Tieve Tara Medical Centre

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 people in decisions about their care and treatment and provided them advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this.

At our last assessment, we rated this key question as good. At this assessment, the rating remains the same.

This service scored 67 (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 people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing, and communication needs with them.

Patient feedback from the 2025 National GP Patient Survey indicated that satisfaction with how the practice worked with them to assess their needs was generally at or above local and national averages. For example, 93%felt the healthcare professional they saw had all the information they needed about them during their last general practice appointment compared to a local average of 93% and a national average of 92%.

The provider had implemented care navigation processes to assess initial patient needs, and requests were triaged by the practice duty doctor when required. Reception staff also utilised digital flags within the care records system to highlight any specific individual needs, such as the requirement for longer appointments or for a translator to be present. Staff checked people’s health, care, and wellbeing needs during health reviews. Clinical staff used templates when conducting care reviews to support the review of people’s wider health and wellbeing.

Overall, we found that patients with long-term conditions were effectively supported and managed. The provider had effective systems to identify patients with previously undiagnosed conditions through routine and specific testing. However, when we examined the potential for missed diagnosis of chronic kidney disease stages 3-5 we found that in 3 out of 5 records reviewed, that a test to check how well the kidneys were working (urine albumin to creatinine ratios) had not been done. Following our feedback on this matter the practice told us that patients were to be reviewed.

The provider had a good understanding of the prevalence of local conditions such as diabetes and had trained staff in how to assess and support their needs. In addition, the provider held registers of patients who were vulnerable or needed enhanced care and support such as palliative care patients, or those patients with a learning disability, and used this information to target and manage support.

Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber.

The service planned and delivered people’s 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.

The provider had systems and processes to keep clinicians up to date with current evidence-based practice. The provider told us that new guidance was discussed at the practice’s weekly clinical meeting, and could also be briefly highlighted at short daily meetings (huddles). The weekly clinical meetings had been suspended for a period of time, but had restarted prior to our assessment. For those unable to attend clinical meetings or huddles, changes in guidance were cascaded to relevant staff via emails.

The provider used clinical supervision sessions and clinical audits to assure themselves that guidance was being followed.

The service worked well across teams and services to support patients. They shared thorough assessments of needs when patients moved between different services, to ensure appropriate care and treatment was provided.

Clinical staff had access to the necessary information they needed to appropriately assess, plan, and deliver care, treatment, and support. This work was supported by the use of standardised clinical templates, and their own patient management processes. The practice worked with other services to ensure continuity of care, including where clinical tasks were delegated to other services. We heard for example, how staff were able to refer on to other specialist services for enhanced patient care such secondary care and community services.

The provider worked closely with their primary care network (PCN) pharmacy team, members of which worked closely with clinical staff from the practice, and who undertook duties which included medicines reviews and medicines reconciliation. Managers from the practice met regularly with their PCN to discuss service developments and quality improvement.

The provider told us that it intended to improve communications with staff who were absent on long-term sick to keep them updated on key issues.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Processes were in place to identify risks to patients’ health, including those in the last 12 months of their lives, patients who were at risk of developing a long-term condition, and those with caring responsibilities.

We saw that the provider delivered a range of health assessments which included NHS health checks, and learning disability health checks.

Staff had been trained, and could refer or signpost patients with specific needs to other organisations. Working within their primary care network, the provider had access to social prescribers and health and wellbeing coach support. In addition, patients were able to access Spectrum People, a local charity affiliated with the provider which offered access to arts-based therapeutic activities and natured-based wellbeing support, as well as social prescribing support. We saw testimonials from patients who had accessed the services, and who confirmed the positive impact this support had had on the physical and mental health, as well as improving their confidence and social wellbeing.

The service regularly monitored people’s care and treatment to continuously improve it. They sought to ensure that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Overall, we saw that patients with long-term conditions had been well managed. We saw for example, that the provider had made improvement to their long-term conditions management processes with regular clinical reports being run to identify and invite in patients for scheduled reviews. Dedicated appointment slots had been allocated to these reviews, and flexibility built into the system which allowed weekend access for these. When appropriate multi-condition reviews were undertaken. Similar, access arrangements have been put in place for NHS Health checks and other assessments.

