Henfield Medical Centre Also known as Henfield Medical Practice

Updated 3 May 2017

Henfield Medical Centre is a dispensing practice offering general medical services to the population of Henfield and surrounding areas in West Sussex. There are approximately 9,600 registered patients.

The practice population has a higher number of patients between 45-85 years and over compared to the national and local CCG averages. The practice population also shows a lower number of patients between the age of 15-44 years compared to the national and local CCG averages. There are a higher number of patients with a longstanding health conditions. The percentage of registered patients suffering deprivation (affecting both adults and children) is lower than the average for both the CCG area and England.

Henfield Medical Centre is run by eight partners, seven GP partners (two male and five female), and a practice manager partner. The practice is also supported by six practice nurses (five female and one male) three healthcare assistants, a dispensary team, a team of administrative and reception staff, and an assistant practice manager.

The practice runs a number of services for its patients including asthma clinics, diabetes clinics, coronary heart disease clinics, minor surgery, child immunisation clinics, new patient checks and travel vaccines and advice.

Services are provided from two locations:

Henfield Medical Centre, Deer Park, Henfield, West Sussex, BN5 9JQ

And a branch surgery at:

Partridge Green Surgery, Woodlawn, High Street, Partridge Green, West Sussex, RH13 8HR.

We did not inspect the branch surgery on the day of inspection.

Opening hours are Monday to Friday 8am to 6.30pm. The practice has extended hours with early morning appointments from 7am Tuesday to Friday inclusive.

During the times when the practice is closed arrangements are in place for patients to access care from IC24 which is an Out of Hours provider. Access is gained to this provider by calling NHS 111.

Updated 3 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Henfield Medical Centre on 6 October 2016. The overall rating for the practice was good but was rated as requires improvement for providing safe services. The full comprehensive report on the October 2016 inspection can be found by selecting the ‘all reports’ link for Henfield Medical Centre on our website at www.cqc.org.uk.

Following this inspection the practice sent to us an action plan detailing what they would do to meet the legal requirements in relation to the following:

• Ensuring the safe and proper management of medicines are reviewed to protect patients against the risk of unsafe care and treatment.

• Ensuring that the assessment, detection and controlling the spread of infections, including those that are associated with health care are reviewed so that their infection control audit procedure has a method of documenting how issues are resolved and when this was done.

Additionally we had found that:

• The practice needed to review their complaints process to ensure patients are given information on how they can escalate a complaint should they remain dissatisfied.

• The practice needed to record and ensure that the reasons for fridge temperatures going out of range was established.

This inspection was an announced focused inspection carried out on 4 April 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. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is still rated as good.

Our key findings were as follows:

• The provider had reviewed all aspects of medicines management and devised new standard operating procedures which all appropriate staff had been notified of and signed to acknowledge the information within these.

• The provider had reviewed their infection control audit process and now documented how issues were to be resolved and when these were to be completed by.

• The provider had reviewed their complaints procedure and now ensured that information was provided to the complainant that allowed them to escalate a complaint should they remain dissatisfied.
• The provider had reviewed how they recorded their fridge temperatures and documented the cause when temperatures went outside the accepted range and undertook appropriate actions.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 December 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.
• Data from 2014/15 showed The percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months was 94% compared to the CCG average of 91% and a 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 a system called “passport to health” which was a personalised care management plan that was agreed in partnership with the patient and gave details of when blood tests and other reviews were required.
• The practice undertook monthly diabetic review clinics led by a practice nurse who had a diploma in diabetic care and supported by a specialist diabetic community nurse.
• The practice undertook quarterly meetings with community and hospice nurses.
• The practice had organised two fitness “boot camps” lasting six weeks each at the local leisure centre for patients needing exercise assistance.
• The partners at the practice each had a personal assistant who was able to be contacted by patients requiring support. This enabled their named GP to be informed of any issues the patients on their list had.

Updated 7 December 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 record that a cervical screening test had been performed in the preceding five years was 81% compared to the CCG average of 83% and a 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 sent a “birthday card” to patients on their 15th birthday advising them of the services available to them.
• The practice provided a drop-in clinic every Wednesday afternoon for young patients between 4pm and 4.30pm.
• The practice was awarded a PACE Setter award in 2016 for their work in attempting to reduce teenage pregnancy.
• The practice took part in a scheme where young people could show a card to receive free condoms.
• The practice was the foodbank location for the village of Henfield.
• The practice had received money from a legacy which allowed young diabetic patients to go on breaks organised by Diabetes UK which allowed them to talk to other young diabetic patients and assist in managing their condition.

Updated 7 December 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 provided care to two local care homes, each with approximately 50 beds and undertook weekly visits to the patients there.
• The practice was active in the pro-active care scheme which identified patients at risk of unplanned admission to hospital and met fortnightly with the team involved to discuss care plans and cases.
• The practice provided educational sessions for nursing home staff in areas such as diabetes care.

Updated 7 December 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.
• Early morning appointments from 7am were offered four days a week.
• The practice offered telephone appointments where appropriate.
• The practice offered electronic prescribing so patients could collect prescribed medicines from a location of their choice.
• The practice had a Facebook page to keep in contact with patients.

Updated 7 December 2016

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

• 81% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which was comparable to the national average of 84%.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months was 95% compared to the CCG average of 90% and a 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 maintained links with a local charity called “Know dementia”. This allowed further support for patients with dementia.
• The practice had undertaken two separate training days specifically on mental health issues in July 2015 and October 2016.

Updated 7 December 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.
• 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.