Hythe Medical Centre

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that staff involved people in decisions about their care and treatment and provided them advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this.

This is the first inspection for this practice since its registration with CQC. This key question has been rated as good.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The practice made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Feedback from people using the practice was positive. People felt involved in any assessment of their needs and felt confident that staff understood their individual and cultural needs.

Reception staff were aware of the needs of the local community. Digital flags were used within the care records system to highlight any specific individual needs, such as the requirement for longer appointments or for a translator to be present. The practice had undertaken work recently to better understand the specific needs of its vulnerable patient groups, by working with individuals to proactively identify reasonable adjustments, to improve their access to care.

Staff checked people’s health, care, and wellbeing needs during health reviews. Clinical staff used templates when conducting care reviews to support the review of people’s wider health and wellbeing. The practice actively identified and added alerts to records of those with a learning disability. This group were offered annual health checks to identify emerging needs. Clinical staff had completed appropriate training in learning disabilities to enable better understanding of the needs of this patient group.

The provider had effective systems to identify people with previously undiagnosed conditions. Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber.

The practice planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Systems were in place to ensure staff were up to date with evidence-based guidance and legislation. Practice leaders demonstrated a commitment to evidence-based medicine through regular multi-disciplinary meetings, educational sessions and collaboration with specialists. Clinical supervision was established across all staff groups to support compliance.

As part of our inspection, clinical record searches were undertaken remotely, and results demonstrated care was provided in line with current guidance. Long-term condition reviews for asthma and diabetes were completed as recommended in National Institute for Health and Care Excellence (NICE) guidelines.

The practice had worked to improve the uptake of annual reviews for long-term conditions. This had been supported by the introduction of an automated recall system, that handled recalls for various reviews and repeat blood tests.

The practice worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. They worked with other services to ensure continuity of care, including where clinical tasks were delegated to other services.

Teams within the practice met regularly to share information, reflect on feedback and incidents, and discuss emerging risk. Clinical and whole practice meetings enabled collaboration across teams to drive improvements through a shared vision of good care. This was further supported by effective leadership within each team and strong processes of oversight and governance from the practice management team.

Many practice staff worked across the Primary Care Network (PCN) and this enabled effective sharing of information, concerns and innovation. Established links with these services promoted collaboration through audits, medicines optimisation and other quality improvement work. This benefitted the wider local community and ensured the needs of the practice patient population were represented at community level

We received positive feedback about the established relationship between the practice and a local care home, where weekly ward rounds were conducted. There was praise for the thorough and responsive care provided to their residents and practice staff were described as helpful and approachable.

A recent initiative sought to improve the care of those unable to physically attend the practice and those for whom care at home was more appropriate. The aim was to provide more cohesive care for these groups and to bridge the gap between the practice and community services. The initiative drew on the enhanced skills of practice staff to extend training and facilities to the care home. For example, the practice had provided equipment and staff training to enable improved medication delivery for those at the end of their life.

The practice supported people to manage their health and wellbeing to maximise their independence, choice and control. The practice supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff supported national priorities and initiatives to improve population health, including stopping smoking and tackling obesity. We observed local and national initiatives and support services were advertised at the practice locations and on the practice website. The practice worked with ‘Active Surrey’ to promote the health benefits of physical activity to patients and staff. Patient responses to the 2026 National GP Patient Survey indicated they felt they were supported by local services. Result showed that 84% of respondents felt they had enough support from local services and organisations in the last 12 months to help manage their long-term conditions or illnesses, which was above the national average of 70%.

Staff focussed on identifying risks to patients’ health, including those in the last 12 months of their lives, and patients at risk of developing a long-term condition. The practice also maintained a register of those caring for others and understood the impact this could have on the health and wellbeing of the carer. A recent audit showed that 355 patients were registered as carers, which was 3.8% of the patient population. These individuals were offered flu vaccination and annual health checks to maintain their own health, as well as referral to support services as needed.

The practice routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

There was a comprehensive programme of clinical audit and quality improvement activity, tailored to the patient population and their health needs, to review the effectiveness and appropriateness of the care provided. From the clinical notes reviewed, we found that people who used the practice experienced positive outcomes as set out in legislation, standards, and evidence-based clinical guidance.

People with long-term conditions were offered an annual review to check their health and medicines needs were being met in line with guidance. For example, our clinical searches identified 22 people with asthma who had 2 or more courses of rescue steroids in the last 12 months. We reviewed 5 of these records and found all 5 had been followed up and reviewed appropriately.

The practice had undertaken work to improve the uptake of screening and immunisations. Since 2021, the practice had achieved sustained improvements in many child immunisation indicators by creating administrative staff roles to focus on recall, and by working closely with Child Health Information Services (CHIS). Clinical staff proactively contacted parents or guardians to discuss vaccine concerns and to rebook when immunisation appointments were not attended. However, cervical screening targets had not always been met by the practice, but staff had worked with the local GP federation to establish and promote weekend appointment availability, to remove barriers for those unable to attend during the working week.

The practice told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff understood and applied legislation relating to consent. Decisions around capacity and patient consent to care and treatment were documented in clinical templates used by staff. Training on the Mental Capacity Act was included in mandatory training for all staff groups. Staff were able to explain how they assess understanding of information given and how they consider the legality of consent to treatment.

Clinical staff we spoke with showed a good understanding of Gillick competency and its application when seeking consenting to treatment. Gillick competency involves assessing whether a child under the age of 16 has sufficient intelligence, competence and understanding to consent to their proposed treatment. Non-clinical staff were able to explain how they considered confidentiality and consent regarding information security, when speaking to patient representatives.

Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation. The practice had undertaken audits to review all DNACPR decisions and associated documentation.