Archived: Eastney Health Centre

Updated 8 June 2016

Eastney Health Centre is located at Highlands Road, Southsea, Hampshire, PO4 9HU. The practice is based in an urban area of Southsea. The practice provides services under a NHS General Medical Services contract and is part of the NHS Portsmouth Clinical Commissioning Group (CCG). The practice has approximately 4800 registered patients. The practice population has a slightly higher proportion of working aged patients (25 to 65 year olds) compared to the national average. A total of 67% of working aged patients registered at the practice are in full or part-time employment or education compared to a national average of 62%. The practice population consists of mainly White British patients, followed by Eastern European patients and a few other ethnicities including patients from the Indian-subcontinent. The buiding is owned by NHS property services.

The practice has three GP partners and one salaried GP. All four GPs are female, when needed the practice is able to arrange for patients to be seen by a male GP. Together the GPs provided care equivalent to just under three full time GPs over 22 sessions per week. The GPs are supported by three practice nurses, who together are equivalent to one and a half full time nurses. There is an outreach nurse who works one day per week for the practice (on secondment) and visits the housebound patients. The practice also employs a health care assistant. The clinical team are supported by a management team including secretarial and administrative staff.

The practice reception and phone lines are open between 8.30am and 6.30pm Monday to Friday. From 8am to 8:30am the practice operates an emergency telephone line. Extended hours appointments with the practice nurse are offered on a pre-bookable basis from 7am to 8:30am every Tuesday and from 7:30 to 8:30am every Thursday. Pre-bookable appointments are also available on alternate Saturday mornings from 8am to 10am. Morning appointments with a GP are available between 9 am and 11am daily. Afternoon appointments with a GP are available from 3:30pm to 5:30 daily. The practice offers a telephone triage service daily. Eastney Health Centre has opted out of providing out-of-hours services to their own patients and patients are requested to contact the out of hours GP via the NHS 111 service.

The practice offers online facilities for booking of appointments and for requesting prescriptions.

Updated 8 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Eastney Medical Centre on 14 April 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.
• 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 provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

• The practice promoted continual development of staff and retained these staff members as employees at the practice. For example, the practice encouraged a staff member to progress from a Health Care Assistant onto medical school training and further training as a GP. They have also encouraged a member of the nursing team to train as an advanced nurse practitioner.

The areas where the provider should make improvement are:

• Consider working together with the other practice to allow for better communication of information to patients. Ensure that the information is easily distinguishable between the two different practices which operate from the premises to increase clarity and accessibility to patients about practice specific information.
• Consider ways to increase the number of identified carers registered at the practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 8 June 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, whose cholesterol reading was within an acceptable range was 68% compared to the national average of 80% (2014/15 data). The practice identified this as an area for improvement and completed an audit reviewing prescribed medicines and cholesterol levels of patients. Data for the 2015/16 cycle showed improvements and current figures were in line with the national average.
• Patients were referred to and encouraged to attend specialist clinics, for example, specific health information days for newly diagnosed diabetics and rehabilitation for patients with Chronic Obstructive Pulmonary Disorder (COPD) with a focus on breathing exercises and support to improve lung function. COPD is a condition which causes long term breathing difficulties.
• 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 8 June 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.
• A total of 77% of eligible women attended a cervical screening examination in comparison to the CCG average of 71% and 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, health visitors and school nurses.

Updated 8 June 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.
• An outreach nurse, conducted the chronic disease reviews for housebound patients and provided a consistent link for nursing home patients.
• The practice held regular multi-disciplinary team meetings with the Macmillan and community nursing teams to discuss elderly patients at risk of hospital admission.

Updated 8 June 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 extended hours appointments with a GP every other Saturday morning and Tuesday and Thursday early morning appointments with the practice nurse.
• 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 8 June 2016

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

• A total of 75% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is worse than the national average of 84%.
• A total of 93% of patients with schizophrenia, bipolar affective disorder and other psychoses had a documented care plan in place compared to 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 refers patients experiencing severe mental health problems and in need of urgent attention to the specialist mental health team.
• 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 displays information on local support services including a self-referral pack to the talking change service.

Updated 8 June 2016

The practice is rated as outstanding for the care of people who circumstances may make them vulnerable. The practice was rated as good for safe, effective and well-led. The practice was rated as outstanding for careing and responsive.

• 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.
• Yearly reviews are offered for patients with learning disabilities. Patients who do not attend are contacted by the practice. The practice also had good links with the local learning disabilities nurse.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients
• Patients were offered referrals to voluntary services who help isolated patients in need of some social contact.
• The practice offered double appointments for patients as needed; an example was given for patients with eating disorders requiring additional support.
• Handheld vibrating buzzers were offered to patients with visual or hearing impairments to notify patients sitting in the waiting room when the GP or nurse was ready to see them.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations including self-referral to the talking change service.
• The practice worked with a local carer representative who visited the practice weekly. The representative set up a stall in the waiting area to provide support and information to carers as well as support the practice identify new carers.
• Patients and carers were contacted by the practice to remind them of appointments and reception staff followed up on any patients who did not attend.
• 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.
• Nursing staff were trained to level 3 for safeguarding children and all administration staff were trained to level 2.
• There was a separate dedicated GP and Nurse safeguarding lead for safeguarding adults and children.