Archived: Stockett Lane Surgery

Updated 13 February 2017

Stockett Lane Surgery (Greensand Health Centre) offers general medical services to people living and working in Maidstone. The practice population has a higher than average number of patients over the age of 65 and a slightly higher proportion of patients with a long-term health condition. Eighty two percent of people living in the area are white and the practice is in one of the least deprived areas of Kent, placed in the second less deprived decile.

The practice holds a General Medical Service contract and is led by three partner GPs (female). The practice occasionally used a locum (male) GP and could call on him should a patient not wish to see a female GP. The GP partners are supported by a paramedic practitioner (male), two practice nurses, a healthcare assistant, a pharmacist, a practice manager an assistant practice manager and a team of reception and administrative staff. A range of services and clinics are offered by the practice including asthma clinics, child immunisation clinics, diabetes clinics, new patient checks, smoking cessation, health walks and weight management support.

The practice is open between 08.30 am and 6.30pm Monday to Friday. Appointments were from 9.00am to 12.00pm every morning and from 3.00pm to 6.00pm daily. Extended hours appointments were offered until 7.00pm weekdays. Between 8.00am and 8.30am and between 6.00pm and 6.30 pm a voicemail message redirected patients to call a different number if their need was urgent, this would enable them to speak to a doctor. In addition, appointments could be booked up to eight weeks in advance as well as urgent appointments, which were also available for people that needed them.

The practice has opted out of providing Out of Hours services to their patients. There are arrangements for patients to access care from an Out of Hours provider (111).

Services are provided from:

Stockett Lane Surgery (Greensand Health Centre)

Maidstone

Kent

ME17 4PS

Updated 13 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stockett Lane Surgery (Greensand Health Centre) on 5 October 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.
• The practice worked with the local council to deliver health improvement services for patients. Initiatives included health promotion coffee mornings and staff led health walks.
• 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 sometimes found it difficult to make an appointment with a named GP although there were 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 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.
• The practice had policies and procedures which governed staff recruitment. However, these had not ensured that appropriate references were received prior to staff commencing in post. For example, two newly appointed staff members had not had a reference returned from their most recent employer.
• Results from the national GP patient survey showed that patients scored the practice lower than average in some areas of GP consultations. However, patients we spoke with told us they were happy with their consultations.
• The practice scored lower than average in patient’s satisfaction with opening hours and being able to get through to the practice by phone. The practice had recently changed the telephone system to improve this and to provide data to help them identify the issues and address them.

We saw two area of outstanding practice:

• The practice had developed their smoking cessation service. They had identified that 52% of patients who had attended hospital through the accident and emergency (A&E) department were smokers. As a result, the project was designed to increase the number of smokers on the programme with an overall aim of improving their health and reducing admissions to A&E. Since starting the project the practice had increased the number of patients stopping smoking from 4 to 20.

• The practice had looked at improving services for young people and had introduced a mobile friendly website and a ‘fast pass’ system for children who were unwell and where parents may need to contact the practice quickly. The ‘fast pass’ was a direct dial telephone number that meant they could bypass the usual phone line. The practice had won a local ‘pacesetter’ award for this service where the practice was awarded for the service and for sharing best practice with other services. The ‘fast pass’ system had been extended to all patients where they were unwell, either acutely or over the long term so they could contact the practice more easily.

The areas where the provider should make improvement are:

• Continue to improve recruitment processes in order to help ensure that where references requested are not received, these are followed up .

• Continue to monitor patient satisfaction with regards to access to the practice, including telephone access and making appointments Monitor and review patient satisfaction with GP consultations with a view to making improvements.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 13 February 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.

• Performance for diabetes related indicators at 94% was similar to the local (89%) and national (90%) average. This reflected the improved recall system introduced by the practice. A monthly retinal screening clinic was held monthly at the practice for patients with diabetes.

• The clinical pharmacist undertook medication reviews, particularly for patients on a number of medicines and for those recently discharged from hospital.

• Longer appointments and home visits were available when needed. The ‘fast pass’ system had been extended to all patients where they were unwell, either acutely or over the long term so they could contact the practice more easily.
• 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.

• Annual reviews of patients with diabetes included the involvement of a diabetic nurse specialist.

Updated 13 February 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. Immunisation rates were relatively high for all standard childhood immunisations.
• The practice had been awarded a PACE Setter award for their work with children and young people following their development of a Health Fast Pass where parents were given card with the emergency contact number for the practice so they could get in touch quicker.
• 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 83% and the national average of 81%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• The practice had set up a system to contact patients on their 15th birthday with a card, suggesting that they update their records with their own contact details.

Updated 13 February 2017

The practice is rated as good for the care of older people.

• The practice offered 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 appointed a member of staff as a care plan co-ordinator to keep in touch with all patients of this population group who were at risk of an unplanned hospital admission.

Updated 13 February 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 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 appointments were available, as well as a walk-in phlebotomy clinic.

Updated 13 February 2017

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

• 89% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the last 12 months, which was better than the national average of 78%.
• Performance for mental health related indicators at 85% were worse when compared to the local (95%) and national (93%) average.
• 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 and had attended specific dementia training. The lead GP was undertaking a Dementia Fellowship to increase their understanding of dementia. 

Updated 13 February 2017

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

• 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.