Dr D Whillier and Partners

Updated 1 February 2017

Dr D Whillier and Partners is a GP practice based in Paddock Wood, Kent. There are 12,500 patients on the practice list.

There are seven partner GPs (four female and three male). The GPs are supported by a staff manager and a business manager (whose combined roles form the role of practice manager), an advanced nurse practitioner, two practice nurses, three healthcare assistants and an administrative team.

Dr D Whillier and Partners is open 8am to 6.30pm Monday to Friday. Extended hours with the nursing team are available Monday and Friday from 7am to 8am and 6.30pm to 8.30pm on Mondays and alternate Thursdays.

There is a branch surgery, East Peckham Surgery, which is open Monday to Friday from 8.15am to 12.45pm. The practice is a training practice (training practices take medical students and training practices have GP trainees and F2 doctors) and currently have three registrars (trainee GPs) working at the practice.

There are arrangements with other providers to deliver services to patients outside of the practice’s working hours.

The practice has a general medical service (GMS) contract and also offers enhanced services for example; minor operations and joint injections.

Services are provided from:

• Dr D Whillier and Partners (Woodlands Health Centre), 1-7 Allington Road, Paddock Wood, Tonbridge, Kent, TN12 6AX.
• East Peckham Surgery, 9 Old Rd, East Peckham, Tonbridge TN12 5AT

We did not visit either of the premises as this inspection was desk based.

Updated 1 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr D Whillier and Partners on 17 March 2016. Breaches of the legal requirements were found.

• The practice was unable demonstrate that annual infection control audits had been undertaken in accordance with national guidance on infection prevention control.
• The designated lead for infection prevention control had not received appropriate training.

Therefore, a Requirement Notice was served in relation to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulations 12 - Safe care and treatment

Following the comprehensive inspection, the practice wrote to us to tell us what they would do to meet the legal requirements in relation to the breaches.

We undertook this desk based inspection on 9 November 2016, to check that the practice had followed their plan and to confirm that they now met the legal requirements. We reviewed written and photographic information sent to us by the practice that told us how the breaches identified during the comprehensive inspection had been addressed. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Dr D Whillier and Partners on our website at www.cqc.org.uk.

Our key findings across all the areas we inspected were as follows:

• The practice was able demonstrate that it was compliant with national guidance on infection prevention control. However, there were some areas in the audit which were marked as having not been completed and there was no entry made as to how the practice were going to action these.
• The designated lead for infection prevention control had received appropriate training.

The areas where the provider should make improvements are:

• Continue to ensure the infection prevention control audit action plan responses are recorded and actioned appropriately and in accordance with the practices policy and guidance documentation.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 20 May 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 79%, which were similar to the CCG and national averages of 77%.

• 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 20 May 2016

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 comparable for all standard childhood immunisations for children aged 12 months to five years old.

• The percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years was 85%.

• 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 20 May 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 population included a high amount of patients who are aged 75 and over. Made up of those who have good health and those who may have one or more long-term physical or mental conditions, which included patients who live at home.

• The practice was responsive to the needs of housebound older people, in order to maintain provision of care in relation to their long term conditions and/or end of life care.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 20 May 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The practice population included a high amount of patients who are of working age, especially commuters. The practice offered extended hours on a Monday and alternate Thursday evenings until 8.30pm. As well as from 7am to 8am Monday to Friday, in order to accommodate patients who commute.

• 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 and were in the early stages of piloting email consultations, in order to meet the needs of working age patients.

• There was a full range of health promotion and screening that reflects the needs for this age group.

Updated 20 May 2016

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

• 78% of patients diagnosed with dementia who had had their care reviewed in a face to face meeting in the last 12 months, which was slightly below the national average of 82%.
• 90% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in the record, in the preceding 12 months,

• 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.

• 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 20 May 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.

• The practice offered longer appointments for patients with a learning disability.

• It had carried out annual health checks for all patients with a learning disability. It offered longer appointments for people with complex needs that related to their circumstances as well as their health concerns.

• 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.