Grove House Surgery

Updated 5 September 2016

Grove House Surgery is situated on the west side of the seaside town of Bognor Regis, West Sussex and operates from a main site at:

Grove House Surgery

80 Pryors Lane

Rose Green

Bognor Regis

West Sussex

PO21 4JB

and a branch site at:

Arthur Griffiths Clinic

The Parade

Pagham

Bognor Regis

West Sussex

PO21 4TL.

The practice provides services for approximately 11,900 patients living within the Bognor Regis 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 significantly large numbers of people aged 65 and older compared to the national average. Deprivation amongst children and older people is very low when compared to the population nationally. The practice has more patients with long standing health conditions and health related problems affecting their daily lives than the national average, which could mean an increased demand for GP services.

As well as a team of four GP partners and two salaried GPs (three male and three female), the practice also employs a lead nurse, three practice nurses, an assistant practitioner and two health care assistants. A practice manager and an assistant practice manager are employed and there is a team of receptionists and administrative clerks. The practice also has on-site midwifes, health visitors, mental health practitioner and counselling service and can refer patients to this services.

The practice is a training practice for GP trainees and foundation level two doctors.

Grove House Surgery is open between 8am and 6.30pm on weekdays and appointments are available from 8.30am to 6.30pm on weekdays. Extended hours appointments are available on Tuesdays from 6.45am to 8am and from 6.30pm to 8pm. Appointments are available at Arthur Griffiths Clinic from 8.30am to 11.30am from Monday to Friday where GPs hold clinics on rotation and there is a practice nurse in attendance and a phlebotomy clinic. There are phone appointments available with GPs throughout the day according to patient need. Routine appointments are bookable up to six weeks in advance. Patients are able to book appointments by phone, online or in person.

Patients are provided with information on how to access the duty GP or the Out of Hours 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 5 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Grove House Surgery on 10 June 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. However, non-clinical staff had not received the appropriate training in consent.
• 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 there was continuity of care, with urgent appointments available the same day. However, patients found it difficult to get through to the practice to make an appointment.
• 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 areas where the provider should make improvements are:

• Ensure all staff receive appropriate training in patient capacity and consent.

• Improve patient access to appointments including access by phone.

• Improve the levels of exception reporting within the practice (Exception reporting is the removal of patients from QOF calculations where, for example, the patients are unable to attend a review meeting or certain medicines cannot be prescribed because of side effects).

• Increase the numbers of patients diagnosed with dementia who receive an annual review.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 5 September 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.

• Performance for diabetes related indicators was better than or in line with the clinical commissioning group (CCG) and national averages. For example, patients with diabetes who had a blood pressure reading in the preceding 12 months of 140/80mmHg or less was 78% which was lower than the CCG average of 83% and the same as the national average of 78%.

• 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 patient participation group (PPG) arranged regular educational health talks for patients.

Updated 5 September 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.

• 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 94%, which was significantly better than the clinical commissioning group (CCG) average of 83% and 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 and health visitors and both of these services offered appointments on site.

• Postnatal and paediatric checks were carried out by the named GP.

Updated 5 September 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 was involved in a ‘Test and Learn’ project to establish more formal collaborative working with the community nurses and palliative care team to reduce unnecessary admissions to hospital.

• The practice provided fortnightly rounds to the local nursing home.

• There was a patient transport service available to those who were unable to make their own way to the practice. This was run by the patient participation group (PPG).

Updated 5 September 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.

• Phone appointments were available where appropriate.

Updated 5 September 2016

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

• The practice achieved lower than the local and national averages for the management of patients diagnosed with dementia. For example 73% of these patients had received a face-to-face review within the preceding 12 months compared to the CCG average of 82% and the national average of 84%.

• 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. For example, patients diagnosed with dementia were referred to local memory clinics.

• The local mental health practitioner and counselling team both ran clinics at the practice.

Updated 5 September 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 other health care professionals in the case management of vulnerable patients, which included a fortnightly meeting.

• 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.

• GPs called at risk patients who had recently been discharged from hospital to ensure their health needs were being addressed.