Archived: The Butchery

Updated 7 July 2022

Primary Care ENT

7 The Butchery

Sandwich

CT13 9DL

Primary Care ENT provide community outpatient Ear Nose and Throat (ENT) clinics. They are staffed by appropriately qualified medical practitioners. These clinics are held at local hospitals and GP surgeries. The Butchery is located within the same premises as a GP service and shares facilities such as the reception and waiting area.

Primary Care ENT Ltd is currently made up of the registered manager/nominated individual as the clinical provider and an administrative assistant who manages the logistics of the clinic. This assistant is employed by Primary Care ENT for three days a week.

Regulated activities include; doctors consultation and treatment service and diagnostic and treatment services. The registered manager is Dr Jonathan Webster and has been the nominated individual since June 2020.

At the three hospital sites (Victoria, QEQM and Spencer) there are also nurses/Health Care Assistants that support the clinic. These staff members are employed by the hospital and it is the hospital that maintains and ensures up to date mandatory training. While working in the ENT GPSI (GP with a Special Interest clinic) the hospital procedures and policies are followed.

The service opened in 2020 and sees and treats patients aged five years and over with an ear, nose or throat problem that are registered with a GP practice within the commissioning boundaries of the three CCGs (Clinical Commissioning Groups) (Canterbury and Coastal, South Kent Coast and Thanet). Patients younger than four are referred to secondary care ENT. In addition patients detained under the Mental Health Act will generally not have access to a community clinic and if they have an ENT problem then it is likely they would be referred to and seen in secondary care.

The weekly community clinics held at each hospital site are located in designated outpatient clinic areas which are run by the different hospitals.

Appointments are available at three locations, on three different days of the week in both the morning or afternoon

Only NHS patients were seen and treated at this service.

How we inspected this service;

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 7 July 2022

This service 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? – Good

Are services well-led? – Good

We carried out an announced comprehensive at The Butchery. We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 18 May 2022. The service is an NHS funded community ears, nose, and throat (ENT) outpatients clinic and is operated by Primary Care ENT Ltd.

The provider is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Our key findings were:

• Patients were protected from the risk of abuse as staff had received training in the safeguarding of vulnerable adults/children. There were written instructions for staff to follow in order to report suspected abuse.
• There was an effective complaints system available.
• The service had direct access to ear, nose and throat (ENT) waiting lists and ENT operating lists. This meant that patients did not have to attend the hospital for a consultation prior to a procedure and were placed on the operating list in a more effective manner.
• Patients had good outcomes because they received effective care and treatment that met their needs.
• The service received positive feedback from patients saying they were treated with a caring attitude and were informed about their treatment.

We found the following areas of outstanding practice:

• Services were tailored to meet the needs of individual people and were delivered in a way to ensure flexibility, choice and continuity of care.
• Feedback from people who use the service, those who are close to them and stakeholders is continually positive about the way staff treat people. People told us that staff go the extra mile and the care they receive exceeds their expectations.
• Patients who were seen in the clinic and where clinically indicated, were given open access to the clinic for a period after they have been “discharged”. This minimised delays for patients to be seen again for the same problem by avoiding the need to go back to their GP and wait for another referral. Patients instead could contact the clinic secretary directly and request a review appointment. This was particularly helpful for patients who have recurrent conditions such as nose bleeds, vertigo attacks and recurrent ear infections requiring frequent micro suction.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care