutes of receiving the phone call.

• We saw positive examples of joint working with midwives and health visitors.

• Children’s safeguarding meetings were held quarterly and attended by the GPs, practice nurses, midwifery team, health visitor and school nurse.

• The practice used early warning sign algorithms to identify acute illness in children.

Updated 18 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 annual reviews and flu vaccines at home for those unable to attend the practice.

• The practice participated in the unplanned admissions and proactive care services to help prevent patients from being admitted to hospital unnecessarily and from losing their independence.

• The practice worked closely with local initiatives utilising community pharmacy support to ensure regular medication reviews were undertaken, including holistic reviews in the patient’s own home if appropriate.

Updated 18 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 a full range of health promotion and screening that reflects the needs for this age group.

Updated 18 January 2017

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

• The practice results for the management of patients diagnosed with dementia were better than local and national averages. For example, 91% of these patients had received a face-to-face review within the preceding 12 months compared to the CCG average of 77% and the national average of 84%.

• The practice results for the management of patients with poor mental health were better than local and national averages. For example, 94% of their patients with severe and enduring mental health problems had a comprehensive care plan documented in their records within the last 12 months which was in line with the CCG average of 76% and the national average of 89%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those 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 18 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 and those with a learning disability.

• The practice had established high quality care plans for patients, including those with learning disabilities.

• The practice offered longer appointments for patients with a learning disability and sent correspondence in ‘easy read’ format to aid understanding.

• 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.