Iridium Medical Practice

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We carried out an assessment of 7 quality statements under the Responsive key question.

We looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination.

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

The provider could not demonstrate that patients were always involved in decisions about their care. People were not always supported to give feedback or confident the provider would take it seriously and act on it.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

To improve patient’s experience the provider told us they offered 12-minute appointments instead of 10 minutes and they offered double appointments for more complex patients. They also offered 30-minute appointments for patients with mental health problems. However, the practice did not always make sure patients were at the center of their care and treatment choices. Care plans we reviewed did not always reflect physical, mental, emotional, and social needs of patients. The provider could not demonstrate that patients were always involved in planning for their care needs or involved in decisions about their care. Results from the national GP patient survey 2024 showed that for the following questions the practice performed below the local and national averages. Of those patients completing the survey, 78% said their healthcare professional they saw or spoke to was good at listening to them during their last general practice appointment. The local result was 83% and the national result was 87% When asked whether their needs were met at their last appointment 81% felt they were, the local result was 87% and the national result was 90%. Eighty-five percent of patients felt they were involved as much as they wanted to be in decisions about their care and treatment during their last appointment. The local result was 89% and the national result was 91%. The practice had carried out their own patient survey in December 2024. We saw that results were more positive and more in line with national results. The provider had identified where patient satisfaction was still lower than national and local levels and where further actions were needed. They planned to continue to monitor patient feedback to make further improvements.

The service understood the diverse health and care needs of patients and their local communities.

We saw the practice worked in partnership with other services to meet the needs of its patient population. Staff referred patients to the social prescriber and the PCN health inequalities lead was building relationships within the community to promote the take up of childhood vaccinations and cancer screening.

The practice worked with the local community healthcare provider to set up Integrated Neighbourhood Teams (INT). The INT supported the most complex patients who frequently used services and faced barriers to care. We saw that one of the GP partners was an integral part of the INT. The practice gave us data that showed the INT had led to reduced GP appointments and reduced hospital admissions for their patients and patients registered at local practices.

The practice provided GP services to 3 local care homes. Feedback from care home staff included that ward rounds and general advice was available from a nominated GP, this promoted continuity in care and helped to build a better patient/doctor relationship.

Patient feedback was mixed and although patients could mostly get a GP appointment when they needed one, they told us it was not always with the same GP. The provider was aware and was taking action to improve continuity in care for patients.

Information was available in a range of languages and different sized fonts. The practice had access to interpreter services, including British Sign Language. Information provided by the service met the Accessible Information Standard.

However, patients were not always informed when appointments were cancelled or if appointments were running behind schedule.

Other patient feedback included that patients were not aware of how to complain or that they were given incorrect information when they tried to complain. This led to delays in making their complaint and then receiving a response from the practice.

The service did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They did not always involve patients in decisions about their care or tell them what had changed as a result. Complaints were not always managed in line with the practice’s policy. Learning from complaints was not always evident and staff were not able to identify changes made as a result of patient feedback, including complaints. Patient feedback and feedback from external partners included that they were not supported to complain or that there were delays in the management of complaints. We saw that not all complaints were responded to in a timely manner, this was partly because there were not effective systems in place to receive complaints. From information the provider sent us, we saw that the practice had received 71 complaints between January and December 2024. Of these complaints, 47 complaints had not been upheld. We saw that many patients received a telephone call and that staff had documented that the patient no longer wished to pursue their complaint following the call. We asked for further information from the provider, as this did not align with their policy. However, it was not provided. The practice had a patient participation group (PPG). Representatives that we spoke to told us attendance at the meetings varied. The practice did not always give sufficient notice and members could not always attend due to other commitments and felt that communication from the practice could improve.

Following the assessment, the provider told us friends and family test surveys were sent out every month to gather patient feedback. They told us that data was analysed every 3 months and an action plan was implemented. From data we viewed, we saw that on average 74% of patients would recommend the practice. This was based on 2735 responses received during 2024. We also saw that patient satisfaction had fallen in December 2024, 65% of patients completing the survey would recommend the practice compared with 72% in November 2024.

In response to the National GP Patient Survey 2024 and from other patient feedback, the provider had identified changes to improve access to the service. For example, they promoted the use of their website and the NHS App to make appointments or order repeat prescriptions. We saw data that showed use of the NHS App for these purposes had increased.

The practice offered extended appointments for patients with complex needs or those with mental health problems.

Patients could access appointments on an evening or weekends.

People could access the service using different methods for example online, in person and by telephone.

Treatment rooms were available on the ground floor and premises were accessible to all patients.

Patient feedback about access was mostly positive with patients being able to make an appointment on the day. However, patients told us they did not know how to make an appointment in advance.

PPG representatives that we spoke to confirmed that access was good and they could make an appointment when needed.

During the onsite inspection we reviewed the appointment system and saw there was good availability of appointments with a range of staff.

Data from the National GP patient survey 2024 showed that of those patients completing the survey, 51% found it easy to get through to this GP practice by phone. This was higher than local results (40%) and the National average of 50%.

Of those patients answering the question how easy is it to contact your GP practice using the NHS APP, 46% found it easy. This was higher than local results of 39% and the National average of 45%.

The provider told us they used a triage system, which was supported by a duty/on call GP. This improved same-day patient access.

Staff invited patients who were more likely to encounter inequality in experience or outcomes to provide feedback on their experience, that could be used when developing services.

The practice worked with local organisations, including within the voluntary sector, to address any local health inequalities.

The practice was a safe surgery and the provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers.

The branch practice was accredited in 2021 as an armed forces veteran friendly practice.

However, there was limited evidence of digital flags within patient records to alert staff to reasonable adjustments that may be needed (other than when an interpreter was required). The provider had recognised this from the national and in-house patient survey results; as part of their action plan staff were in the process of identifying vulnerable patients and placing flags on their records to ensure better continuity in care for these patients.

From staff files we reviewed, the provider could not demonstrate that staff had completed required learning disability and autism training. We reviewed a sample of records for patients with learning disabilities and found that action plans were not always completed in line with good practice. When we questioned this staff showed a lack of understanding of why individualised care plans were required.

Patients were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Our records review showed patients were supported to consider their wishes for their end-of-life care, including cardiopulmonary resuscitation. This information was shared with other services when necessary. Care home staff reported that the GP visited on site to review patients who were end of life and that patients and or their carers/family were always involved in decisions as appropriate. However, the GP did not always complete do not attempt cardiopulmonary resuscitation or ReSPECT forms in a timely manner.