Archived: Sunnyside Medical Centre

Updated 21 April 2016

Dr A R Tollast and Partners is situated in an urban area of Portsmouth, on a retail estate. The practice is also known as Sunnyside Medical Centre. The practice has five partners and three salaried GPs. Six of the GPs are female and two GPs are male. The practice is a training practice for doctors to become GPs. The practice also has medical students for placements. The practice has a practice manager and a business manager; seven practice nurses and four healthcare assistants. In addition there is a team of administration and reception staff.

The premises are purpose built and offer level access for patients with limited mobility. All consulting and treatment rooms are on the ground floor.

The practice holds a primary medical service contract and has approximately 13,200 patients registered. There are slightly higher numbers of patients who are 25 to 49 years old, when compared with the national figures. There are a small number of patients with English as a second language and translation services are available when needed.

The practice is open between 8am and 6.30pm Monday to Friday. Appointments are from 8am to 1.30pm and 2.30pm until 6pm. In addition appointments are available on alternate Saturday mornings from 8am until 11.15am and on alternate Tuesday and Thursday evening from 6.30pm until 8pm.

The urgent care clinic is open on weekdays between 8.30am and 10.30am and from 3pm until 5pm. The urgent care team consists of a GP, a practice nurse and a healthcare assistant. Patients are able to arrive on the day and be seen. Five of the GPs offer telephone consultations prior to asking patients to attend the practice. The other GPs preferred to offer face to face consultations. Children are always seen on the same day. Information on practice opening times and appointment times are displayed on the practice website, within their practice leaflet and on the information screen in the waiting room.

We inspected the only location:

Sunnyside Medical Centre

Southsea

Portsmouth

PO4 8TA

Updated 21 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr A R Tollast and Partners on 19 January 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 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. Complaints were consistently handled in an open and transparent manner. Patients were given an apology if needed. When complaints were formally closed, patients were also given the opportunity to have the concerns looked at again if they were not fully satisfied or after further information became available.
• Governance and performance management arrangements had been proactively reviewed and took account of current models of best practice.
• Patients said they found it easy to make an appointment with a named GP and that 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.
• There was a high level of constructive engagement with staff and a high level of staff satisfaction.
• Feedback from patients about their care and treatment was consistently and strongly positive.
• We observed a strong patient-centred culture.
• The provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider should make improvement are:

• Ensure that fire drills are carried out as planned.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 21 April 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.
• Performance for diabetes related indicators was better than the national average. For example, 90% of patients on the diabetes register had a foot examination in the previous 12 months, compared with the national average of 88%.
• A total of 70% of patients on the asthma register had a review within the last 12 months.

• 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 21 April 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 accident and emergency 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.

• A confidential young persons’ clinic was available every week for advice on keeping healthy, sexual health and mental health.

• The practice’s uptake for the cervical screening programme was 88%, which was better than 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.

Updated 21 April 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 patients in its population.
• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.
• All patients aged 75 years and over had a named GP.
• The practice assisted with booking transport for hospital appointments.

Updated 21 April 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 students temporary registration during term times.

• Extended hours and Saturday morning appointments were available.

• The practice ran a daily urgent care clinic staffed by a GP, a practice nurse and a healthcare assistant for on the day needs.

• Online repeat prescription and appointment booking systems were in place.

• Patients who worked in the practice area, but lived elsewhere, were able to register with the practice as an ‘out of area’ patient and receive care and treatment when needed.

Updated 21 April 2016

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

• A total of 75% of patients diagnosed with dementia that had had their care reviewed in face to face meeting in the past 12 months, this is below the national average of 84%.

• Outcomes for patients who were diagnosed with a mental health condition were better than the national average. For example, 92% of patients with a diagnosis of schizophrenia, bipolar affective disorder and other psychoses with a comprehensive agreed care plan was 93%, 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.

• 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.

• The practice carried out Dementia screening and signposted patients and their relatives or carers to support groups.

Updated 21 April 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 patients, travellers and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with multi-disciplinary teams 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.

• Staff were motivated and inspired to offer kind and compassionate care and worked to overcome obstacles to achieving this. For example, when assisting a patient of no fixed abode they provided warm clothing and food, as well as care and treatment. The practice also supported a temporary patient at the end of their life, to ensure they received appropriate treatment and support.