Selsey Medical Practice

Updated 7 September 2016

Selsey Medical Practice is situated in the town of Selsey near Chichester in West Sussex. It serves approximately 12,250 patients.

There are seven GP partners, three salaried GPs and two GP registrars. There are seven practice nurses two of whom are independent prescribers, two health care assistants, two phlebotomists and one paramedic practitioner. There is a practice manager, business manager and a team of administrative and reception staff. The practice is a training practice and provides placements for trainee GPs and under-graduate doctors and paramedics.

Data available to the CQC shows that the practice serves a significantly higher than average number of patients over the age of 65 and one of the lowest shares of under eighteens compared to the national and clinical commissioning group (CCG) average. Income deprivation affecting children and older people is higher than the CCG average but lower than the national average

The practice is open from 8.00am until 6.30pm Monday to Friday. Appointments with GPs are available from 8.30am until 11.30am and from 2pm until 5.30pm Monday to Friday. Appointments with practice nurses are available from 7.30am until 6pm Monday to Friday. The practice is open all day and does not close at lunchtime. Extended access is available on different days each week from 7.30am and until 7pm for pre-bookable appointments with a GP or practice nurse. Appointments can be made on line, by telephone or in person. Patients are provided with information on how to access the out of hour’s service in the practice leaflet, 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, hypertension, women’s health, childhood immunisations, phlebotomy and family planning, travel immunisations and a minor surgery clinic. The practice shares its premises with district nurses, health visitors, physiotherapists and podiatrists.

The practice provides services from the following location:-

Selsey Medical Centre

High Street,

Selsey

Chichester

West Sussex

PO20 0QG

Updated 7 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Selsey Medical Practice on 21 July 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 named GP and there was continuity of care, with urgent appointments available 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 7 September 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 performed well against the quality and outcomes framework (QOF) indicators for diabetes. For example, 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 was 77% compared to the clinical commissioning group (CCG) average of 80% and the national average of 81%.

• 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 also reduced the number of times the patient had to attend the surgery.

• The practice hosted diabetic retinopathy clinics and held regular combined clinics with diabetic specialist nurses and dieticians.
• The practice also hosted regular group diabetic education sessions.

Updated 7 September 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.
• The number of women aged between 25 and 64 who attended cervical screening in 2014/2015 was 77% compared to the clinical commissioning group (CCG) average of 83% and national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice was able to work closely with the health visitor who was based in the same premises.
• The health visitor checked whether children who registered with the practice on a temporary basis were on any ‘at risk’ registers.
• Nurses were trained to offer contraception advice and worked in liaison with GPs to provide routine contraception. GPs were trained to fit hormonal implants and inter uterine devices and the practice held combined clinics with a GP and a nurse for this.
• The practice provided ante and post natal checks and six week baby checks where a 30 minute appointment was provided to follow up the mother and child
• One of the GPs acted as the link with a local support service for young people in Selsey and provided confidential advice and guidance to young people.

Updated 7 September 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 identified older patients at risk of unplanned hospital admission and worked with other health and social care professionals to ensure care plans were in place to provide enhanced support at home.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• The GPs and paramedic made regular visits to patients who lived in local care and nursing homes.
• The practice held regular seasonal flu clinics as well as providing opportunistic vaccines during routine visits and appointments.
• All patients had a named GP and the practice did its best to ensure older patients saw their own GP to ensure continuity of care.

Updated 7 September 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. This included a variety of extended access early morning appointments with nurses, paramedic practitioners, phlebotomists and GPs.
• The practice was proactive in offering online services. This included booking appointments, prescription requests, access to summary care records and access to detailed coded records. 
• The practice provided a full range of health promotion and screening that reflected the needs for this age group which included NHS health checks for 40 – 74 year olds and new patient checks for newly registered patients.

Updated 7 September 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.
• One of the GPs was the mental health lead for the CCG and provided valuable input to the practice in relation to services available.
• The practice hosted NHS counselling services and clinics with the mental health liaison practitioner.
• The percentage of patients with severe and enduring mental health problems who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 84% which was comparable to the CCG average of 90% and the national average of 88%.
• 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 7 September 2016

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

• The practice had identified patients living in vulnerable circumstances including those with a learning disability and people who lived in care homes.
• The practice offered longer appointments for patients with complex needs or 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.
• The practice worked closely with community groups to help identify and provide support for people living in vulnerable circumstances.
• The practice was a distributor of food vouchers which could be given to patients in crisis.