St Anne's Group Practice

Updated 29 August 2018

St Anne’s Group practice delivers services from two sites, St Anne’s Surgery and Beltinge Surgery. Both are located in Herne Bay, Kent. At St Anne’s Surgery all patient areas are on the ground floor and are accessible to patients with mobility issues, as well as parents with children and babies. There is one consulting room on the first floor at Beltinge Surgery which is primarily used by the counselling service. A lift is available to help make this service accessible for all patients.

There are approximately 14400 patients on the practice list. The practice has more patients aged 85 years and over (practice average 4%, local average 3% and national average 2%).

Information published by Public Health England, rates the level of deprivation within the practice population group as six on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

The practice holds General Medical Service contract and consists of nine GP partners (six male and three female) and one salaried GP. St Anne’s Group Practice is a training practice so, alongside their clinical roles, the GPs provide training and mentorship for trainee GPs. There are currently two GP registrars training at the practice. The practice has employed a paramedic (male). There are seven practice nurses (female), a lead nurse (female) one pharmacist (female), two healthcare assistants (female), a phlebotomist (phlebotomists take blood samples). Alongside their clinical roles the nurses provide training and mentorship for student nurses.

The GPs, nurses and pharmacist are supported by a practice manager and a team of administration and reception staff. A wide range of services and clinics is offered by the practice including: asthma, diabetes and antenatal clinics. There is a seven day a week minor surgery unit at the Beltinge branch where patients across Kent can receive services such as cataract surgery.

The practice is open Monday to Friday from 8am to 8pm. Morning appointments are from 8.40am to 11.30am, afternoon appointments are from 2.30pm to 5.30pm and evening appointments are from 6.30pm to 7.30pm.

An out of hours service is provided by NHS 111, outside of the practices opening hours. There is information available to patients on how to access this at the practice, in the practice information leaflet and on the website.

Services are delivered from:

161 Station Road, Herne Bay, Kent, CT6 5NF and

269 Reculver Road, Beltinge, CT6 6SR.

We visited both sites during the inspection.

Updated 29 August 2018

This practice is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Outstanding

Are services well-led? - Good

We carried out an announced comprehensive inspection at St Anne’s Group Practice on 22 May 2018. This inspection was carried out under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned 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.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured care and treatment was delivered according to evidence- based guidelines.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• There was a clear leadership structure and staff felt supported by management.
• Patients we spoke with and some comment cards indicated that patients sometimes found it difficult to get through to the practice on the telephone and to access routine GP appointments. The practice was aware of this and were looking at establishing a reception hub to deal with phone calls in a different way. Urgent appointments were available on the same day.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw areas of outstanding practice:

• The practice worked collaboratively with a health and social care organisation that worked across mental health, learning disability, substance misuse, primary care, the criminal justice system and employment.
• The practice had employed a pharmacist and Herne Bay Town had also employed a pharmacist, between them they were doing polypharmacy medication reviews as well as post discharge medicines reconciliation and though not specifically targeting the elderly, inevitably however, because of their demographics, this was often focussed on elderly patients.
• The practice and community pharmacists were working with the other Herne Bay practices and starting to develop a one stop shop for Diabetes. This would be for the whole town, however currently it was just for patients at St Anne’s Group Practice. This was run by a GP, a practice nurse and a pharmacist. The plan was to relocate to the Queen Victoria Hospital and that both practices in Herne Bay would cover on a rota basis.
• There was a proactive approach to understanding the needs of different groups of patients and to deliver care in a way that met these needs and promoted equality. This included patients who were in vulnerable circumstances or who had complex needs. For example, the practice funded a GP led substance misuse service in partnership with a national health and social care provider that provided patients with access to weekly clinics.
• The practice had been proactively involved with the Herne Bay Care Home pilot scheme, which was part of the East Kent Frailty Service being developed across the whole health Economy. The project which was funded for three months, targeted care homes which were then visited by a community geriatrician and a GP who would arrange with the home to review patients and produce high quality anticipatory care plans for patients. The second phase of the project which was about to be implemented was the reactive element, whereby the care home would have a single number to ring, instead of defaulting to 999 which would enable the care home to get immediate clinical advice or a visit if necessary to try and reduce further hospital admissions. The practice continued to support this scheme without any funding.
• There was seven days a week access to minor surgery at St Anne’s Group Practice including cataract surgery, dermatology and carpal tunnel surgery. The practice had performed approximately 220 per year which was 35% of East Kent procedures. Patients attended the Beltinge location minor surgery unit from all East Kent CCG’s (clinical commissioning groups). The success rate was last measured up to January 2017 and the success rate measured by patient self-rating questionnaires stood at 88%.
• The practice had had an increase in the number of MARAC (multi-agency risk assessment conference) referrals to the point where they are one of the highest areas in East Kent.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Updated 29 August 2018

Updated 29 August 2018

Updated 29 August 2018

Updated 29 August 2018

Updated 29 August 2018

Updated 29 August 2018