The Charing Medical Partnership

Updated 23 December 2022

The Charing Medical Partnership is located in Ashford at:

1 Surgery Close

Charing

Ashford

Kent

TN27 0AW

The Charing Medical Partnership (also known as the Charing Practice) provides services from a purpose built property located in Charing, Ashford, Kent, supporting a large rural community. There are approximately 11,000 patients on the practice list. The practice population is statistically much older than national average with, for example, 30% more 55- 59 year olds, 50% more 75-79 years old than national average which means the practice is managing more frailty, long term conditions and social needs than practices with populations close to the national average.

The practice holds a General Medical Services contract (a contract between NHS England and general practices for delivering general medical services). There are four GP partners (two male and two female) and five GPs (two male and three female). There are four part-time GPs who undertake surgical procedures. The Charing Medical Partnership is training practice so alongside their clinical roles, the GPs are training three doctors to become GPs. There are two practice nurses (female) and four health care assistants (female) and two phlebotomists. There is a lead nurse, an advanced nurse practitioner, two trainee advanced nurse practitioners.

The GPs, nurses and pharmacists are supported by a practice manager and a team of administration and reception staff. A wide range of services are offered by the practice including weight management, asthma clinics, counselling services and complimentary therapies.

Responsibility for the overall leadership of the practice sits with the four GP Partners, the Business Manager and Practice Manager.

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

The Charing Medical Partnership is able to provide dispensary services to those patients on the practice list who live more than one mile (1.6km) from their nearest pharmacy premises. A pharmacy delivery driver delivers medicine to housebound patients.

The practice is situated within the Kent & Medway Integrated Care System (ICS) and delivers General Medical Services (GMS) to a patient population of about 11,000. This is part of a contract held with NHS England.

The practice is part of a wider network of GP practices. Charing Surgery is a member of the Ashford Rural Primary Care Network (PCN). The PCN comprises Charing, Ivy Court (Tenterden), Hamstreet and Woodchurch surgeries. Woodchurch Surgery is a member practice of the Ashford Rural Primary Care Network (PCN) along with Ivy Court Surgery, Charing Surgery and Hamstreet Surgery. The Ashford Rural PCN has 41,000 patients. The Clinical Director is the senior partner from Charing Surgery.

The PCN works together to deliver a number of services jointly including ultrasound, echocardiograms and domically INR (international normalised ratio), blood testing. The PCN consists of staff to support their patients including clinical pharmacists, first contact physiotherapists and social prescribers.

Information published by UK Health Security Agency (Public Health England) shows that deprivation within the practice population group is in the sixth lowest decile (two 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 1.3% Asian, 96.7% White.

The practice is open 8am to 6.30pm Monday to Friday and Saturdays 9am to 12.30pm.

Enhanced Access appointments available across the PCN between 6.30pm and 8pm, Monday to Friday and Saturday 9am to 5pm.

Out of Hours provision is commissioned by Kent & Medway CCG and fulfilled by Integrated Care 24 (IC24) and South East Coast Ambulance Service (SECAmb).

Updated 23 December 2022

We carried out an announced inspection at The Charing Medical Partnership on 19 and 20 July 2022. Overall, the practice is rated as Outstanding.

The key questions at this inspection are rated as:

Safe - Good

Effective - Outstanding

Caring - Good

Responsive - Outstanding

Well-led - Outstanding

Following our previous inspection on 10 February 2016, the practice was rated Good overall and for providing safe, effective, responsive and well-led services. The practice was rated Outstanding for providing caring services.

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

Why we carried out this inspection

This inspection was a comprehensive inspection as the practice had not been inspected since February 2016.

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting staff interviews using video conferencing
• Completing clinical searches on the practice’s patient records system and discussing findings with the provider
• Reviewing patient records to identify issues and clarify actions taken by the provider
• 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 have rated this practice as Outstanding overall

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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 and the surrounding community to share and deliver best practice. There was a wide range of services, clinical and non-clinical that recognised that a patient’s emotional and social needs were as important as their physical needs.
• 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.
• In response to patient feedback the practice had implemented a new GP led triaging system to ensure patients, urgent and non-urgent, were referred appropriately and efficiently to the most suitable health care professional.
• There were systems to promote continuity of care, with urgent appointments available on 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 which promoted teaching, training and development opportunities for staff and trainee GPs.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw several areas of outstanding practice:

• There was a proactive approach to anticipating and managing risks to people who use the service which was embedded and recognised as all staffs responsibility. The whole team were engaged in reviewing and improving safety and safeguarding systems.
• The practice was innovative and utilised the skills of GPs with special interests to reduce referrals to secondary health care providers for orthopaedic conditions and minor surgery.
• The practice recognised that patient’s emotional and social needs were as important as their physical needs by supporting a range of activities including gardening, walking and support groups.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services