Green Porch Medical Centre

Updated 16 June 2023

As part of our inspection we visited Green Porch Medical Centre, Green Porch Close, Sittingbourne, Kent, ME10 2HA, where the provider delivers regulated activities.

The provider also delivers regulated activities at Newington Surgery, 43 High Street, Newington, Sittingbourne, Kent, ME9 7JR. We did not visit Newington Surgery as part of this inspection.

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services, family planning, treatment of disease, disorder or injury and surgical procedures. These are delivered from both sites.

The practice is situated within the Kent and Medway Integrated Care Board (ICB – formally the Clinical Commissioning Group - CCG) and delivers General Medical Services (GMS) to a patient population of about 8,450. This is part of a contract held with NHS England.

The practice is part of a wider network of GP practices, Sittingbourne Primary Care Network (PCN).

Information published by UK Health Service Agency (UKHSA) shows that deprivation within the practice population group is in the fifth lowest decile (5 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 95% White, 1.8% Black, 1.3% Asian, 1.4% Mixed and 0.2% Other.

The age distribution of the practice population closely mirrors the local and national averages. There are more female patients registered at the practice compared to males.

The practice staff consists of 2 GP partners, 1 salaried GP, 2 nurse practitioners, 2 practice nurses, 1 healthcare assistant, a practice manager, an assistant practice manager, a Quality and Outcomes Framework (QOF) and Quality Manager; as well as reception and administration staff.

Green Porch Medical Centre is open Monday to Friday 8am to 6.30pm and Newington Surgery is open Monday to Friday 9am to 2pm.

The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

Out of hours services are provided locally by Sittingbourne Memorial Hospital and Sheerness Community Hospital 9am-9pm or by contacting the NHS 111 Service.

Updated 16 June 2023

We carried out an announced inspection at Green Porch Medical Centre on 13 April 2023 Overall, the practice is rated as Requires Improvement.

The ratings for each key question are as follows:

Safe - Good

Effective – Good

Caring - Requires Improvement

Responsive – Requires Improvement

Well-led – Good

We carried out an announced comprehensive inspection at Green Porch Medical Centre on 18 January 2022. The practice was rated Inadequate overall and placed into special measures as a result of this inspection and we took enforcement action.

We carried out an announced comprehensive inspection at Green Porch Medical Centre on 19 July 2022, to check the practice’s special measures status and to provide a new rating. Overall, the practice was rated as Inadequate and the practice was placed into a second period of Special Measures. Breaches in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were found and further enforcement action was taken.

We carried out an announced follow up inspection on 28 November 2022, to check progress against the requirements of the enforcement action issued and found full compliance had been achieved. The practice was not rated as a result of this inspection and the rating of Inadequate awarded to the practice following our full comprehensive inspection on 19 July 2022 remained unchanged.

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

Why we carried out this inspection

This inspection was a comprehensive inspection to re-rate the practice and ensure ongoing compliance with the regulations.

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:

• 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.
• Conducting staff interviews using video conferencing.
• Conducting staff questionnaires.
• 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:

We have rated the practice as Good for providing safe, effective and well-led services because:

• The practice’s systems, practices and processes kept people safe and safeguarded from abuse.
• The practice’s systems for the appropriate and safe use of medicines, including medicines optimisation were effective.
• Patients’ needs were assessed, and care and treatment was delivered in line with current legislation, standards and evidence-based guidance supported by clear pathways and tools.
• The provider carried out quality improvement activity.
• Staff worked together and with other organisations to deliver effective care and treatment.
• Staff helped patients to be involved in decisions about care and treatment.
• Leaders had taken action to ensure the quality, safety and performance of the service.
• There were clear systems to support good governance.
• The practice had processes for managing issues, risks and performance.

We have rated the practice as Requires Improvement for providing caring and responsive services because:

• Patients experienced difficulty accessing the practice by telephone.
• The practice had taken action to address issues regarding access. However, the provider had not yet collected patient feedback to demonstrate whether improvement actions taken were effective..
• National GP Survey satisfaction scores for July 2022 had declined further since our previous inspection. However, no regulatory breaches were identified.

The areas where the provider should make improvements are:

• Continue to monitor performance relating to child immunisations and cervical screening, promote uptake and address identified issues with external stakeholders.

This service was placed in special measures in January and July 2022. The practice has made significant improvements and is now rated Requires Improvement overall; Good for the key questions of safe, effective and well-led and Requires Improvement for caring and responsive. I am taking this service out of special measures. This recognises the improvements made to the quality of care provided by the service. The service will be kept under review and will be inspected within 12 months to ensure improvements are sustained.

Please refer to the detailed report and the evidence table for further information

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care