A Brighton doctors’ surgery has inadequate leadership while the overall practice requires improvement, according to an official inspection report.
The Brighton Station Health Centre was given the “requires improvement” rating – the second worst of four grades – by the Care Quality Commission (CQC).
The doctors, nurses and receptionists were mostly praised but the management was singled out for a list of shortcomings, including an inability to retain medical staff.
The practice in Queen’s Road, Brighton, is run by Care UK and service manager Carol Boyd-Jones. It was criticised for not providing services that were safe, effective, caring and responsive enough.
To read the report, click here.
The chief inspector of general practice Steve Field said: “Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses.
“However, information about safety was not consistently recorded, monitored, appropriately reviewed and addressed. There was no evidence of learning and communication with staff.”
The walk-in centre’s sexual health service was rated as outstanding. Specialist nurse Tamuka Gonah has already been recognised with a national award for his work in reducing the number of people in Brighton and Hove with sexual infections and improving detection rates.
Professor Field also said: “Due to difficulties recruiting medical staff there had been occasions when there had been insufficient medical cover and reliance on locum staff.
“This had an impact on patients having to wait to be seen and lack of continuity of care.
“Systems, processes and policies in place to manage and monitor risks to patients, staff and visitors were not in place.
“The practice’s extended opening hours enabled patients to access appointments and in a way and at a time that suited them.
“The practice actively encouraged its patients to live healthier lives. It provided health and well-being checks to registered patients and encouraged them to attend for a range of health checks.
“Patient feedback from the national GP survey showed good levels of satisfaction with getting through on the phone, the receptionists, the opening hours and the extent to which the nurses involved patients in their care and treated them with care and concern.
“Information about services and how to complain was not easily available. There was limited evidence to show that lessons from complaints were acted upon and shared.”
The practice was praised for working with other Brighton and Hove surgeries on the EPIC (Extended Primary Integrated Care) project to try to improve services.
The EPIC collaboration, involving more than a dozen surgeries, was awarded £1.8 million from the Prime Minister’s Challenge Fund to improve patient access to care and support services.
Care UK said: “We were pleased that the report highlighted the centre’s outstanding sexual health service and praised how we work closely with other organisations and the local community to ensure health services meet people’s needs.
“However, we accept that the inspectors did find areas that they thought required improvement and as soon as they gave us their feedback we immediately started to write and implement a robust action plan to put right the areas they highlighted.
“This improvement plan has been overseen and supported by senior managers and clinicians from the wider Care UK team.
“Since then we have introduced a more rigorous clinical audit process, ensured that the training of team members is fully up to date, overhauled the way we learn from feedback given by patients and sought ways to recruit more GPs.”
Care UK is not alone in finding it hard to recruit and retain GPs (general practitioners) and the problem is not confined to Brighton and Hove.
The CQC said that the areas where the practice must make improvements were
- Ensure an ongoing programme of clinical audit is developed and undertaken and that audit cycles are completed and that the learning is shared.
- Ensure there are formal governance arrangements in place and staff are aware how these operate.
- Ensure information about safety is consistently recorded, monitored, addressed and appropriately shared and reviewed to ensure that lessons have been learnt.
- Ensure systems, processes and policies are put in place to manage and monitor risks to patients, staff and visitors.
- Ensure action plans are developed and implemented in response to feedback from staff and patients that address specific areas of concern including low levels of satisfaction in relation to consultations with doctors including GPs treating patients with care and concern, giving patients enough time, involving patients in decisions and explaining test results.
- Ensure patients know how to complain and that complaints are thoroughly investigated and acted upon, that the lessons learned are shared with staff and other stakeholders and that records are kept to demonstrate this.
- Ensure sufficient numbers of suitably qualified, competent, skilled and experienced staff are employed in order to provide a safe and effective service to patients.
- Ensure staff undertake a comprehensive induction and have an annual appraisal which is recorded.
- Ensure all staff who undertake chaperone duties have received appropriate training.
In addition, the CQC said that the practice should
- Ensure action plans are put in place to address the areas identified for improvement from audits of infection control.
- Put arrangements in place that allow staff to routinely work and meet with other health and social care services to understand and meet the range and complexity of people’s needs and to assess and plan ongoing care and treatment.
The Brighton Station Health Centre was inspected on Tuesday 29 September and the CQC report was published on Thursday 28 January.
It said: “This report describes our judgment of the quality of care at this service. It is based on a combination of what we found when we inspected, information from our ongoing monitoring of data about services and information given to us from the provider, patients, the public and other organisations.”
Three services are provided at the Queen’s Road premises – a traditional GP (general practice) surgery, a specialist sexual health clinic and a walk-in centre.
The GP service and walk-in centre are open from 8am to 8pm seven days a week. The sexual health clinic sees walk-in patients from 9am to noon and 3pm to 7pm each day while also offering pre-booked appointments.
Health chiefs are hoping that the walk-in centre will help ease the burden on the Royal Sussex County Hospital in Brighton tomorrow (Wednesday 10 February) during the doctors’ strike.
But with the closure of other walk-in centres around the country and the closure of other doctors’ surgeries in Brighton and Hove, concerns remain about the Brighton Station Health Centre’s future.
The walk-in centre contract has already been extended and questions remain about whether it will be extended further, put out for tender or ended.
If the contract is not retendered and the walk-in centre closes, Care UK would almost certainly review whether the GP surgery remained viable. This would affect thousands of patients.
Health chiefs are already trying to deal with the impending closure of five surgeries in Brighton and Hove run by the Practice Group. They are due to close in June, with 11,500 patients affected, including in Whitehawk, Hangleton and Bevendean.
Last year GP surgeries closed in Eaton Place, Brighton, and Goodwood Court, Hove. Goodwood Court also had a second surgery in Eaton Gardens, Hove. Other surgery closures in Brighton and Hove in recent years have included the practice in St James’s Avenue, Brighton.