Heathcote Medical Centre

Updated 22 February 2018

Heathcote Medical Centre offers primary medical services via a general medical services (GMS) contract to approximately 12,000 registered patients. The practice provides services to a higher number of patients who are aged 65 years and over, when compared with the local clinical commissioning group (CCG) and England average.

Care and treatment is delivered by three GP partners, two male and one female and five associate (salaried) GPs. There is a good mix of male and female GPs. The practice also has an advanced nurse practitioner, two practice nurses, two healthcare assistants and a team of receptionists and administration staff and team leaders. Operational management is provided by the practice manager.

The practice runs a number of services for its patients including a minor illness clinic, asthma clinics, child immunisation clinics, diabetes clinics, new patient checks, and weight management support.

The practice is open between 8.00am and 6.30pm Monday to Friday with extended opening Tuesday and Thursday evenings from 6.30pm until 8:30pm. The practice is also open on some Saturdays 9am to 11am.

The practice is part of a hub of GP practices that offer evening appointments until 9pm and weekend appointments 9am until 1pm. These appointments are not run from the practice but from separate locations in Leatherhead, Epsom and on the Downs.

There are arrangements for patients to access care from an Out of Hours provider via the 111 service. The out of hours provider is Care UK.

Services are provided from the following addresses:

Heathcote Medical Centre, Heathcote, Tadworth, Surrey, KT20 5TH

Updated 22 February 2018

Letter from the Chief Inspector of General Practice

Heathcote Medical Centre was previously inspected in December 2015 and was rated good in all domains and overall.

At this inspection in January 2018 the practice is rated as Good in all domains and overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Heathcote Medical Centre on 17 January 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

• The practice had clear systems to manage risk, including risk assessments, so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Staff were supported in personal development and training and received regular appraisal.
• The practice had accessible facilities and was equipped to treat patients and meet their needs.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it. However, the patient survey showed lower than average results for the question ‘how easy is it to get through to someone at your GP surgery on the phone’. We explored this with the surgery and found that the surgery was putting measures in place to improve patient satisfaction.
• The practice ensured patients had good access to care by offering extended hours surgeries, and telephone consultations, as well as offering appointment booking on the practice website.
• The practice had several GPs who were on maternity leave and to provide continuity of care they had employed long term locums to cover their patients.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider should make improvements are:

• Consider ways to identify and support more patients who are carers.
• Continue to review ways to improve patient satisfaction when contacting the practice.
• Consider ways to identify when risk assessments are due.
• Review the recording of information for those patients requiring additional care by using registers and centrally recording information.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 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.

• Performance for diabetes related indicators was comparable to the CCG and national average. For example: the percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months was 85% compared to the national average of 88%.

• Longer appointments and home visits were available when needed.
• All these patients had a named GP and a structured annual review to check that their health and medicines needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 11 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. 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, 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 good examples of joint working with midwives, health visitors and school nurses.

Updated 11 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.
• Patients discharged from hospital were alerted to the GP on the same day and actions taken to follow up their care.
• It was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 11 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 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.
• Evening and telephone consultations were available. Extended hours are provided on Saturday mornings, Tuesday evenings and Thursday evenings for patients who find appointments during working hours difficult to attend.

Updated 11 April 2016

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

• It carried out advance care planning for patients with dementia. 91.3% of people diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months compared to the national average of 84.1%.
• 90.48% of people schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in the record, in the preceding 12 months compared with the national average of 88.47%.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• It had a system in place 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 people with mental health needs and dementia.

Updated 11 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 those with a learning disability.
• It offered longer appointments for people with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• It had told 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.