Archived: Folkestone East Family Practice

Updated 7 September 2016

Folkestone East Family Practice shares purpose built premises with several other health care providers in a residential part of Folkestone, Kent and has access to a reception area, office space and four clinical rooms. As well as providing services at Folkestone East Family Practice, the provider (known as Sandgate Road) also provides services from another separately registered location, Sandgate Road Surgery, Folkestone, Kent.

There are approximately 4,700 patients on the practice list. The practice population is close to national averages. However, there are more patients with a long-standing health condition than the national average (practice average 63%, national average 54%). The surrounding area has a high prevalence of people living in deprived circumstances.

The practice holds General Medical Service contract. Between the locations there are nine GP partners (three female and six male). Three of the partners (two male and one female) work regularly at Folkestone East Family Practice to provide continuity of care for patients, however, the remaining six partners provide cover at the practice as required. There are six practice nurses (female); one of which has started training to become an Independent Prescriber, and two healthcare assistants (female). The nursing team work across both sites. The GPs and nurses 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 and childhood immunisations.

The practice is open from 8am to 6.30pm. Morning appointments are from 8.10am to 11am and afternoon appointments are from 2.30pm to 5.20pm. Patients registered at Folkestone East Family Practice have access to extended hours every Monday to Friday from 6.30pm to 7pm at Sandgate Road Surgery. Alongside several other local GPs in the South Kent Coast Clinical Commissioning Group (CCG) patients from the practice can also access services between 8am to 8pm at the Queen Victoria Hospital Hub in Folkestone and an urgent home visit service by a paramedic practitioner via funding from the Prime Minister’s Challenge Fund.

Services are provided from 15-25 Dover Road, Folkestone, Kent, CT20 1JY.

Updated 7 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Folkestone East Family Practice on 9 June 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.
• There was continuity of care, with urgent appointments available the same day. However, some patients reported they had to wait for routine appointments.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Despite a high number of patients on the practice list living in deprived circumstances the practice achieved better Quality and Outcomes Framework (QOF) figures than national and local averages in some areas of care (QOF is a system intended to improve the quality of general practice and reward good practice).For example, in the care of patients with diabetes.
• Patient Group Directions had been adopted by the practice to allow nurses to administer medicines.
• There was a clear leadership structure and staff felt supported by management. The practice sought feedback from staff and patients, which it acted on.
• During the course of the inspection we found that some family planning activities were taking place such as implants. The practice was not registered with the CQC to deliver family planning services from this location. Once informed of the situation the practice submitted an application to deliver family planning services from this location. Evidence of the application was submitted to the CQC inspection team within the required 48 hours.
• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Review how infection prevention audits are carried out to help ensure effectiveness.

• Continue to identify patients who are also carers and build on the current carers register to help ensure that all patients on the practice list who are carers are offered relevant support if required.
• Continue to review the security of prescription forms.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 September 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 were higher 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 7 September 2016

The practice is rated as good for the care of families, children and young people.

• The practice had strong focus on safeguarding in response to the needs of the local patient population and the whole team was engaged in improving and reporting safeguarding concerns for this population group.

• 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 (A&E) attendances. Immunisation rates were relatively high 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.
• The practice’s uptake for the cervical screening programme was 89%, which was better than 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 7 September 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 patient 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 collaborated with other GPs in the area to provide urgent home visits with a paramedic practitioner and extended hours for patients from 8am to 8pm at Queen Victoria Hospital hub, Folkestone. This service is funded by The Prime Minister’s Challenge Fund.
• The practice had been selected to take part in an international project called Sustain (sustainable tailored integrated care for older people in Europe). The project was a European collaboration involving academic and healthcare partners from nine countries aimed at improving integrated care for older people.
• After taking part in the Pro-Active care project, the practice continued to run an over 75’s service led by the practice matron.

Updated 7 September 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 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.

• Patients registered at Folkestone East Family Practice had access to extended hours every Monday to Friday from 6.30pm to 7pm at Sandgate Road Surgery.

Updated 7 September 2016

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

• 83% of patients diagnosed with dementia had received a care review in a face to face meeting in the last 12 months, which was similar to the clinical commissioning group (CCG) and national average of 84%.
• The practice had completed a two cycle audit to help ensure dementia patients were being identified. As a result seven patients were added to the dementia register.
• 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. The practice had provided a training day enabling all staff to become ‘dementia friends’.

Updated 7 September 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 and those with a learning disability.
• The practice offered longer appointments for patients with a learning disability and those who would benefit from this.
• 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.
• The practice was part of collaboration, funded by the Prime Minister’s Challenge Fund, which sought to encourage people who were homeless to engage and access healthcare services.