Aylesham Medical Practice

Updated 13 April 2016

Aylesham Medical Practice and its branch surgery, Wingham Practice, are located in residential areas in Aylesham, Kent. They serve a large rural area including the surrounding villages of Nonington, Woolage Village, Woolage Green and Sheperdswell. There are 6272 patients on the practice list.

Aylesham is an ex-mining village, which until 1987 provided the majority of the workforce for Snowdown Colliery. There is a high prevalence of chronic disease, with a proportion of this being industrially acquired.

The practice holds a General Medical Contract (a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract) and consists of three GPs, two male and one female, three female practice nurses and one female healthcare assistant. The GPs and nurses are supported by a practice manager and a team of administration and reception staff. The practice provides a wide range of services including minor injury, diabetes, Chronic Obstructive Pulmonary Disease (COPD) and asthma clinics. Access to further services on site includes speech therapy, podiatry and counselling.

The practice and the branch surgery (Wingham Surgery) are open between 8am and 6pm, with telephone access until 6.30pm, Monday to Friday, although Wingham Surgery closes on a Thursday at 1pm. There is a walk in clinic every day from 8.30am to 10am and pre-bookable appointments 3pm to 6pm. The practice has collaborated with local GPs to provide extra appointments for patients at the Royal Victoria Hospital Hub from 8am to 8pm every day.

An out of hour’s service is provided by Invicta Health, outside of the practices open hours and there is information available to patients on how to access this.

Services are delivered from the central surgery at;

Aylesham Medical Practice

Queens Road

Aylesham

Canterbury

Kent

CT3 3BB

There is a branch surgery at

Wingham Surgery

2 North Court Road

Wingham

Canterbury

Kent

CT3 1BN

Updated 13 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Aylesham Medical Practice on 13 January 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 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.
• 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 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 some areas of outstanding practice:

Patients not on the practice list with minor injuries could attend the walk in clinics to prevent unnecessary visits to the local hospital Accident and Emergency Department.

The areas where the provider should make improvement are:

• Review how minutes from whole practice meetings are recorded.
• Promote the availability of extended hours at The Royal Victoria Hub, which are provided through collaboration with local GPs.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Updated 13 April 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 worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• The practice had identified that their patient population had a higher than average prevalence of Chronic Obstructive Pulmonary Disease (COPD) and worked with this group to reduce unnecessary hospital admissions. The practice COPD register showed there were 273 patients on the COPD register (4.34% of the practice population). Due to increased input from the nursing team, a recent audit from 1 October 2015 to 1 January 2016 demonstrated that only five patients received treatment outside of General Practice for COPD exacerbations during this time.

Updated 13 April 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.
• 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.
• 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 13 April 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.
• Specific health promotion literature was available as well as details of other services for older people.

Updated 13 April 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 offered online services as well as a full range of health promotion and screening that reflects the needs for this age group.
• Extended hours were available at The Royal Victoria Hub in Dover, through collaboration with local GPs; however, this service was not shown on the practice’s opening hours.

Updated 13 April 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 and maintained a register. The clinical auditor alerted the GPs if a patient had missed an annual review and patients or carers were contacted. Home visits were provided if required.
• Staff had a good understanding of how to support patients with mental health needs and 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.

Updated 13 April 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.
• Patients with a learning disability were given double appointments at the beginning of surgery sessions to ensure they had adequate time and to reduce distress from waiting in busy areas of the practice. GPs and nurses had access to a Learning Disabilities Pack to support communication during consultations with patients’ who have a learning disability.
• 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.
• A member of staff from the administration team had completed British Sign Language training.