Iridium Medical Practice

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that staff involved patients in decisions about their care and treatment and provided them advice and support.

At our last assessment, we rated this key question as requires improvement. At this assessment, the rating has changed to good.

Staff had a thorough understanding of the needs of the patient population they served. Care delivered was based on up-to-date evidence and national guidelines. Teams worked well together and the practice provided opportunities for health promotion and education. Staff understood and worked to overcome barriers to effective care and treatment for vulnerable groups. The practice used data and feedback to monitor the effectiveness of treatment. All staff complied with legal requirements for obtaining consent.
 

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The practice made sure patients care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. At our previous inspection some patients told us they did not feel involved in assessment of their needs or that their needs were fully met. At this inspection we did not have any negative patient feedback about the assessment of needs. Results from the National GP Patient Survey 2026 to the question ‘Did the health professional you saw have all the information they needed about you’ showed a consistent improvement over time from 84% in 2024 to 92% in 2026 which is similar to the national average. Staff used digital flags within care records systems to highlight individual needs, such as the requirement for a translator. The practice had implemented a robust system for reviewing these flags to ensure they were up to date and this was monitored and reported to the governance team.

At our previous inspection we found that medicine reviews were not always comprehensive, a proportion of patients with undiagnosed conditions had not been identified and medical records did not always clearly document the reasoning for clinical or prescribing decisions. At this inspection clinical searches carried out by a GP Specialist advisor did not find any concerns regarding the assessment of patients’ needs. Staff checked patient’s health, care, and wellbeing needs during health reviews. Clinical staff used templates when conducting care reviews to support the review of patient’s wider health and wellbeing. The provider had effective systems to identify patients with previously undiagnosed conditions.

In response to our previous inspection and feedback from staff at the practice an audit had been carried out of the annual reviews of 21 learning disability patients. The audit highlighted areas for improvement and led to the appointment of a Learning Disability Clinical Lead who was tasked with improving the services provided to this group of patients. This resulted in tangible benefits for patients as 100% of patients had received an annual review and the number of patients with a Health Action Plan increased from 54% to 95%.

Staff understood the needs of their local population and could refer patients to a social prescribing team. This team was managed by a health inequalities lead and all members collaborated with the integrated neighbourhood team to provide support to the most vulnerable patients and overcome barriers to care.
 

The practice planned and delivered patients care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Systems were in place to ensure staff were up to date with evidence-based guidance and legislation.

Searches of the clinical system showed that patients prescribed high-risk medicines were monitored and reviewed in line with guidelines. Care plans we reviewed were individualised and comprehensive. At our previous inspection, we identified that care provided to some patients with asthma and those with learning disabilities was not in line with guidelines. The practice had undertaken audits to review the care for these groups and implemented improvements to ensure care was delivered within guidelines. For example, patients with an exacerbation of asthma who were prescribed a steroid medicine were previously not consistently reviewed. The practice initiated a digital pop up when the steroid was prescribed to remind the prescriber to book the required follow up appointment.

Systems were in place to ensure that staff maintained up to date knowledge of relevant clinical evidence, guidelines and safety alerts. Staff records we reviewed showed all staff were up to date with relevant role specific training such as immunisations updates. Staff described how they accessed opportunities to maintain their continuing professional development and were supported in this via the appraisal system, paid time off and support with the cost of professional courses.

However, the provider was not meeting national targets for the uptake of childhood immunisations or cervical cancer screening. We discussed this with the provider who told us of the actions they were taking to improve this.
 

The practice worked well across teams and services to support patients. Staff had access to the information they needed to appropriately assess, plan, and deliver patients care, treatment, and support. The practice worked with other services to ensure continuity of care.

Following our previous inspection work had been undertaken to develop and strengthen IT systems to ensure that staff had timely access to the information they needed. Governance systems were in place that allowed information to be effectively managed, updated and shared across the organisation. Staff had access to a shared electronic system which allowed them to view patient records from in-patient admissions. External stakeholders such as those providing out-of-hours services could access and record information within the practice systems.

Multiple staff including the lead GP and health inequalities lead participated in the local Integrated Neighbourhood Team and worked with other staff from the local authority, Primary Care Network and Community Healthcare Trust to provide seamless care and prevent hospital admissions for their most vulnerable patients.

The practice provided GP services to 3 local care homes. Care home staff we spoke with told us they could contact the practice by telephone or a dedicated email address. Staff at one care home felt that although previously complaints had not been well managed things had improved over the last 12 months. Staff at another care home reported that they had weekly ward rounds with a GP by telephone. They described a good relationship with the GP and they had never needed to complain. Feedback regarding regular meetings with the practice was inconsistent. Staff at both the care homes we spoke to advised that their residents had timely access to vaccinations and that medicine requests were dealt with efficiently.
 