We saw 90% of respondents to the 2025 National GP Patient Survey felt their needs had been met during their last general practice appointment compared to local and national averages of 90%.

The provider had used clinical audits to measure assurance and to drive quality improvement, and had a developed clinical audit programme in place. The depth of clinical audits were variable, with some being restricted to the findings of clinical searches and ongoing actions. Other audits including consultation and prescribing audits and assessments were more comprehensive.

From published data we saw that the provider was below the national target for cervical screening with latest published screening performance (31 March 2025) of 69.6% of 25-49 year olds and 64.2% of 50-64 year olds against a target of 80% for both age groups. The provider had recognised this underperformance and put in place revised measures to increase take-up. Activities included proactive contacts with patients by members of the nursing team, and the follow-up of non-attenders by a care coordinator. Booking slots had also been made more flexible, and appointments for screening had been made available at weekends. As part of this assessment the provider sent us unverified/unpublished information based on Quality Outcomes Framework (QOF) data which indicated an increase in cervical screening performance of 14.1% for 25-49 year olds, and 14% for 50-64 year olds. Other unverified/unpublished information supplied to us showed similar improvement in QOF performance during 2025/26 for conditions such as diabetes management.

Bowel screening rates (2023/24) for patients were near the national average at 70.7% compared to the average of 71.8%, however the figure for breast screening rates for this period were significantly lower at 54.4% compared to a national average of 70.4%. When we raised this with the practice, they told us that this had been recognised and actions had been taken to improve performance. This included a large scale communications/media campaign using their online consultation and messaging system, as well as other social media, and the use of practice notice boards and call screens. Formal data submitted to us by the practice showed in 2024/25 breast screening coverage for 53 to 70 year olds had risen to 66.6% and uptake rates had risen to 64.9%. This approach has since been adopted by the primary care network cancer team, and they have recommended the approach to other practices. As a whole the provider was aware of the challenging nature of the local patient population for participation in screening programmes, and saw this as an important area of work. Other actions had included raising patient awareness at local events.

Child immunisation performance was satisfactory with 3 of 5 target measures exceeding the 95% World Health Organisation coverage target, and 2 out of 5 meeting the 90% minimum target. The provider told us that they had measures in place to escalate concerns regarding the failure to vaccinate children and attend planned appointments, and worked with other partners to promote uptake.

The provider had 43 patients on the learning disability register. In 2024/25 we saw that 81% of these patients had received a learning disability health check and completed a health action plan. In the period 1 April 2025 to 6 March 2026, we saw that of 45 registered learning disability patients that only 33% of patients had received a health check and action plan. The practice explained to us that they were aware of this performance, and usually undertook these reviews during March and April, and therefore the work was currently ongoing. We were informed by the clinical lead that invitations had been sent out, and clinics booked for these remaining patients. They had in addition also identified in-year coding issues which they told us had made these latest performance figures appear low. This was being rectified.

The service told people about their rights around consent, and respected these when delivering person-centred care and treatment.

Staff we spoke with all had a good understanding of consent, including care which would require more detailed written consent, considerations to be given when providing care to children and young people, and the need to assess the mental capacity of patients to give consent. We saw that staff had received appropriate training in the requirements of mental capacity legislation and best practice principles. Results from the 2025 National GP Patient Survey show that patients were actively involved in their care, with 94%of respondents reporting that they were involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment, this compared to local and national averages of 91%.

From a search of 5 patient records, we saw that ReSPECT forms (Recommended Summary Plan for Emergency Care and Treatment – a document which holds personalised recommendations for a person's clinical care in an emergency), which included decisions related to Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were accessible to staff, and had been completed in line with relevant legislation. However, in all 5 cases we saw that these decisions had been made over 12 months previously, and were therefore in need of review. We heard later from the practice that they had reviewed some of these decisions, and were in the process of completing reviews of others.