Cathedral Medical Group

Updated 30 June 2017

Cathedral Medical Group is located in Chichester, West Sussex. The practice provides services for approximately 12,700 patients living within the Chichester area.

The practice holds a personal medical services (PMS) contract with NHS England (NHSE). PMS contracts are locally agreed between the NHSE and a GP practice. The practice has relatively large numbers of people over 65 compared to the national average and a higher number of patients aged between 18 and 24. 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.

The practice has an on-site dispensary which employs four dispensary staff.

As well as a team of five GP partners and four salaried GPs (three male and six female), the practice also employs eight practice nurses and four health care assistants. A practice manager and a business manager are employed, supported by a team of receptionists and administrative clerks.

The practice is a training practice for GP trainees and foundation level two doctors and for pre-registration nurses.

The practice is open between 8am and 6.30pm on weekdays. Extended hours appointments are available to accommodate people who may not be able to attend during normal hours on Mondays from 7am to 8am and from 6.30pm to 8.50pm and on Wednesdays from 6.30pm to 7.30pm. 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 requiring a GP outside of normal working hours are advised to contact the NHS GP out of hours service on telephone number 111. Patients are provided information on how to access this service on the practice website and on the telephone answering message.

The Cathedral Medical Group provide regulated activities from Cawley Road, Chichester, West Sussex, PO19 1XT.

Updated 30 June 2017

Letter from the Chief Inspector of General Practice

This announced focused inspection was carried out on 7June 2017 to confirm the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations we identified in our previous comprehensive inspection on15 March 2016. In March 2016 the overall rating for the practice was Good with Requires Improvement for the safe domain. The full comprehensive report for the March 2016 inspection can be found by selecting the ‘all reports’ link for The Cathedral Medical Group on our website at www.cqc.org.uk.

This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as Good

Our key findings were as follows:

The practice had clearly defined systems, processes and practices to minimise risks to patient safety.

Risks to patients were assessed and well managed in relation to the safe management of medicines and prescriptions.

A risk assessment was in place to ensure patient safety in respect of the employment of suitable staff. The appropriate staff had received a Disclosure and Barring Service (DBS) check. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).

The practice had made changes to the décor of the building to improve cleanliness and infection control.

Since the last inspection the practice had formed a patient participation group (PPG) that met regularly and worked alongside the virtual PPG to make improvements at the practice; for example, introducing ways of encouraging patients to use the self-help blood pressure monitoring machine located in the waiting area.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 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 practice ran the Diabetes Year of Care initiative and operated a one stop shop for diabetic patients who were unable to engage in this process.

• Longer appointments and home visits were available when needed.

Updated 7 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.

• The practice’s uptake for the cervical screening programme was 82%, which was comparable to 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. A midwifery clinic was held in the practice every week.

Updated 7 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.

• The practice ran a weekly leg ulcer clinic for patients requiring complex wound care. We saw evidence of improvements in care and treatment response time for these patients.

Updated 7 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 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.

• A team of administration staff from the practice attended the local university fair for first year students every year to encourage them to register and provide them with information on how to access services.

Updated 7 June 2016

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

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  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.

• A counselling service was held within the practice.

Updated 7 June 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.

• 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.