Thorkhill Surgery Also known as Dr Roberts, Mitchell & Taki

Updated 8 February 2017

Thorkhill Surgery offers general medical services to the population of the Thames Ditton in Surrey. There are approximately 4,600 registered patients.

Thorkhill Surgery is run by two partner GPs (one male and one female). The practice is also supported by a salaried GP, two practice nurses and a phlebotomist. The practice also has a team of administrative and reception staff.

Thorkhill Surgery is a training practice for FY2 doctors. (FY2 Doctors are newly qualified doctors who are placed with a practice for four months and will have their own surgery where they see patients)

The practice runs a number of services for its patients including asthma reviews, child immunisation, diabetes reviews, new patient checks and holiday vaccines and advice.

Services are provided from - :

Thorkhill Gardens, Thames Ditton, Surrey,KT7 0UP

Opening Hours are:-

Monday to Friday 8am to 6.30pm

Surgery Times are:-

Monday 9.10am to 12.10pm and 3pm to 6pm

Tuesday 8am to 12pm and 3pm to 6pm

Wednesday 9.10am to 12.10pm and 3pm to 6pm

Thursday 9.30am to 12.30pm and 3pm to 6pm

Friday 8am to midday and 3pm to 6pm

During the times when the practice is closed, the practice has arrangements for patients to access care from an Out of Hours provider.

The practice population has a higher number of patients aged between 5 to 9 and 29 to 69 years of age than the national and local clinical commissioning group (CCG) average. The practice population also shows a lower number of patients aged from birth to 4 and 10 to 34 years of age than the national and local CCG average. The percentage of registered patients suffering deprivation (affecting both adults and children) is lower than the average for England. Less than 10% of patients do not have English as their first language.

Updated 8 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Thorkhill Surgery on 4 May 2016. During this inspections we found a breach of legal requirements and the provider was rated as Good overall but with requires improvement under the effective domain. The practice sent to us an action plan detailing what they would do to meet the legal requirements in relation to the following:-

• To ensure administrative staff undertake the practice’s mandatory training.

We undertook this announced focused inspection on 20 December 2016 to check the provider had followed their action plan and to confirm that they now met legal requirements. The provider was now meeting all requirements and is rated as good under the effective domain.

Our key findings across the area we inspected were as follows:

• Administrative staff had completed the practice’s mandatory training. This included Safeguarding children and vulnerable adults, fire awareness, infection control, health and safety and information security.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection published on 27 June 2016, by selecting the 'all reports' link for Thorkhill Surgery on our website at www.cqc.org.uk.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 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.
• 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 and practice nurse worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• Performance for diabetes related indicators were either slightly higher or similar to the clinical commissioning group (CCG) and national average. For example, 86% of patients on the diabetes register, had a record of a foot examination and risk classification within the preceding 12 with the national average being 88%.
• The practice hosted dermatology, paediatric and neurology clinics which patients could be referred to.

Updated 27 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 practice’s uptake for the cervical screening programme was 82%, which was comparable to the national average of 82%.71% of female patients aged 50-70, had been screened for breast cancer in last 36 months which was comparable to the CCG average of 72%.
• 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.
• Safeguarding policies and procedures were readily available to staff.
• The practice ensured that children needing emergency appointments would be seen on the day.

Updated 27 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 was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.
• Older patients with complex care needs and those at risk of all had personalised care plans that were shared with local organisations to facilitate the continuity of care.
• The practice was working to the Gold Standards Framework for those patients with end of life care needs.
• The practice nurse telephoned patients on discharge from hospital to offer support, and enquire whether a visit or other assistance was required.

Updated 27 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 advice by telephone each day for those patients who had difficulty in attending the practice and there were daily evening emergency appointments available.
• Electronic Prescribing was available which enabled patients to order their medicine on line and to collect it from a pharmacy of their choice, which could be closer to their place of work if required.
• The practice offered NHS health-checks and advice for diet and weight reduction.

Updated 27 June 2016

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

• 91% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was higher than the national average of 84%
• 90% of patients diagnosed with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record, in the preceding 12 which was comparable 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 living with dementia.
• The practice carried out advance care planning for patients living 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 27 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 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.
• The practice could accommodate those patients with limited mobility or who used wheelchairs.
• Carers and those patients who had carers, were flagged on the practice computer system and were signposted to the local carers support team