Dr Miles and Partners Also known as Wye Surgery

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Drs Miles, Fox and Di Biasio on 31 August 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, clinical and non-clinical. The practice was a Multi-speciality Community Provider with an ethos to bring services to the patient rather sending patients to the service.
• 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.
• The practice was part of a vanguard site combining with other providers to deliver services across a substantial area of East Kent.
• 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:

• Wye Surgery was one of the first practices chosen to roll out this service.For example, the Community Tele-Dermatology service ( which had reduced referrals by 40%. The practice was proactive in reducing medicines waste. An audit of repeat ordering of prescriptions had identified significant cost savings that could be made, if patients were directly involved in the ordering process and were educated to only order what they needed. In line with Better health Better care and Social prescribing initiatives, the practice met with the secretary of the programme management group for ‘Our Place Wye’ (OPW) to help coordinate social support for isolated people. Another new initiative in the village was the ‘Wye Shed’ project; men would meet in a shed for a cup of tea and chat, maybe learn new skills off of each other or repair tools.
• The practice had employed a senior district nurse care coordinator who visited patients to ensure they received the best possible support and prevent unplanned admissions.

The areas where the provider should make improvement are:

• Continue to ensure that the dosage, type, batch number and expiry date of local anaesthetic given is being recorded into patient’s notes.
• 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