Archived: Parkside Surgery

Updated 9 July 2015

Parkside Surgery is a GP practice located in a part urban area and part rural area of Rochester, Kent and provides care for approximately 8,600 patients. The practice has somewhat less than the national average of patients over 65 years and over 75 years and only two thirds of the national average of patients over 85 years. It is not overall an area of high depravation though there are patches of high depravation within the practice boundaries.

There are six GP partners, three female and three male, as well as one male salaried GP. There are 35 GP sessions each week, one session being half a day. There are two female nurses providing 26 nurse sessions weekly and there are two female healthcare assistants. The practice has a general medical services (GMS) contract with NHS England for delivering primary care services to local communities. The practice is a training practice.

Services are delivered from the central surgery at;

Parkside

Cliffe Woods

Rochester Kent

ME3 8HX

There is a branch surgery at;

The Parks Medical Practice

Wainscott Surgery

Miller Way Wainscott

Rochester Kent

ME2 4LP

We did not visit the branch surgery

The practice has opted out of providing out-of-hours services to their own patients. There is information available to patients on how to access out of hours care.

Updated 9 July 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Parkside Surgery on 17 December 2014. During the inspection we spoke with patients, members of the patient participation group (PPG), interviewed staff of all levels and checked that the right systems and processes were in place.

Overall the practice is rated as good. This is because we found the practice to be good for providing safe, responsive, effective, caring and well led services. It was good for providing services for older people, people with long-term conditions, for working age people (including those recently retired and students) and families, children and young people. people whose circumstances may make them vulnerable and people experiencing poor mental health (including people with dementia).

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example audit of inherited high cholesterol
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group (PPG).
• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand
• The practice had a clear vision which had quality and safety as its top priority. High standards were promoted and owned by all practice staff with evidence of team working across all roles. The practice contributed leadership and mentoring locally and nationally.

We saw one area of outstanding practice including:

• The practice had conducted audits that influenced health care locally and nationally.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 July 2015

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. Patients with more than one long-term condition were seen in extended appointments which considered their holistic care, as opposed to repeatedly attending different clinics. The practice had undertaken work to help identify patients with specific long-term conditions which were likely to have an impact nationally. Patients with long-term conditions had named GPs and a structured annual review to check that their health and medication needs were being met. NHS health checks conducted by the practice had resulted in long-term conditions being identified at an early stage.

Updated 9 July 2015

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 generally slightly higher than nationally 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. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 9 July 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were very good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of their older patients. The practice used a frailty index and other risk tools to identify older patients most at risk. Specific administrative staff were tasked with organising and managing multidisciplinary meetings designed to provided individualised care. Specific GPs were responsible for end of life care and dementia care. Communication with the out of hours service regarding the needs of older patients was well organised and effective.

Updated 9 July 2015

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 patient population, those recently retired and students had been identified and the practice had adjusted the services it offered to help 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 reflected the needs for this age group.

Updated 9 July 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). 98% of patients experiencing poor mental health had received an annual physical health check. The practice has a GP qualified in the care of patients with mental health problems. Patients were referred within the practice to this GP. The practice had built working relationships with local mental health services as well as access to advice and secondary care. There was a GP lead for patients with dementia.

Patients experiencing poor mental health were encouraged to attend with family members or carers to explain their problems and how these affected themselves and their family or carers. The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. There was signposting to support services for patients experiencing poor mental health and dementia. Staff had received training on how to care for patients with mental health needs and dementia.

The practice had delivered training to GPs across the CCG aimed at improving the care and treatment for patients with mental health problems in the locality.

Updated 9 July 2015

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 such as those with a learning disability. It had carried out annual health checks for patients with a learning disability. It offered longer appointments for patients with a learning disability. Appointments for patients with a learning disability were arranged with consideration for the needs of the patients as well as their carers. The practice continued to provide enhanced services to all its patients with learning disability despite only being funded for less than half of 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.