New Dover Road Surgery

Updated 10 March 2017

New Dover Road Surgery delivers services from a converted Edwardian house in Canterbury, Kent. Not all patient areas are accessible to patients with mobility issues. Staff told us patients with mobility issues are seen in the ground floor treatment and consulting rooms. There are approximately 10,000 patients on the practice list. The practice has slightly more patients aged over 85 years. There are also slightly more patients with a long term condition than national and local averages (practice average 56%, clinical commissioning group (CCG) average 55% and national average 54%). There is a higher than average amount of patients aged between 20 and 24 years old as the practice is situated close to a university.

The practice holds a General Medical Service contract and consists of six GPs partners (four female and two male). Dover Road Surgery is training practice so, alongside their clinical roles, the GPs provide training and mentorship for trainee GPs (called registrars). The practice also provides training opportunities for physician’s associates. There are two practice nurses (female), one healthcare assistant (female) and two phlebotomists (phlebotomists take blood samples).

The GPs, nurses, healthcare assistants and phlebotomists are supported by a practice manager and a team of administration and reception staff. A wide range of services and clinics are offered by the practice including: asthma, diabetes, minor surgery and antenatal clinics.

The practice is open from 8am to 6.30pm Monday to Friday. There are extended hours from 6pm to 8.15pm Tuesdays and Thursdays. Morning appointments are from 8.30am to 11.30am and afternoon appointments are from 2.30pm to 6.30pm.

When the practice is closed, an out of hour’s service is provided by Primecare. There is information available to patients on how to access this at the practice, in the practice information leaflet and on the website.

Services are delivered from:

10 New Dover Road, Canterbury, Kent, CT1 3AP.

Updated 10 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at New Dover Road Surgery on 11 January 2017. 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. The practice had identified some areas of infection prevention and control that required improvement and at the time of inspection had begun to implement a range of improvements. However, the action plan for these improvements did not contain timescales.
• 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.
• The practice was committed to working collaboratively and participated in the Community Hub operating Centres (CHOC) aimed at improving communication between health and social care services.
• 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.
• The practice was a member of the Encompass Vanguard (an integrated multi specialty community provider consisting of 16 other GP practices, the CCG, three other NHS trusts, the local council and local social services, the local hospice and numerous voluntary groups), which aimed at providing services in the community and reducing the need for patients to travel to secondary care.
• 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).
• 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 one area of outstanding practice:

• In response to staff suggestions the practice implemented a direct telephone line and issued business cards with contact details for the care co-ordinator to help ensure vulnerable patients, carers and other health and social care providers could obtain support and information to meet their needs in a timely manner.

The areas where the provider should make improvement are:

• Review infection prevention and control action plans to include timescales for the completion of any actions and improvements. Ensure lead members of staff have received suitable training to support this role.
• Review the process for managing childhood immunisations to help ensure immunisation data is accurate.
• Continue to develop the carers register and review how the needs and requirements of this group of patients are being met.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 March 2017

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.
• Data from the Quality and Outcomes Framework (QOF) showed diabetes indicators were comparable to local and national averages.
• 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 10 March 2017

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.
• There were four areas where childhood immunisations were measured; each had a target of 90%. The practice was above the target in two areas and below the target in the remaining two areas.
• 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 86%, which was comparable to the national average of 82%.
• 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 10 March 2017

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. Through collaboration with local GPs patients had access to a paramedic practitioner.
• The practice had a care coordinator to support elderly patients who, alongside one of the GPs, attended weekly multidisciplinary meetings.

Updated 10 March 2017

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 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 reflects the needs for this age group.

Updated 10 March 2017

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

• 77% of patients diagnosed with dementia had received a face to face care review meeting in the last 12 months, which was comparable to the local average of 81% and the national average of 84%.
• Performance for mental health related indicators were comparable with local and national averages.
• 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 10 March 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• There was a proactive approach to understanding the needs of different groups of patients and to deliver care in a way that met these needs and promoted equality. This included patients who were in vulnerable circumstances or who had complex needs. For example, the practice reviewed two homeless patients with the CHOC group to help ensure that their emotional, social and wellbeing needs were given equal consideration alongside their physical needs.
• The practice held a register of patients living in vulnerable circumstances including homeless patients 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.