Riverbank Medical Centre

Updated 1 August 2016

Riverbank Medical Centre is situated in the town of Midhurst. It serves approximately 12,200 patients.

There are six GP partners, two salaried GPs and two GP registrars. There are four practice nurses and five health care assistants. There is a practice manager and a team of 18 administrative and reception staff. The practice is a training practice and provides placements for trainee GPs and under-graduate doctors.

Data available to the Care Quality Commission (CQC) shows the practice serves a higher than average percentage population over the age of 65. There is a comparatively low level of deprivation amongst the practice population.

The practice is open from 8.00am until 6.30pm Monday to Friday. Extended access is available on a Tuesday evening from 6.30pm until 8.30pm for pre-bookable appointments with a GP or practice nurse. All GP appointments are triaged which means that when a patient telephones the practice, the receptionist takes their telephone number and the GP calls them back. The patient speaks directly with a GP who assesses their clinical need and either deals with it on the telephone or, if necessary, makes an appointment for the patient to be seen.

Telephone triage appointments can be booked over the telephone, on line or in person at the surgery. Patients are provided with information on how to access the out of hour’s service on the practice website or by calling the practice.

The practice provides a number of services and clinics for its patients including smoking cessation, asthma, diabetes, cardiovascular disease, cervical smears, childhood immunisations, family planning, travel immunisations and a minor injuries clinic. The practice provides medical cover for the neighbouring community hospital beds.

The practice provides a based for community nurses, school nurses and health visitors. It also hosts a number of services including counselling service, midwifery clinics. private complementary medicines and local authority well-being clinics.

The practice provides services from the following location:-

Dodsley Lane

Easebourne,

Midhurst,

West Sussex,

GU29 9AW

Updated 1 August 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Riverbank Medical Centre on 7 June 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 GP and that there was continuity of care. Urgent appointments were available on 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 1 August 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 on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months ( 04/2014 to 03/2015) was 96% compared to the clinical commissioning group (CCG) average of 91% and 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.
• The practice had adopted a model of diabetes care which meant that the patient was fully involved in developing their own care plan and managing their condition. This reduced the number of times the patient had to attend the surgery.

Updated 1 August 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 high for all standard childhood immunisations.
• The number of women aged between 25 and 64 who attended cervical screening in 2014/2015 was 81% compared to the CCG and national average of 82%
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• Receptionists used a triage system for appointments to identify any children needing an appointment which ensured they were called back as a priority. Unwell children were usually seen within two hours of calling for an appointment.
• The health visitors and school nurses were based in the practice premises which enabled close working. The GPs had regular safeguarding meetings with the health visitor to discuss families of concern.
• The community midwives held regular clinics at the practice, which enabled ante-natal care to be provided close to home.

Updated 1 August 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 GPs worked with multi-disciplinary teams to develop care plans for older patients in order to prevent avoidable, unplanned hospital admission. The care plans were regularly reviewed.
• The GPs were able to work closely with community nurses who were based in the practice premises in order to co-ordinate the care of older housebound patients.
• The practice had an exercise on prescription scheme which was popular with older patients. Classes aimed to improve strength and balance in order to help reduce the incidence of falls.
• The practice had access to the neighbouring community hospital beds which provided frail elderly patients with increased levels of care. This helped prevent the need for acute hospital admission and provided care closer to home.

Updated 1 August 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 provided extended access with evening appointments available with both GPs and nurses.
• 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.
• The practice operated a telephone triage system which enabled some problems to be dealt with on the telephone, or with face to face appointments arranged to suit the patient
• A minor injury service was provided throughout the day allowing patients greater access to simple treatments, avoiding unnecessary attendance at accident and emergency departments.

Updated 1 August 2016

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

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice also had meetings to discuss patients with the local mental health team. The voluntary sector was involved in these meetings.

• 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. Two staff members had been identified as dementia ‘champions’ as part of the local town initiative to become ‘dementia friendly’.

Updated 1 August 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice registered all patients in the area 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 and ensured they had an annual health check.
• There was a hearing loop for patients with hearing difficulties. Patients with hearing difficulties were able to make appointments directly without having to use the telephone triage system.
• The practice had a register of patients who required letters and information sent in a different format, for example, a large font for those with visual impairment.
• 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.