Archived: Orchard Medical Centre

Updated 10 March 2016

Orchard Medical Centre is a GP practice based in Coxheath, Kent. There are 4,366 patients on the practice list.

There is a principal GP (female) and a salaried GP (male). The GPs are supported by a practice manager, two practice nurses, a healthcare assistant and an administrative team.

Orchard Medical Centre is open 8am to 6pm, Monday to Friday. Appointment times are: 8:30am to12pm and 3pm to 5:30pm Monday to Friday. On Thursdays from 8.30am to 10.30am there is a walk in clinic and from 6.30pm to 8.15pm, there is a commuter clinic. There was an emergency number for patients to be able to contact the practice during the hours of 12.30pm and 2.30pm and after 6pm.

There are arrangements with other providers (Integrated Care 24) to deliver services to patients outside of the practice’s working hours.

The practice has a general medical service (GMS) contract and also offers enhanced services for example; minor operations and joint injections.

Services are delivered from; Orchard Medical Centre, 146 Heath Road, Coxheath, Maidstone, Kent, ME17 4PL.

Updated 10 March 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Orchard Medical Centre on 21 January 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles.
• 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.
• All risks to patients were consistently assessed and well managed.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
• The practice worked closely with other organisations and with the local community in planning how services were provided to help ensure that they met people’s needs.
• Urgent appointments were available the same day and pre bookable appointments were available up to 12 weeks in advance.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.
• There was a business plan that was monitored, regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles.
• There was a clear leadership structure and staff felt supported by management.

The areas where the provider should make improvements are:

• Review the infection control audit, to ensure that actions taken to address issues raised are formally recorded.

• Review processes for communicating with patients when appointment times are running behind schedule.

• Revise how staff meetings are held within the practice, in order to include whole staff teams meetings, as well as revise how minutes of meetings are recorded, to help ensure that actions from previous meetings are discussed and documented.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 10 March 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• National GP Patient Survey results show performance for diabetes assessment and care was 77.5%, which was comparable to the local clinical commissioning group (CCG) average of 77.5% and the national average of 77.7%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 10 March 2016

The practice is rated as good for the care of families, children and young people.

• There were systems to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances.

• Immunisation rates were high for all standard childhood immunisations, meaning that the majority of children registered at the practice received their immunisations.

• National GP Patient Survey results show performance for reviews of patients diagnosed with asthma was 77%, which was better than the local clinical commissioning group (CCG) average of 73% and the national average of 75.7%.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

• The practice’s uptake for the cervical screening programme was 83.7%, which was slightly above CCG average of 83.5% and the national average of 82.5%.

Updated 10 March 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 10 March 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs of this age group.

Updated 10 March 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 10 March 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including travellers and those with a learning disability.

• Longer appointments for patients with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.

• Vulnerable patients were informed about how to access various support groups and voluntary organisations.

Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.