Gossops Green Medical Centre

Updated 2 March 2017

Gossops Green Medical Centre is located in a residential area of Crawley and provides primary medical services to approximately 6,775 patients.

There are three GP partners and two salaried GPs (four male, one female) with a further locum salaried GP about to start. The practice also currently has one male locum GP. The GP partners are full time, and the salaried GPs collectively cover 17 sessions per week. The practice is registered as a GP training practice, supporting medical students and providing training opportunities for doctors seeking to become fully qualified GPs.

There are three female members of the nursing team; one nurse practitioner, one senior practice nurse and one health care assistant. GPs and nurses are supported by the practice manager, a deputy practice manager and a team of reception/administration staff.

Data available to the Care Quality Commission (CQC) shows the practice serves a slightly higher than average number of patients who are aged 75 years or older when compared to the national average. The number of patients aged 5 to18 is also slightly higher than average. The number of patients aged 5 to18 is also slightly higher than average. The number of registered patients suffering income deprivation is below the national average.

The practice is open from Monday to Friday between 8:30am and 1pm for morning appointments, and 2pm to 6pm for afternoon appointments. Between 6pm and 6:30pm a telephone service is offered by the on call duty GP. Extended hours appointments are offered every Thursday between 7am and 8am. Appointments can be booked over the telephone, online or in person at the surgery. Patients are provided information on how to access an out of hours service by calling the surgery or viewing the practice website.

The practice runs a number of services for its patients including; chronic disease management, asthma clinics, diabetes clinics, new patient checks, and holiday vaccines and advice. The practice shares the premises with Crawley Clinical Commissioning Group led services, which enables patients to access additional services from the practice; including a hearing and audiology clinic, ultrasound scanning, weight clinic and dermatology services.

Services are provided from the location of Gossops Green Medical Centre, Hurst Close, Crawley, West Sussex, RH11 8TY.

The practice has a Personal Medical Services (PMS) contract with NHS England. (PMS is one of the three contracting routes that have been available to enable commissioning of primary medical services). The practice is part of the NHS Crawley Clinical Commissioning Group.

Updated 2 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Gossops Green Medical Centre on 19 January 2016. The overall rating for the practice was good, but breaches of legal requirements were found in the safe domain. The practice was found to be good in the effective, caring, responsive and well-led domains but requires improvement in the safe domain. The full comprehensive report on the January 2016 inspection can be found by selecting the ‘all reports’ link for Gossops Green Medical Centre on our website at www.cqc.org.uk.

At the previous inspection of January 2016 our key findings were as follows:

• Not all systems and processes to address risks were implemented well enough to ensure patients and staff were kept safe. Specifically not all Patient Group Directions (PGDs) had been completed in line with legislation, blank printer prescriptions were not always stored securely and no children’s oxygen masks could be located on the day. These findings were in breach of the legal requirements

Additionally we found that:

• The practice should seek to improve the information displayed in the patient waiting room to meet the needs of the local population.

• The practice should improve processes to engage with the patient reference group in order to gather feedback and involve patients in the delivery of the service.

This inspection was an announced focused inspection carried out on 19 January 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 19 January 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• All systems and processes to address risks were now implemented well and ensured patients and staff were kept safe. Specifically all Patient Group Directions (PGDs) had been completed in line with legislation, blank printer prescriptions were stored securely and children’s oxygen masks were available.

Additionally we saw that:

• There was a good selection of information available to patients in relation to local support services.

• The practice engaged with the patient reference group and involved patients in the delivery of the service. In particular members of the group acted as a link with the Crawley voluntary service and also a local social group linked to a new social prescribing pilot scheme. (Social prescribing is a means of enabling primary care services to refer patients with social, emotional or practical needs to a range of local, non-clinical services, often provided by the voluntary and community sector.)

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 March 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 was committed to improving performance and had a dedicated diabetes clinic to improve outcomes for patients.

• 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 offered a range of enhanced services to people with long term conditions. This included asthma and diabetes clinics.

Updated 24 March 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. The practice attended child safeguarding meetings that included school nurses and health visitors. Children who were at risk were identified on the practice computer system using an alert on their record.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• 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 practice had a comprehensive screening programme. The practice’s uptake for the cervical screening programme was 72% which was comparable to the CCG average of 72% and the national average of 74%.

• Immunisation rates were good for all standard childhood immunisations.

• The practice had a designated GP lead for sexual health and family planning, who offered a wide range of services.

Updated 24 March 2016

The practice is rated as good for the care of older people.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• Patients were able to speak with or see a GP when needed and the practice was accessible for patients with mobility issues.

• The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services. These included services such as; dementia identification and reducing unplanned hospital admissions. These patients had personalised care plans to meet their complex care needs.

• The practice was responsive to the needs of older patients, and offered home visits, urgent appointments and longer appointments for those with enhanced needs.

• The practice held a dedicated joint injection clinic to meet the needs of its patients, particularly those with arthritis and patients with multiple health conditions who were unable to have surgical interventions.

Updated 24 March 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 offered extended hours appointments every Thursday between 7am and 8am.

• 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.

Updated 24 March 2016

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

• We found that 81% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average of 84%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice provided a dementia screening service and 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.

Updated 24 March 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 those with a learning disability, and offered longer appointments where required.

• 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.

• The practice ensured timely referral to urgent response services to ensure the changing needs of vulnerable patients were met.

• 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.