Headcorn Surgery

Updated 16 June 2017

Headcorn Surgery’s original premises in Clerks Field closed in January 2014 and the practice moved to purpose built premises in Grigg Lane. Ferris Chemist also re-located to Grigg Lane. The practice is a semi-rural practice and covers the areas of Headcorn, Biddenden, Bethersden, Egerton, Pluckley, parts of High Halden, Frittenden, Smarden, Boughton Malherbe, Ulcombe, St Michaels and parts of Staplehurst. The practice has a catchment area of 7,500 patients and provides a wide range of medical support services for all the family, with easy parking and full disabled access. The practice building is arranged over two storeys, with all the patient areas being accessible via a lift to the upper floor.

The practice is on the eighth centile deprivation indices, meaning this practice is in the least in terms of deprivation in Kent and has a white British population, with some pockets of deprivation.

The practice is similar to the national averages for each population group. For example, 5% of patients are aged 0 - 4 years of age compared to the clinical commissioning group (CCG) average of 6% and the national average of 6% and 30% are 5 to 18 years of age compared to the CCG average of 34% and the national average of 32%. Scores were similar for patients aged 65, 75 and 85 years and over.

The practice holds a General Medical Service contract and consists of three GP partners (two female and one male) and one practice manager/managing partner. The primary care team are supported by two specialist nurse practitioners (female), two practice nurses (female), two healthcare assistants (female), administration/clerical and reception staff which includes one reception supervisor.

The practice is in the process of changing its registration in accordance with the CQC (Registration) Regulations 2009. At the time of our visit, the practice were applying to remove Dr Clive Thorpe as a registered partner and as registered manager. Applications were also pending to register a new partner and registered manager.

A wide range of services and clinics are offered by the practice including:

• Minor Surgery,

• Joint injections,

• Vascular, diabetes, chronic obstructive pulmonary disease (COPD) and asthma,

• Counselling.

The practice worked regularly to accommodate allied health professionals such as a counsellor to be able to provide reviews of patients. The practice was also able to offer the services of a Health and Social Care Co-ordinator who was available on Wednesday morning’s between 9.30am and 12.30pm.

The practice is a training practice which takes foundation year three registrar GPs, there were no GP registrars working at the practice at the time of our visit.

The practice is open Monday to Friday 8am to 6pm. Saturday 9am to 1pm by appointment only (alternate weeks). A GP is available on the telephone from 6pm to 6.30pm.

The out of hour’s service is provided by Integrated Care 24 (which patients accessed via NHS 111), available outside of the practices open hours and there is information available to patients on how to access this at the practice, in the practice information leaflet and on their website.

Services are provided from:

Headcorn Surgery, Grigg Lane, Headcorn, Kent TN29 9AATN27 9AALaneHeadcornKent

Updated 16 June 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Headcorn Surgery on 10 May 2017. Overall the practice is rated as good.

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

We saw areas of outstanding practice:

• There were innovative approaches to providing integrated person-centred care. The practice held a monthly multi-disciplinary meeting (known as Tender Loving Care (TLC) meetings). The meetings purpose included ensuring that patients’ emotional and social needs were met and given equal importance alongside their healthcare needs. Attendees included a Health and Social Care Co-ordinator, a district nurse,social services,an admiral nurse (admiral nurses local hospice staff, a continence nurse and long term conditions nurse.

• The practice had developed an innovative recording tool (called Headcorn Educational Learning Points (HELP) for non-clinical incidents that was understood, regularly used and valued by all staff.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 June 2017

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. For example, asthma, diabetes, insulin Initiation, (COPD).

• Performance for diabetes related indicators were above the local and national average. For example, 85% of patients with diabetes, on the register, in whom the last IFCCHbA1c is 64 mmol/mol (a blood test to check blood sugar levels) or less in the preceding 12 months (local average 80% and national average 78%).

• 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 16 June 2017

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 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.

• The practice’s uptake for the cervical screening programme was 80%, which was comparable to the CCG and national average of 81%.

• Appointments were available outside of school hours and the premises were suitable for children and babies. Additionally, appointments were available for young people aged 18 and under to offer free confidential advice concerning relationships, how to stop smoking, safer sex and contraceptive advice from the nursing team. They were encouraged to bring along a friend, partner or parents if they wished to.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 16 June 2017

The practice is rated as good for the care of older people.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs. The practice provided care and treatment for 51 patients who lived in a residential and nursing home, who often had complex needs, dementia and were vulnerable. The practice offered a weekly ward round to the care home and unlimited telephone consultations. This involved registering all the patients (with their consent) with one of two lead GPs who looked after that home. Weekly and as required visits to the residential and nursing home were conducted.

• The practice held a monthly multi-disciplinary meeting (known as Tender Loving Care (TLC) meetings). The majority of these patients were elderly. The meetings purpose included ensuring that patients’ emotional and social needs were met and given equal importance alongside their healthcare needs.

Updated 16 June 2017

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 open Monday to Friday 8am to 6pm. Saturday 9am to 1pm by appointment only (alternate weeks). 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.

Updated 16 June 2017

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

• 82% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is comparable to other practices and the national average of 84%.

• Performance for mental health related indicators were above the national average. For example, 96% of patients with schizophrenia, bipolar affective disorder and other psychoses who have a comprehensive, agreed care plan documented in the record, in the preceding 12 months (national average 89%), which is comparable to other practices.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• Advance care planning for patients with dementia was carried out.

• 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 16 June 2017

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 homeless people, travellers and those with a learning disability.

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

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• The practice worked regularly to accommodate allied health professionals such as a counsellor to be able to provide reviews of patients. The practice was also able to offer the services of a Health and Social Care Co-ordinator who was available on Wednesday morning’s between 9.30am and 12.30pm.

• 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.