New Hayesbank Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at New Hayesbank Surgery on 11 January 2017. 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 worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs.The practice was an approved host for NHS outpatient clinics and services in East Kent and a wide range of services and clinics are offered in the practice.

• 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.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs.The practice was an approved host for NHS outpatient clinics and services in East Kent and a wide range of services and clinics are offered in the practice.

• 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 had employed three specialist community nurses, with a community matron background, who visited patients to ensure they received the best possible support and prevent unplanned admissions. The most recent evidence of their impact on the practice’s over 75 patients shows the downward trend in hospital admissions for over 75’s registered at New Hayesbank Surgery, compared to last year.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs. For example, an ophthalmology clinic was set up in 2007 as part of a practice based commissioning service.The service was developed in order to achieve 18 week targets for first out-patient appointments.The service offers a more tailored personal service closer to home for patients registered in the local area. The ophthalmology clinic now offers a service to a wider group of patients within Ashford CCG and other neighbouring CCGs.

• The practice provided services to women accommodated at a local refugee centre. Whilst mainly transient, the 12 women had been registered as permanent patients with a PO Box address, thereby ensuring continuity of care and safeguarding of their personal information.

• The practice funded 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 areas where the provider should make improvement are:

• Revise the system that identifies patients who are also carers to help ensure that all patients on the practice list who are carers, are offered relevant support if required.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice