Billingshurst Surgery Also known as Dr Polwin & Partners

Updated 3 April 2017

Billingshurst Surgery is located on Roman Way in Billingshurst, West Sussex. The practice provides services for approximately 13,200 patients living within the Billingshurst area. The practice holds a General Medical Services (GMS) contract and provides GP services commissioned by NHS England. A GMS contract is one between GPs, NHS England and the practice where elements of the contract such as opening times are standard. The practice patient population is higher than the national average amongst the 40-79 year olds. Deprivation amongst children and older people is low compared to the national averages. The local population is predominantly white British and life expectancy for men and women is similar to the national averages.

As well as a team of nine GP partners (four male and five female), the practice employs an advanced nurse practitioner, six practice nurses and three health care assistants. An executive manager is employed and supported by receptionists, administrative clerks and a dispensing team.

The practice is a training practice for GP trainees and foundation level 2 doctors.

The practice is open between 8am and 6.30pm on weekdays. GP and nurse appointments are available between 8am and 6.30pm. Extended opening is available from Monday to Thursday evenings until 8pm.

Patients are provided information on how to access the out of hours service by calling the surgery or viewing the practice website.

The practice is registered to provide the regulated activities of diagnostic and screening procedures; treatment of disease, disorder or injury; family planning, and surgical procedures. There is an on-site dispensary.

Updated 3 April 2017

Letter from the Chief Inspector of General Practice

The practice is rated good overall and good for providing safe services.

We carried out an announced comprehensive inspection of this practice on 25 February 2016. The overall rating for the practice was good. However, a breach of legal requirements was found during that inspection within the safe domain. After the comprehensive inspection, the practice sent us an action plan detailing what they would do to meet the legal requirements. We conducted a focused inspection on 8 March 2017 to check that the provider had followed their action plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

During our previous inspection on 25 February 2016 we found the following area where the practice must improve:

• Establish arrangements for the safe management of medicines within the practice.

Our previous report also highlighted the following areas where the practice should improve:

• The practice should continue to improve their appointments system and look at ways of improving the emergency appointments system to include seeking advice from outside of the practice.

• Ensure the registered manager is correctly registered with CQC.

• Review their policy for recruitment checks and ensure this is adhered to.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link on our website at www.cqc.org.uk

During the inspection on 8 March 2017 we found:

• Arrangements were in place for the safe management of medicines within the practice.

We also found the following in relation to the areas where the practice should improve:

• The practice was taking steps to improve the appointments system. There was now a duty team with an established nurse practitioner service, which increased the availability of emergency appointments. Patients were also able to book appointments up to six weeks in advance.

• The practice had submitted the relevant forms to ensure the registered manager is correctly registered with CQC.

• The practice had reviewed and updated their policy for recruitment checks. There was a checklist detailing the documents and checks required prior the employment a new staff member.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 5 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.

• Performance for diabetes related indicators were better than or similar to the 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 the same as the national average of 78%; and the percentage of patients with diabetes who had a record of a foot examination and risk classification within the preceding 12 months was 95% which was better than 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.

• Patients diagnosed with diabetes received a tailored care plan and a monthly review with the local Diabetes Nurse Specialist.

• Community pharmacies could collect prescriptions for delivery.

Updated 5 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. For example, childhood immunisation rates for the vaccines given to under two year olds ranged from 96% to 98% (CCG 93% to 97%) and five year olds from 91% to 97% (CCG 89% to 96%).

• 76% of patients diagnosed with asthma, on the register, had an asthma review in the last 12 months, which was in line with the 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.

• The practice’s uptake for the cervical screening programme was 84%, which was better than the national average of 81%.

• 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.

Updated 5 May 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 had a dedicated GP for each local care home and sheltered housing with scheduled weekly visits to both.

• Home visits and urgent appointments were available for those with enhanced needs.

Updated 5 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 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 5 May 2016

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

• 93% of patients with schizophrenia, bipolar effective disorder and other psychoses had a comprehensive care plan in the preceding 12 months which was better than the national average of 88%.

• 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.

• Counselling support services were available to patients from within the practice.

• 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 5 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 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.