Sandwich Medical Practice

Updated 21 December 2022

Sandwich Medical Practice is located at New Street, Sandwich, CT13 9ET. The practice is a training practice for trainee GPs.

The practice has a branch surgery at The Butchery Surgery, 7 The Butchery, Sandwich, CT13 9DL. We conducted an onsite visit to the branch surgery as part of this inspection.

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury and surgical procedures. These are delivered from both sites.

The practice offers services from both the main practice and the branch surgery. Patients can access services at either surgery. The provider intends to close the branch surgery around April 2023 when the extension at Sandwich Medical Practice is complete. All services will then take place only at Sandwich Medical Practice.

The practice is situated within the Kent and Medway Integrated Care System and delivers General Medical Services (GMS) to a patient population of about 12,790. This is part of a contract held with NHS England.

The practice is part of a wider network of GP practices in East Kent: Deal and Sandwich Primary Care Network (PCN).

Information published by Public Health England shows that deprivation score within the practice population group is seven (out of ten). The lower the score, 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 97.3% White, 1.2% Asian, 0.3% Black, 1.2% Mixed and 0.2% Other.

The number of patients aged 18 to 64 closely mirrors the local and national averages. The practice has a slightly higher than average proportion of patients over the age of 65 and a slightly lower than average number of patients under the age of 18.

The practice consists of three GP partners (male and female) and six salaried GPs (male and female). The GPs are supported at the practice by six practice nurses (female); one nurse prescriber (female); one advanced nurse practitioner (female); one paramedic (male); one advanced clinical practitioner (female); three health care assistants (female) and a team of reception and administration staff. The practice management team consist of a practice manager, deputy practice manager, business manager, senior administrator and senior receptionist who provide managerial oversight. All staff provide cover at both practices.

Both practices are open between 8am and 6.30pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

Extended access is provided locally by the PCN, where late evening and weekend appointments are available. Out of hours services are provided by NHS 111 and Integrated Care 24 (IC24). NHS 111 and IC24 deals with urgent care problems when GP surgeries are closed.

Updated 21 December 2022

We carried out an announced inspection at Sandwich Medical Practice. We conducted remote clinical searches on the practice’s computer system on 7 November 2022 and conducted an onsite inspection of the practice on 10 November 2022 under Section 60 of the Health and Social Care Act 2008, as part of our regulatory functions.

Overall, the practice is rated as Good.

The key questions at this inspection are rated as:

Safe – Good

Effective – Requires Improvement

Caring – Good

Responsive - Good

Well-led – Good

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

Why we carried out this inspection

This was a comprehensive inspection to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection focused on the following:

• Are services safe?
• Are services effective?
• Are services caring?
• Are services responsive in relation to access?
• Are services well-led?

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 Good overall.

We found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• The practice had systems and processes to keep people safe.
• Appropriate standards of cleanliness and hygiene were met.
• The practice learned when things went wrong.
• The practice demonstrated that staff had the skills, knowledge and experience to carry out their roles.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs.
• The way the practice was led and managed promoted the delivery of high-quality, person-centred care.
• There was evidence of systems and processes for learning, continuous improvement and innovation.
• Our clinical record searches found improvement was required in relation to the safe management and monitoring of some high-risk medicines, safety alerts and patients with long-term conditions.

We found one breach of regulation. The area where the provider must make improvements are:

• The provider must ensure there are effective systems and processes to ensure person centred care.

The area where the provider should make improvements are:

• Continue to ensure there are alerts placed on all family and other household members of children on the at-risk register.
• Continue to monitor and review their action plan in relation to the management of patients diagnosed with chronic kidney disease stages four or five, hypothyroidism, and diabetic retinopathy.
• Continue to monitor and improve the practice’s system for acting on Medicines and Healthcare products Regulatory (MHRA) safety alerts to help ensure processes are being followed and embedded.

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