Cowfold Medical Group

Updated 22 February 2017

Cowfold Medical Group provided general medical services to people living and working in Cowfold.

Cowfold Medical Group has four partner GPs (two male and two female) . There are three practice nurses and two healthcare assistants, nine dispensers, as well as a practice manager and a range of reception and administrative staff. There are approximately 4460 registered patients.

The practice and its branch have dispensaries offering pharmaceutical services to those patients on its practice list who live more than one mile (1.6km) from their nearest pharmacy premises.

The practice is open between 8.00am to 6.30pm Monday, Tuesday, Thursday and Friday and 8.00am to 6.00pm on a Wednesday. The telephone lines are open between 8.30am and 6.00pm. Between 8.00am and 8.30am and between 6.00pm and 6.30pm an out of hours provider (IC24) takes telephone calls for the practice. If a patient needs to speak with a GP urgently IC24 contacts the on call GP for the practice directly.

Appointments are available in the mornings from 9.00am to 11.40am on Monday and Friday, Tuesday and Wednesday between 9.00am-11.30am and Thursday between 9.10am and 11.40am. Afternoon appointments are available on Mondays between 4.20 and 6pm, Tuesdays between 3.30pm and 5pm, Wednesdays between 4pm and 5.30pm and 2.00pm to 6pm on Thursdays and Fridays. In addition to pre-bookable appointments can be booked up to six months in advance, urgent appointments are also available for people that need them

The practice runs a number of services for its patients including asthma clinics, child immunisation clinics, diabetes clinics, new patient checks, and weight management support.

Services are provided from:

Cowfold Surgery (Main practice)

St Peter's Close,

Horsham,

West Sussex

RH13 8DN

And

Oakleigh Surgery (Branch)Village Hall LanePartridge GreenWest SussexRH13 8HX

The practice has opted out of providing Out of Hours services to their patients. There are arrangements for patients to access care from an Out of Hours provider NHS (111).

The practice population has a marginally higher proportion of patients over the age of 65 and lower than average proportion of patients under the age of 18. They have a higher than average number of working patients and slightly higher than average unemployment.

Updated 22 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 23 March 2016. Breaches of regulatory requirements were found during that inspection within the safe domain. The practice was rated as good overall and requires improvement in the safe domain. After the comprehensive inspection, the practice sent us an action plan detailing what they would do to meet the regulatory responsibilities in relation to the following:

• Ensure that systems for the management and security of medicines are robust and safe:

We undertook this announced focused inspection on 19 January 2017 to check that the provider had followed their action plan and to confirm that they now met regulatory requirements.

This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Cowfold Medical Group on our website at www.cqc.org.uk. This report should be read in conjunction with the last report published in July 2016.

The practice continues to be rated as good overall and is now rated as good in the safe domain.

Our key findings across the areas we inspected were as follows:-

• We saw evidence to demonstrate that a safe system for managing and disposing of controlled medicines was in now place and was kept under regular review.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 8 July 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 similar to the local and national averages. For example the practice achieved 93.6% compared with the CCG (95.9%) and national (89.2%) averages.

• 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 July 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 78.2%, which was comparable to the CCG average of 79.3% and the national average of 80.5%.

• 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 July 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 provided support to a local nursing home which included continuity provided by a lead GP and regular weekly visits.

• The practice had introduced atrial fibrillation screening to this patient group in order to work proactively and minimise the risk of stroke. As a result they had identified more patients with this risk, twice that of the national average identified by other practices.

Updated 8 July 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. They provided flexible telephone appointments and ensured that all patients who required an on the day appointment received one.

• 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 July 2016

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

• 68.8% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, was worse than the national average of 77%.

• Performance for the mental health performance indicators was higher than the national and local averages at 77.8% compared with 70% (CCG) and 77.2% (national).

• 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.

Updated 8 July 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 worked with carers and support staff from a local care home for patients with severe autism to ensure that patients received appointments with the minimum of distress and disruption.

• 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.