Archived: Pilgrims Way Surgery

Updated 24 June 2016

Pilgrims Way Surgery is located in a residential area of Dartford, Kent and provides primary medical services to approximately 6400 patients. The practice is based in Dartford East Health Centre which is shared with another GP practice. The centre is purpose built and has good access for wheelchairs and disabled facilities. There is a large car park for patient use.

The practice has a higher than average percentage of children from 0 to 9 years and a higher than average percentage of working age people (from 25 – 49 years). It is in an area which scores 6 on the IMD decile (1 is more deprived and 10 is less) which indicates that the population are mixed in terms of levels of deprivation. There are people who live in the area who do not have English as their first language, particularly Indian and Black African population groups.

There are two GP partners at the practice, both male and two regular locum GP’s, both female. The practice is registered as a GP training practice, for doctors seeking to become fully qualified GP’s.

There are three female members of the nursing team; two practice nurses and one health care assistant. GP’s and nurses are supported by the practice manager and a team of seven reception/administration staff.

The practice is open from Monday to Friday between 7.30am and 6.30pm except for Wednesday when the practice closes at 1.30pm. Appointments are from 7.30am to 11.30 am and from 2.30pm to 6.30pm. On Wednesday afternoons there is a GP on call for emergencies. Appointments can be booked over the telephone, online or in person at the practice. Patients are provided with information on how to access an out of hours provider by calling the surgery and in the practice leaflet. Out of hours services are provided by Integrated Care 24(IC24).

The practice runs a number of services for its patients including; chronic disease management, new patient checks, minor surgery, family planning, counselling and travel vaccines and advice.

Services are provided from Pilgrims Way Surgery, Pilgrims Way, Dartford, Kent, DA1 1QY.

Updated 24 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Pilgrims Way Surgery on 16 March 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.

• The practice sought to identify young carers.

• Information about services and how to complain was available and easy to understand.

• 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.

• The provider was aware of and complied with the requirements of the Duty of Candour.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 June 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 percentage of patients with diabetes, on the register, in whom the last IFCCHbA1cis 64 mmol/mol or less in the preceding 12 months (01/04/2014 to 31/03/2015) is 79% compared to the national average of 78%

• Home visits were available when needed.

• The practice used Telehealth and remote monitoring of blood pressure and blood sugars, and clinicians discussed care needs over the phone for increased patient convenience.

• The practice ensured the availability of frequent nurse led clinics to support patients.

• The percentage of patients with asthma, on the register, who had an asthma review in the preceding 12 months that included an assessment of asthma control using the 3 Royal College of Physicians (RCP) questions (01/04/2014 to 31/03/2015) was 73% compared to a national average of 75%.

• 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 24 June 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.

• The percentage of women aged 25-64 whose notes record that a cervical screening test had been performed in the preceding 5 years (01/04/2014 to 31/03/2015) was 86% compared to 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, health visitors and school nurses.

Updated 24 June 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 encouraged attendance for over 75 health checks and ensured that patients were aware of their named GP for continuity of care.

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

• The practice encouraged clinicians to nominate patients with complex needs for discussion at the monthly clinical meeting and/or the monthly multi-disciplinary team (MDT) meeting.

Updated 24 June 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 extended hours surgeries daily from 7.30am for doctor, nurse and health care assistant appointments, with doctor appointments extended to 6.30pm.

• The practice offered online services for booking and cancelling appointments and for prescription requests.

Updated 24 June 2016

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

• The practice regularly worked with multi-disciplinary teams in the case management of people 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 used internet based resources such as MoodGYM and self–led cognitive behavioural therapy sites.

• 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 June 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 held frequent reviews of homeless patients and worked within a co-ordinated approach to support them.

• The practice offered longer appointments for patients with a learning disability and increased time for annual reviews.

• The practice offered chaperones for all examinations.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• 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.