Archived: The Eastry Surgery

Updated 12 October 2016

The Eastry Surgery is a GP practice located in the village of Eastry Kent. It provides care for approximately 8200 patients. It is one part of a larger practice, the Market Place Surgery in Sandwich, Kent and the 8200 patients are cared for from both practice locations. The Eastry practice is in a rural area.

There are two partners, both male GPs. There are two salaried GPs both male. There are four nurses and two healthcare assistant all female. There is a practice manager and administrative and reception staff.

The demographics of the population the practice serves is more complex than the national averages. There are fewer patients under the age of 10 and markedly fewer patients between the ages of 16 and 40. There are more patients over the age of 45 and there is a significant increase, over the national averages in the numbers of patients in all the age groups from 65 to 85 plus years. The majority of the patients describe themselves as white British. Income deprivation and unemployment are low. Although the practice as a whole is not in an area of deprivation there are pockets of rural deprivation within it.

The practice has a general medical services contract with NHS England for delivering primary care services to local communities. The practice offers a full range of primary medical services. The practice is not a training practice.

The practice is open between 8am and 6.30pm Monday, Wednesday and Friday. It is open 8am to 5pm on Tuesdays and 8am to 4pm on Thursdays. On those days the patients can go to the Market Place surgery which is open to 6.30pm each day.

The surgery building is single story with consulting, treatment rooms and administration rooms on the ground floor.

Services are provided from

Eastry Surgery,

High Street,

Eastry,

Kent,

CT13 0HE

The practice has opted out of providing out-of-hours services to their own patients. This is provided by Integrated Care 24. There is information, on the practice building and website, for patients on how to access the out of hours service when the practice is closed.

Updated 12 October 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Eastry Surgery on 11 August 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 for reporting and recording significant events.
• Most risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff were experienced and had been trained to provide them with the skills and knowledge 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.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and 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.

We saw one area of outstanding practice:

The practice manager maintained an “at risk” register for the most vulnerable patients. In addition, recent hospital discharges and Accident & Emergency attendances were reviewed for this group on a daily basis, and patients contacted to check on their wellbeing or current needs post discharge or hospital attendance.

The areas where the provider must make improvement are:

The provider must ensure that staff who are used as chaperones are subject to Disclosure and Barring Service checks, or there is a risk assessment recording why such checks are not necessary.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 12 October 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 aggregate QOF figures for diabetes were 78% against the national average of 89%. This had been identified as a mainly reporting, as opposed to a service issue. The practice was aware of this and had implemented effective plans to address it.

• Longer appointments and home visits were available when needed.
• All these patients had a named GP and most had 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 12 October 2016

The practice is rated as good for the care of families, children and young people.

• There were systems 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 Accident and Emergency 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 practice’s uptake for the cervical screening programme was 84%, which was comparable to the CCG average of 83% and the national average of 82%. This result placed the practice in the top 25% of practices nationally.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice established itself as “C” card center (for the distribution of condoms) after a local town pharmacy had stopped providing this service.

Updated 12 October 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 had developed customised frailty assessments and memory loss assessments to better identify and support patients with these problems.
• The practice manager maintained an “at risk” register for the most vulnerable patients, most of whom were older patients. In addition, recent hospital discharges and Accident & Emergency attendances were reviewed for this group on a daily basis, and patients contacted to check on their wellbeing or current needs post discharge or hospital attendance.

Updated 12 October 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The practice offered a full range of online services
• The practice offered NHS health checks for patients aged 40–74. Appropriate follow-ups for the outcomes of health assessments and checks were made, where abnormalities or risk factors were identified. We were told of examples where these checks had identified conditions which might otherwise have gone undiagnosed. Patients were signposted to the relevant service.

Updated 12 October 2016

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

• Performance for patients diagnosed with dementia was compatible national averages, the practice achieved 92% the national figure being 94%.
• Performance for mental health related indicators was low with the practice achieving 71% against a national average of 92%. This had been identified as a mainly reporting, as opposed to a service issue. The practice was aware of this and had implemented effective plans to address it.
• 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 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 12 October 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. All learning disability patients were able to decide whether to have an annual health check at their home or at the practice, most chose to have it at home The checks and other visits were generally carried out by a specific GP, who had completed additional training, and was accompanied by the community learning disability nurse.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.