Archived: Albion Street Surgery

Updated 18 April 2017

Albion Street Surgery offers general medical services to people living and working in the city of Brighton and Hove and operates from:

9 Albion Street

Brighton

East Sussex

BN2 9PS

Albion Street Surgery has two partner GPs (one female and on male) and one salaried GP (female). There is a practice nurse working two days a week, an advanced nurse practitioner working one morning a week and a healthcare assistant working three days a week. There are approximately 6,075 registered patients.

The practice is open between 8.30am and 6.00pm Monday to Friday. Between 8.00am and 8.30am and 6.00pm and 6.30pm calls are diverted to an out of hours service. Appointments are from 8.50am to 12.00am every morning and 3.30pm to 5.30pm daily. In addition to pre-bookable appointments that can be booked up to six weeks in advance, urgent appointments are also available for people that need them.

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 via NHS 111.

The practice population has a lower number of patients under the age of 18 and a lower percentage of patients over the age of 65 compared with the England average. The practice population has higher than average levels of unemployment and patients who are disability allowance claimants, which can mean a greater need for health services.

Updated 18 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 17 November 2015. 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 17 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 17 November 2015 we found the following area where the practice must improve:

• Ensure that all GPs are trained to level three children’s safeguarding.

• Ensure that a fire risk assessment, regular drills and fire training for staff are all carried out.

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

• Continue to improve the uptake of new patient and NHS health checks.
• Continue to improve patient recall and reviews for patients with a learning disability and those living with long term conditions.
• Build on the work to demonstrate quality improvement by increasing the number of full cycle audits conducted within the practice.

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 17 March 2017 we found:

• All clinical staff were now trained in children’s safeguarding level three.

• The practice conducted regular fire drills, fire training and fire risk assessments in accordance with practice policy.

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

• The practice was taking steps to improve the uptake of new patient and NHS health checks within the practice. Patients were sent a letter inviting them to attend and reminders about their appointments by text.

• The practice was taking steps to improve patient recall and reviews for patients with a learning disability and those living with long term conditions. The Quality and Outcomes Framework (QOF) performance results for the practice in 2015/2016 were 97% (92% clinical commissioning group and 95% nationally) which was an increase from 85% in 2014/2015. (QOF is a system intended to improve the quality of general practice and reward good practice). The practice now had a policy in place to phone non-attenders which had improved uptake.

• The practice had increased the number of full cycle audits conducted within the practice and four full cycle audits had taken place over the last 12 months.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 March 2016

The practice is rated as good for the care of people with long-term conditions.

• Performance for asthma related indicators was better than the CCG and national averages at 100%, compared to 97% (CCG) and 97.4% (national). Performance for diabetes related indicators was worse than CCG and national averages at 50%, compared to 89.5% (CCG) and 89.2% (national).

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. There was an advanced nurse practitioner session to undertake regular diabetic reviews for patients.The practice had not been successful in recruiting a permanent practice nurse and this had impacted on some patient reviews being delayed.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 24 March 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 83.5% which was comparable to the CCG average of 80.8% and the national average of 81.8%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

Updated 24 March 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.

• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice reviewed unplanned hospital admissions on a weekly basis as part of the regular practice meeting attended by GPs and nursing staff.

Updated 24 March 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 24 March 2016

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

• 100% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months

• Performance for mental health related indicators was 57.7% which was worse than the CCG (89.5%) and national (92.8%) averages.However, we saw evidence of some improvement in this area at the time of our inspection, with 77% of patients having received an annual review and comprehensive care plan.

• 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 and the practice hosted a local Wellbeing Service who ran clinics from 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 people with mental health needs and dementia.

• One of the GP partners had undertaken a dementia care fellowship programme.

Updated 24 March 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.

• It offered longer appointments for people with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• It had told vulnerable patients about how to access various support groups and voluntary organisations.

• The practice worked as part of a cluster of local practices on a ‘proactive care’ initiative to identify and offer additional support to people who were vulnerable.

• 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.