Archived: Saddleton Road Surgery

Updated 5 August 2016

Saddleton Road Surgery is a GP practice in Whitstable Kent and has a registered patient population of approximately 2,800.

The practice staff includes four GPs, two female and two male. There are two practice nurses both female, one healthcare assistant (female), there are three managers who are responsible for different aspects of the practice for example, finances or information technology. There are other administration and reception staff. The practice building is a bungalow and all the patient areas are accessible to patients with mobility issues, as well as parents with children and babies.

The age of the population the practice serves is other than the national averages. For example the number of patients over 75 years is about a third more than that nationally and this also applies to the number of patients over 85 years. This trend is particularly marked in the Seasalter area of the town where the practice has a branch surgery.

The practice is training practice which takes foundation year two doctors.

The practice has a personal medical services contract with NHS England for delivering primary care services to the local community.

In March 2015 Saddleton Road Surgery was one of three local founding practices to become a Vanguard site. Vanguard sites are being developed as part of implementing the NHS Five Year Forward View. Part of the objective is to support improvement and integration of services. Saddleton Road’s particular Vanguard site is called Encompass. On its launch it covered a practice population of some 53,000 patients but has since expanded to cover about 170,000 patients. It is a partnership with local health, care and support organisations including Canterbury & Coastal CCG, Kent County Council, East Kent Hospital University Foundation Trust, Kent Community Health NHS Foundation Trust, Kent Partnership Trust and AgeUK. However this report deals with the services provided by the Saddleton Road Surgery in its own right.

The practice is open at Saddleton Road Monday to Friday between the hours of 8.00am to 6.30pm. Extended hours surgeries are offered on Tuesdays to 8pm. The practice is open at Seasalter between the hours of 9am and 2pm Monday to Friday with the exception of Thursday when Seasalter is open to 6.30pm. Primary medical services are available to registered patients, appointments can be by telephone, in person at reception or on line. There is a range of clinics for all age groups as well as the availability of specialist nursing treatment and support.

There are arrangements with other providers (Medway On Call Care) to deliver services to patients outside of the practice’s working hours.

Services are provided from:

Saddleton Road Surgery

32 Saddleton Rd,

Whitstable

CT5 4JQand

28 Faversham Road

Seasalter

Whitstable

Kent

CT5 4AR

We visited both surgeries as part of the inspection.

Updated 5 August 2016

We carried out an announced comprehensive inspection at Saddleton Road Surgery on 19 April 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.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with 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.
• 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 had held educational events for carers attended by about 125 people, areas covered included long term conditions and end of life care.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Updated 5 August 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.
• Performance for diabetes related indicators was better than the national average
• 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.

Updated 5 August 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 A&E attendances. Immunisation rates for all standard childhood immunisations were comparable with local and national standards.
• 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 comparable to the CCG and national averages.
• 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 5 August 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 participated in a paramedic home visiting service, which afforded assistance, mostly to this population group, when a GP was unavailable.
• The practice had been effective in reducing the number of unplanned admissions to hospital for patients over 74 years. There was evidence to support that this was linked to the practice’s paramedic practitioner home visit service.
• In an area with an elderly population and poor public transport links, the practice had extended their building to house a small community pharmacy.

Updated 5 August 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.

Updated 5 August 2016

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

• The practice had worked hard to improve its diagnosis of dementia. Eighty four per cent of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average.
• Performance for mental health related indicators showed that 14 out of 15 patients on the register had received an annual review of their mental health plan.
• 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 5 August 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.
• The practice offered longer appointments for patients with a learning disability. Visited at their home if this supported their emotional needs.
• 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 and had held educational events to support this. The events had been attended by about 125 people and were highly regarded by those who attended them
• 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.