The practice always supported patients to manage their health and wellbeing to fully maximise their independence, choice and control. Patients were supported to live healthier lives and where possible, reduce their future needs for care and support.

The practice provided a smoking cessation service and supported patients in the last 12 months of their lives.

The practice social prescribing team provided appointments, group sessions and drop-in clinics with the specific aim of reducing barriers to care, preventing hospital admission and facilitating behavioural and lifestyle modification. The practice ran a variety of regular clinics such as:
• Energy clinic providing information and support for patients experiencing energy poverty and / or debt, high utility bills and difficulty managing household costs.
• Occupational therapy clinic providing mobility assessments, equipment for the home and falls prevention work.
• Domestic abuse support providing emotional support, confidence building and housing advice.
• A disability resource clinic providing advice about benefits, housing, debt management and the blue badge scheme.
• An employment support clinic including skills development, return to work planning and confidence building.
• A diabetes support clinic providing a personalised care plan including healthy eating and diet workshops, fitness sessions and education.

The social prescribing team could also refer patients to a wide range of other services including weight management, exercise on prescription and mental health services. The team also used searches of the clinical system to identify cohorts of patients who were most likely to experience inequalities or barriers to healthcare and target interventions accordingly. Staff we spoke with were able to provide examples of successful interventions. This included supporting a refugee family with complex health and social care needs to apply for leave to remain in the country, obtain financial support and receive comprehensive assessments of their medical needs. In another example staff facilitated an elderly patient with mobility needs to access a chair-based exercise program which improved their independence and reduced social isolation.

Staff from the practice were an integral part of the local Integrated Neighbourhood Team supporting vulnerable patients with complex needs to improve their overall health and wellbeing and reduce their use of GP appointments and hospital admissions.
 

Following our previous inspection the practice had taken action to revise and improve their systems and governance processes to benefit patients, particularly those with long-term conditions. The practice ran regular searches to identify patients who required annual reviews of their condition or medication, capture patients who may have missed diagnoses and ensure that patients on high-risk medicines had the required monitoring on time. This was corroborated by the clinical searches we conducted and the patient records we reviewed.

The practice had completed numerous audits to review the quality of patient care and measure performance against national guidelines. For example, a recent audit of end-of-life care showed that 95% of patients were involved in decision making and 95% of records documented a clear clinical rationale for the decisions made. Compliance with recent guidelines regarding the hospital referral of high-risk patients following non-fatal strangulation had been audited and showed that clinicians were aware of and following the new guidelines. Audits also resulted in quality improvement work. For example, an audit identified that children who did not attend appointments were not always recorded using the correct ‘child not brought’ code. This coding is important to support safeguarding, follow-up and rebooking arrangements. The audit identified one staff group were not recognising and coding these encounters appropriately and training was provided to improve this.

There were effective systems in place to ensure that a result was received for every cervical screening sample taken and that where samples were inadequate staff were informed.
The service had a dedicated Health Inequalities Team overseeing the social prescribers who monitored referral activity and assessed the impact of clinics and projects they offered. An audit of high-volume attenders referred showed that the interventions resulted in a reduction in appointment use.

However, the provider was not meeting national targets for the uptake of childhood immunisations or cervical cancer screening. There are 5 cohorts of childhood immunisations and the practice ranged between 81.5% - 91.4% for the period up to 31 March 2026. The national target for these immunisations is 95%. Only 1 cohort of immunisations showed an improving trend over time. The most up to date data held by CQC for cervical screening (from 30/6/2024) showed that for eligible patients aged 25-49 years 64% of patients had been screened. For the age group 50-64 years 74% had been screened. The national target is 80%. We discussed this with the provider who shared more recent data which showed an improving trend and told us of the actions they were taking to improve further. However, this was unverified data and the CQC uses data collected as part of the NHS Cervical Cancer Screening programme to look at a practice’s clinical effectiveness in cervical cancer screening. The practice had a dedicated administrator who was in charge of contacting patients for cervical screening and parents and carers for child immunisations. There was an embedded process of repeated contact, patient education and follow up of patients who did not attend or children who were not brought. The practice had plans to improve information sharing for both groups with posters, leaflets and videos. The practice recognised that patient education was the biggest barrier to uptake due to differing cultural attitudes and norms. Work was ongoing to address it.
 

The practice told patients about their rights around consent and respected these when delivering person-centred care and treatment. Staff understood and applied legislation relating to consent. Capacity and consent were clearly recorded. Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation.