Haslemere Health Centre

Updated 17 August 2021

Haslemere Health Centre is located in a purpose built centre on a site next to the community hospital and ambulance station.

Haslemere Health Centre
Church Lane
Haslemere
Surrey
GU27 2BQ

The practice has a branch surgery located approximately four miles away at:

Crossfields
Fernhurst
West Sussex
GU27 3JL

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services, family planning services, treatment of disease, disorder or injury and surgical procedures. These are delivered from both sites.

The practice offers services from both a main practice and a branch surgery. Patients can access services at either surgery.

The practice is situated within the Surrey Heartlands Clinical Commissioning Group (CCG) and delivers Personal Medical Services (PMS) to a patient population of about 19,300. This is part of a contract held with NHS England. The practice is part of a wider network of local GP practices.

Information published by Public Health England shows that deprivation within the practice population group is in the highest decile (10 of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 96.4% White, 1.5% Asian and 1.3% Mixed.

The age distribution of the practice population closely mirrors the local and England averages, with a slightly lower number of patients aged between 25 and 45 years old.

There was at the time of our inspection a team of five GP partners and eight salaried GPs who provided cover at both practices. The practice has a team of eight nurses, including four nurse prescribers who provide nurse led clinic’s for long-term condition of use of both the main and the branch locations. There are also three health care assistants. The GPs are supported at the practice by a team of reception/administration staff. The practice manager and assistant practice manager are based at the main location to provide managerial oversight.

The practice is a training practice and there are regularly GP trainees working in the practice.

Due to the enhanced infection prevention and control measures put in place since the pandemic and in line with the national guidance, most GP appointments were telephone consultations. If the GP needs to see a patient face-to-face then the patient is offered a choice of either the main GP location or the branch surgery.

Extended access is provided locally where late evening and weekend appointments are available. Out of hours services are provided by contacting NHS 111.

Updated 17 August 2021

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Haslemere Health Centre on 9 March 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 the skills, knowledge and experience to deliver effective care and treatment. There was a broad skill mix amongst the staff.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• The practice took a proactive approach to providing care for patients most at risk of admission to hospital.
• The practice had developed a robust repeat medication system to ensure the appropriate reviews had been carried out where required.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment and that there was continuity of care, with urgent appointments available the same day. There was a daily minor ailments clinic.
• 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 practice had a very well developed bespoke intranet system which contained referral forms and pathways making it easy for the GP to access up to date information and coordinate care.
• The practice had recently employed a pharmacist who reviewed medication for patients discharged from hospital and provided a source of expertise for the practice.

We saw several areas of outstanding practice:

• The practice had established a joint clinic with the practice nurse and vascular consultant allowing prompt and expert assessment of patients at potential risk of joint amputation. This early prioritisation had identified three patients who were at risk of significant loss of limb.
• The practice provided pulse checks at the annual flu clinics and as a result identified 2.1% of their population as having atrial fibrillation, against a national average of 1.6%.

The area where the provider should make improvement is:

• Review the arrangements for ensuring that patients with long term conditions receive high quality care in light of the high level of exception reporting in the Quality and Outcomes Framework.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 May 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.
• 76% of patients on the diabetes register had their last blood pressure reading (measured in the preceding 12 months) as 140/80 mmHg or less, which is comparable with 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.

Updated 10 May 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.
• 72% of patients with asthma, on the register, had an asthma review in the preceding 12 months compared to a national average of 75%.
• 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.
• 78% of eligible female patients had a cervical screening test which was slightly below 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.

• The practice offered a daily minor ailments clinic which allowed patients to access on the day treatment for minor infections and other minor ailments.

Updated 10 May 2016

The practice is rated as outstanding 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 identified those patients most at risk of hospital admissions and created proactive care plans. They employed a care coordinator to ensure these care plans were kept up to date and were shared with the ambulance service, GP out of hours and the hospital. This had reduced the ambulance conveyance rate for at risk patients to 42% compared to a national average of 65%.
• The practice kept a register of frail elderly patients and discussed these patients weekly with the community matron to avoid hospital admission where possible.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs. The appointment system had been designed to give continuity with a preferred GP for patients with complex needs.
• The practice carried out weekly visits at two care homes for older people and feedback from the homes was positive.
• The practice provided medical cover at the local community hospital carrying out daily ward rounds, including at weekends. This gave patients continuity of care and the chance to rehabilitate near their home area.
• The practice provided pulse checks at the annual flu clinics and as a result identified 2.1% of their population as having atrial fibrillation, against a national average of 1.6%. 
• The practice had established a joint clinic with the practice nurse and vascular consultant allowing prompt and expert assessment of patients at potential risk of joint amputation. This early prioritisation had identified three patients who were at risk of significant loss of limb.

Updated 10 May 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 early morning appointments from 7am three times a week and late evening appointments until 8pm twice a week.

• A Health Care Assistant offered well person health checks during the day and evening, and a bespoke printout was given to each patient to inform them of their results and actions required.

• 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.
• The practice had actively worked with a pharmacy chain to bring a pharmacy with long opening hours to the building providing convenient access to patients.

Updated 10 May 2016

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

• 74% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is below the national average of 84%.
• 92% of patients experiencing poor mental health had an agreed care plan, which is better than the 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 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.

• The practice had worked with dementia specialists to review dementia diagnosis levels and the support required for patients with dementia and mild cognitive impairment.

Updated 10 May 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 patients, 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 patients. The practice sits on the boundary of three counties and had to work hard to coordinate care with district nurses and social services across the different counties.
• 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.

• Educational sessions for doctors and nurses had been held on the treatment of addiction and assessing suicide risks.