Background to this inspection
Updated
22 September 2021
Birchington Medical Centre is located in Kent at:
Minnis Road
Birchington-on-sea
Kent
CT7 9HQ
The practice has a branch surgery at:
Orchard House Surgery
Bleak Road,
Lydd,
Romney Marsh
Kent
TN29 9AE
The practice and their branch surgery are located in different areas of Kent. Birchington Medical Centre is situated in East Kent and Orchard House Surgery in South Kent 40 miles away. Whilst there is a single patient list the practices operate day to day as separate surgeries.
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 a main practice and a branch surgery. Patients can access services at either surgery. However, they are geographically dispersed and therefore staff and patients predominately attend a single site.
The practice is situated within the Kent and Medway Clinical Commissioning Group (CCG) and delivers General Medical Services (GMS) to a patient population of about 8929. This is part of a contract held with NHS England.
The practice is part of a wider network of GP practices as part of Coastal and Rural East Kent (CARE) Primary Care Network.
Information published by Public Health England report deprivation within the practice population group as six on a scale of 1 to 10. Level one represents the highest levels of deprivation and level 10 the lowest.
Both practices, Birchington Medical Centre and Orchard House Surgery have an aging demographic above the local and national averages. They cater for a high proportion of patients experiencing a long-standing health care condition. Their patients have a high prevalence of coronary heart disease, obesity, hypertension, chronic obstructive pulmonary disease, cancer and atrial fibrillation.
There is a large and comprehensive clinical team to support patients registered with Birchington Medical Centre. There are five GPs providing patients with access to both male and female GPs, advanced clinical practitioners (Clinical Pharmacist, Advanced Paramedic, Paramedic practitioner, Complex Care Practitioner, Nurse Practitioner. Complemented by a large nursing team, with specialists in long term condition management and Advanced Healthcare Assistants). The team is supported by a large administrative team and reception team managed by the practice manager and overseen by corporate governance services at Invicta Health Community Interest Company.
Orchard House Surgery is the branch service of Birchington and has a smaller core team of staff providing services to their patients. There are two long term locum GPs (one male the other female). They are complemented by advanced clinical practitioners (Clinical Pharmacist, Paramedic Practitioner and Nurse Practitioner and a nursing team including healthcare assistants). The clinicians are supported by an administrative and reception team overseen by a practice manager and corporately by Invicta Health Community Interest Company.
Due to the enhanced infection prevention and control measures put in place since the pandemic and in line with the national guidance, most GP appointments were telephone consultations. If the GP needs to see a patient face-to-face then the patient is seen at their local surgery.
Neither of the practices provide out of hours services to its patients and there are arrangements with another provider (the 111 service/Integrated Care 24 limited) to deliver services to patients when the practice is closed.
Updated
22 September 2021
We carried out an announced inspection at Birchington Medical Centre on 6 August 2021.
Prior to this, the service was inspected on 30 April 2019. The practice was rated Requires Improvement overall and for the key questions of effective and well led. The practice was rated as good for the remaining three domains safe, responsive and caring.
We previously found;
- The overall governance arrangements were not consistently effective for the training, development and appraisal of staff.
- The practice was required to establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
We previously advised the provider they should;
- Continue to strengthen monitoring systems to ensure the practice can demonstrate that members of the nursing team are appropriately registered.
- Continue to monitor their responsiveness to patient enquiries, to improve patient confidence in contacting the practice by telephone.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for Birchington Medical Centre on our website at www.cqc.org.uk
The provider for this service has since changed. The service is now being managed by Invicta Health Community Interest Company.
Our inspection of the service conducted in August 2021 found significant improvements. We have rated the practice good overall and in each of the five domains, safe, effective, caring, responsive and well led.
Why we carried out this inspection
We conducted a comprehensive inspection as the provider had recently registered the service. Where previous concerns had been highlighted with the previous provider these were revisited to assess compliance.
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 and good for all population groups.
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.
- The staff told us of a positive work culture and environment where they were trusted and supported to work autonomously.
Whilst we found no breaches of regulations, the provider should:
- Ensure they document responses to risks identified.
- Provide a comprehensive narrative of discussions to illustrate actions taken.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care