Buxted Medical Centre

Updated 17 October 2022

Buxted Medical Centre is situated within NHS Sussex Integrated Care Board. The practice is a semi-rural practice and has two smaller branch surgeries (East Hoathly Medical Centre and Manor Oak Surgery). The practice offers a dispensary service at Buxted Medical Centre and East Hoathly Medical Centre. During this inspection we visited all three locations.

The practice is involved in the education and training of doctors and is also able to dispense medicines to patients. There are approximately 15,500 registered patients. The practice is run by three partner GPs (two female, one male) who are supported by five salaried GPs. The practice also has two advanced nurse practitioners, five paramedics, a senior nurse, six practice nurses, a clinical pharmacist, a pharmacy technician, four health care assistants, one phlebotomist, a dispensary team, a team of receptionists and administrative staff, a practice director, and a team of managers and supervisors.

Services are provided from three sites:

The registered location,

• Buxted Medical Centre, Framfield Road, Buxted, Uckfield, East Sussex, TN225FD

Two branch surgeries,

• East Hoathly Medical Centre, Juziers Drive, East Hoathly, BN8 6AE
• Manor Oak Surgery, Horebeech Lane, Horam, East Sussex, TN210DS

Patients can access services at all three surgeries.

Information published by Public Health England shows that deprivation within the practice population group is in the nineth highest decile (nine of 10). The lower the decile, the more deprived the practice population is relative to others. The percentage of registered patients suffering deprivation (affecting both adults and children) is significantly lower than the average for England. According to the latest available data, the ethnic make-up of the practice area is 98% white, 0.9% Asian, 0.2% black, 0.2% mixed and 0.9% Other.

The practice is registered to provide:

• Maternity and midwifery services
• Surgical procedures
• Family planning
• Diagnostic and screening procedures
• Treatment of disease, disorder and injury

Further information can be accessed via the practice website: www.buxtedandeasthoathlymedicalcentres.co.uk

Updated 17 October 2022

We carried out an announced comprehensive inspection at Buxted Medical Centre between 8 September and 14 September. The onsite visit was on the 13 September. Overall, the practice is rated as Good.

Safe - Good

Effective - Good

Caring - Good

Responsive - Good

Well-led - Good

Following our previous inspection in March 2020, the practice was placed in special measures after being rated inadequate overall and for the key questions safe and well led. Effective was rated as requires improvement and responsive and caring was rated as good. The practice was re-inspected in November 2020, to follow up on warning notices issued and there was no change in ratings. The practice received a further comprehensive inspection in August 2021 and was rated as inadequate in safe and well led, and therefore remained in special measures. The other key questions were rated as good. In December 2021, an inspection was carried out to follow up on warning notices issued. The practice had shown improvement but was not rated at that inspection.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Buxted Medical Centre on our website at www.cqc.org.uk

Why we carried out this inspection

The practice had been previously placed in special measures in March 2020. The practice remained in special measures after being inspected in August 2021 and was issued warning notices for regulation 12 safe care and treatment and regulation 17 good governance.

How we carried out the inspection/review

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A short site visit.

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We found that:

• Leaders were aware of the improvements needed and had worked as a team to improve processes to ensure they were working as intended. There was an understanding of what the challenges were and the practice had put actions in place to address them.
• The practice was using innovative technologies to ensure that the recording of fridge temperatures was assessible to all staff members involved in the task. The new way of working ensured that processes were consistent across all three sites.
• The practice required all staff members to provide evidence of their immunisation status. Where necessary the practice had conducted a full risk assessment to ensure safe working for the individual staff member and patients.
• Our remote searches of patient records showed that patients were now being effectively and safely managed.
• A variety of audits and risk assessments had been conducted, including infection control. Any concerns or required actions had been completed or were in progress.
• We noted an open culture in which all safety concerns raised, including significant events and complaints, were highly valued as being integral to learning and improvement. Shared learning was communicated widely to support improvement.
• Managers and partners were now actively monitoring and reviewing activity within the practice to understand risks and ensure a clear, accurate and current picture of safety.
• The practice now provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients now received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

Whilst we found no breaches of regulations, the provider should:

• Continue to take action in relation to recording staff immunisation.
• Continue to improve cervical screening uptake.
• Continue to review and improve patient access

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

This service was placed in special measures in March 2020. The practice has made significant improvements and is now rated good overall and for all domains. I am taking this service out of special measures. This recognises the significant improvements made to the quality of care provided by the service. The service will be kept under review and will be inspected within 12 months to ensure improvements are sustained.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services