The Care Quality Commission
  • Doctor
  • GP practice

Hamstreet Surgery

Overall: Good read more about inspection ratings

Ruckinge Road, Hamstreet, Ashford, Kent, TN26 2NJ (01233) 730190

Provided and run by:
Hamstreet Surgery

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Hamstreet Surgery on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Hamstreet Surgery, you can give feedback on this service.

During an assessment under our new approach

The practice was last inspected on 10 October 2022 and rated as Good overall. On 12 March 2024, we carried out a targeted assessment regarding the quality statement: Equity in Access, under the key question “Are services responsive?”. This was conducted without a site visit. The purpose of the assessment was aimed to understand the current experiences of service users and examine the practice’s efforts to enhance patient access. Hamstreet Surgery is located in Ashford at: Ruckinge Road, Hamstreet, Ashford TN26 2NJ. Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the 6th lowest decile (2 of 10). The lower the decile, the more deprived the practice population is relative to others. According to the latest available data, the ethnic make-up of the practice area is White, 97.9%, Asian 0.7%, Black 0.2% and 1% Mixed. The practice is open between 8am and 6.30pm Monday to Friday. Extended access is also provided locally by the practice where appointments are available, every Tuesday 6.30pm to 8.00pm (mix of nursing and GP), monthly on a Friday 6.30pm to 7.30pm (GP) and monthly on a Saturday 9am to 1.00pm (Social Prescriber Link Worker and a Pharmacist). Services are tailored to meet the needs of individual people and are delivered in away to ensure flexibility, choice and continuity of care. Out of hours services are provided by NHS 111. The practice offers a range of appointment types including book on the day, telephone consultations, advance appointments and home visits are available for patients who are housebound because of illness or disability. The results of the most recent GP Patient Survey (published in June 2023) showed the practice performance was above the national averages for all 4 of the indicators measured in relation to access;100% of patients responded positively to phone accessibility.

10 October 2022

During a routine inspection

We carried out an announced comprehensive inspection at Hamstreet Surgery on 10 October 2022. Overall, the practice is rated as Good.

Safe - Good

Effective - Good

Caring - Good

Responsive - Good

Well-led - Good

Following our previous inspection on 21 September 2016, the practice was rated Outstanding overall and for caring, responsive and well-led and Good for safe and effective services.

At the last inspection in September 2016 we rated the practice as outstanding for providing caring, responsive and well-led services.

  • Data from the Quality and Outcomes Framework (QOF) showed patient outcomes were at or above average compared to the national average.
  • The practice had developed a wide range of other services for patients. The practice objective was to place the patients at the heart of the services, rather than the patients being sent round the health care system to access the services.
  • The practice had a clear vision and strategy to deliver high quality care and promote good outcomes for patients. Staff were clear about the vision and their responsibilities in relation to it.

At this inspection, we found that those areas previously regarded as outstanding practice were now embedded throughout the majority of GP practices. While the provider had maintained this good practice, the threshold to achieve an outstanding rating had not been reached. The practice is therefore now rated good for caring, responsive and well-led services.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Hamstreet Surgery on our website at www.cqc.org.uk.

Why we carried out this inspection

We carried out this comprehensive inspection as the practice had not been inspected since September 2016. This inspection was conducted 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.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

  • Conducting staff interviews using video conferencing.
  • Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Requesting evidence from the provider.
  • A short site visit.

Our findings

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we inspected
  • information from our ongoing monitoring of data about services and
  • information from the provider, patients, the public and other organisations.

We found that:

  • Staff were consistent in supporting people to live healthier lives through a targeted and proactive approach to health promotion and prevention of ill-health, and every contact with people is used to do so.
  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • Patients received effective care and treatment that met their needs.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • Patients could access care and treatment in a timely way.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

The area where the provider should make improvements are:

  • Continue to ensure that all qualified dispensary staff are competency assessed around the use of split packs
  • Continue to monitor and review their actions in relation to the management of patients prescribed high risk medicines, for example, (ACE) inhibitors (used primarily for the treatment of high blood pressure and heart failure).
  • Continue to monitor and improve the practice’s system for acting on Medicines and Healthcare products Regulatory (MHRA) safety alerts to help ensure processes are being followed and embedded.

We saw several areas of outstanding practice:

  • The practice had a Caring for Veterans and their families protocol/policy. Information on what was available to veterans was shared with all staff and listed in this policy, for example, organisations to direct them to for support and where to write for service/medical records.
  • The practice had a GP with a special interest (GPSI) in cardiology who was 1 of 4 cardiology GPSI’s and saw patients from all over the Ashford area not just the Primary Care Network. All their clinics, bookings and administration took place in the surgery. This reduced referrals to secondary care making it more cost effective, shorter waiting times and more convenient to the patient (less travel, more local, free parking).

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services

21 September 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Hamstreet Surgery on 21 September 2016. Overall the practice is rated as outstanding.

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 used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. There was a very wide range of services, both clinical and non-clinical. The practice was a multi-speciality community provider with an ethos to bring services to the patient rather than sending patients to the service.

  • The practice was part of a vanguard site combining with other providers to deliver services across a substantial area of East Kent.

  • 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.

  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.

  • The practice had strong and visible clinical and managerial leadership and governance arrangements.

  • The provider was aware of and complied with the requirements of the duty of candour.

We saw areas of outstanding practice:

  • The practice offered a community ‘virtual’ ward which met once a fortnight. Team members included GPs, an elderly care consultant, social care staff, community nurses and representatives from the voluntary sector. The aim of the virtual ward was to help to ensure that patients’ emotional and social needs were met and given equal importance.

  • The practice provided access to services seven days a week through collaboration with two neighbouring surgeries. This service provided access to urgent appointments at the weekend from 9am to 12pm on Saturday at The Ivy Court Surgery (Tenterden) and Sunday at The Hamstreet Surgery for over 25,000 patients.

  • The practice had recognised the needs of its local, rural community and the difficulty in collection of prescriptions and had organised a secure collection point in two local villages located more than five miles (8km) from the practice.


Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice