Sovereign Practice

Updated 31 August 2017

Sovereign Practice is situated at Princes Park Health Centre close to a large residential area in Eastbourne, West Sussex. The building is purpose built and accommodates a number of additional services such as X-ray, MRI and ultrasound scanning. The practice is part of the NHS Eastbourne, Hailsham and Seaford CC and has approximately 14,500 patients.

The number of registered patient over 60 years of age is higher than the national average and number between 20-45 is lower than the national average.. The area the practice serves has relatively low numbers of patients from different cultural backgrounds. The practice area is in the mid-range for deprivation nationally. The practice has a higher proportion of patients with a long standing condition compared to local and national averages.

There are eight GPs at the practice. Five are male and three are female. Five GPs are partners with two salaried GPs. There are eight practice nurses and nine health care assistants. The practice manager is also a partner at the practice and there is a team of administrators and receptionists. The practice is open between 8.25am and 6.00pm. Appointments are from 8.30am to 11am and 3pm to 5.10pm. Extended hours pre-bookable appointments are offered between 6.30pm to 7.40pm on Tuesdays and Thursdays and on Wednesday mornings between 7am and 8.10am. The practice operates a duty doctor system from 8.00am to 8.30am and also from 6.00pm to 6.30pm. This is accessed by calling IC24.

When the practice is closed patients are advised, via the practice website and an answerphone message, to ring the NHS 111 service for advice and guidance. Out of hours service is provided by IC24.

Sovereign Practice is registered to provide services from the following location:

Princes Park Health Centre, Wartling Road, Eastbourne East, Sussex, BN22 7PG

Updated 31 August 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the Sovereign Practice on 26 April 2016. We found that the practice required improvement for the provision of effective services because breaches of regulation were identified. The full comprehensive report on the 26 April 2016 inspection can be found by selecting the ‘all reports’ link for Sovereign Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 15 August 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 26 April 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

The practice is now rated as good for providing effective services as well as good overall.

Our key findings were as follows:

• Improved systems and processes had been implemented to ensure performance and patient outcomes were effectively monitored and audited.

• Systems had been initiated to effectively manage and monitor role specific training requirements.

At the previous inspection in April 2016 we also told the provider that they should make improvements in relation to:

• Ensuring that the system for recording significant event actions was improved. At this inspection we found that a new electronic recording form was available where detailed information was recorded. Significant events were a standing item on the agenda of practice meetings. Outcomes and learning points were discussed, reviewed and detailed in the minutes of meetings.

• The identification of patients who are registered with them who are also carers. The practice had increased the percentage of patients on the register from 0.3% (54 patients) to 2% (257 patients). Identified carers for whom it was appropriate were referred to a local support organisation.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 29 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 offered home visits for housebound patients requiring a diabetic review or an INR review.

• Retinal screening was available on-site for diabetic patients.

• The practice offered a self-test facility for blood pressure which was situated in the waiting area.

• The practice had purchased a wheel chair weighing scale to support the on-going care of patients locally.

• The percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) was 5 mmol/l or less (01/04/2014 to 31/03/2015) was 76% compared to the national average of 81%

• The percentage of patients with diabetes, on the register, who had had influenza immunisation in the preceding 1 August to 31 March (01/04/2014 to 31/03/2015) was 89% compared to the national average of 94%.

• 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 29 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 percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding 5 years 79% compared to 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.

• The practice offered family planning clinics both within and outside of core hours.

• The practice offered immunisation clinics for children, teenagers and travellers.

Updated 29 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 offered home visits to housebound older people to be immunised against flu.

• The practice had employed pharmacists whose role included conducting medicines reviews for those patients over the age of 75 years.

Updated 29 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.

• The practice offered evening and early morning pre-bookable appointments

• GP telephone consultations were available throughout the day.

• The practice offered evening family planning clinics.

Updated 29 June 2016

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

• 75% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was lower than the national average of 84%.

• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had had a comprehensive, agreed care plan documented in their record, in the preceding 12 months (01/04/2014 to 31/03/2015) was 71% 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.

• One GP was trained to conduct dementia assessments and clinics were held on site.

• The practice accommodated trained personnel to deliver counselling and cognitive behaviour therapy clinics.

• 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 29 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.

• There was some evidence of proactivity in the identification of carers.

• The practice held a palliative care register.

• 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.