The Sidings 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 people in decisions about their care and treatment and provided them with advice and support. Staff did not always regularly review peoples’ care or work effectively with other services to achieve this.

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

This meant the effectiveness of peoples’ care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulations relating to safe care and treatment and governance.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

At our visit in February 2025 it was evidenced that the service did not always make sure patients’ care and treatment were effective.

Feedback from patients using the service was mixed. Patients did not always feel involved in assessment of their needs or that their needs were fully considered.

Other providers of care who used the practice were not always positive about the service received and told us that there were often delays in responding to requests for reviews when requesting by AskMyGP. They described issues with communication and a reluctance to attend when a GP was required to carry out a home visit to assess a patients’ needs. For example, they described end of life care reviews and prescribing as being delayed this led appropriate medication not always being in place for patients nearing the end of life.

A care co-ordinator based at the practice liaised with the care homes registered with the practice and when they were involved in manging the care requirements by the practice the response was described as good by the 4 care facilities we spoke with.

Our patient record reviews indicated that medication reviews were not always comprehensive and they had not always involved patients and fully considered their needs.

At out visit in April 2025 we found the provider had commenced a series of meetings with one of the other care providers to improve the relationships and understand the care requirements of their service users.

A member of the local management team had met with representatives of other care homes to improve relationships and identify improvements to care delivery.

We saw a new process included in the CWP to improve the quality of medication reviews which had been introduced following our visit in February 2025.

Recent improvements made or planned by the provider had not been implemented or in place for sufficient time to become part of normal working practice. The impact of the changes on patient care could not be assessed at this assessment.

The service did not always make sure patients’ care and treatment were effective. Patients did not always receive the required reviews for their care and treatment within the required timeframes.

The remote clinical searches that we undertook of the practices’ clinical records system showed the monitoring of people with some long-term conditions was not always in line with national guidance and recommendations. For example, we found 63 patients living with asthma who had been prescribed 2 or more courses of rescue steroids to manage acute exacerbation of the condition. We reviewed 5 randomly selected records all of which had aspects of management that had not followed evidence based guidance. We also found wrong doses of steroids being issued, inadequate clinical assessment, follow up not arranged in line with national guidance and overdue annual asthma reviews.

Eight patients living with a thyroid condition had not been monitored in line with evidence based guidance.

One hundred and ninety five diabetic patients had a very raised blood sugar result suggesting poor diabetic control which could result in complications associated with diabetes. We reviewed 5 randomly selected records all of which had aspects of management that had not followed evidence-based guidance. For example, annual diabetic reviews were overdue, medicines were not adjusted to improve diabetic control and patients were not followed up.

We reviewed records of 5 randomly selected patient living with kidney disease. All 5 patient records identified the patient had not been monitored in line with evidence based guidance, medical records were not always updated following receipt of hospital correspondence and patients were not followed up if they failed to attend appointments.

The issues identified above led to increased risk of deterioration and potentially poor outcomes for patients. The provider took immediate action to review all identified patients and arranged changes in treatment as required.

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. These included theme days for children to attend for vaccinations, increased number of staff skilled in administration, discussion regarding the importance of vaccination instigated early with pregnant women, discussion with families when attending for other issues and promotion of the importance of cervical screening in the practice waiting room.

At our visit in April 2025 leaders told us they were improving the systems in place to ensure patients received care and treatment in line with guidance. The CWP was in progress to review all patients with long term conditions in a sustainable way. We saw evidence of improvements in care to patients living with long term conditions during our visit.

Not all actions from the CWP had been implemented the time of our assessment and those in place had not had time to become embedded in normal working practice. The impact of the changes on patient care could not be assessed at this assessment.

At our visit in February 2025 we saw evidence that the practice had not always worked effectively with other services and key stakeholders or always have good internal working relationships.

Other care providers told us they were did not always feel communication was good between the practice and themselves and this led to poor working relationships with some of the team.

Relationships with the PCN, a group of GP practices who work together to provide some services to their patients had not been strong. Staff had not always been encouraged and supported to attend PCN meetings or actively engage with the other services within the network.

We were told by representatives of the Integrated Care Board (ICB) and Local Medical Committee (LMC) that relationships with the local management team had not been open and always effective.

Staff had access to the medical records but they did not always contain the information they needed to assess, plan and deliver peoples’ care, treatment and support. For example, we saw evidence of some missed diagnosis and records not updated to reflect new diagnoses from hospital correspondence and medicines not updated from hospital requests.

At our visit in April 2025 the provider confirmed issues had been identified with both the practical delivery of care and communication between other key stakeholders associated with The Sidings Medical Practice.

Meetings had taken place with other care providers to understand their specific requirements to improve the delivery of individualised care to the patients registered at the practice. We were told this work would be ongoing.

We were told by representatives of the ICB and LMC that improvements in communication and openness had been seen following recent changes within the practice and increased liaison.

Dedicated staff now attended PCN meetings and were encouraged to engage with other services.

Staff relationships were improving since changes in leadership and management. This had led to improvements in the staff working together to assess, plan and deliver care to meet peoples’ needs.

The improvements made had not had time to become embedded in normal practice and proof of sustainability was not yet available. Further work was also required to improve areas not addressed at the time of our report. The impact of the changes on patient care could not be assessed at this assessment.

At our visit in February 2025 we saw people were not always involved in reviewing their health and wellbeing needs or the reviews were not regular enough. For example, inconsistent evidence of patient involvement in medication reviews, people with long term conditions not being reviewed in a timely manner and patients with potential missed diagnosis diabetes did not always have follow up blood tests in a timely manner to confirm the diagnosis.

At our visit in April 2025 the CWP introduced by the provider included plans to improve patient involvement in medication reviews, a sustainable plan to manage long term condition reviews and routine checks for missed diagnosis.

People could access support to manage and improve their health and wellbeing so they could maximise their independence, choice and control. People were supported to live healthier lives and where possible with promotion of national initiatives related to health. For example, access to lifestyle advice was available in the practice and on the website.

People were informed about the availability of evening and weekend appointments. People whose first language wasn’t English were supported by an interpreter and provided written information in their preferred language. The service made reasonable adjustments for those who were nervous about attending or had specific needs. This included the availability of extended appointments.

The improvements made had not had time to become embedded in normal practice and proof of sustainability was not yet available. The impact of the changes on patient care could not be determined at this assessment.

At our first visit in February 2025 the service did not routinely monitor peoples’ care and treatment to continuously improve it. During our remote clinical searches we identified issues with monitoring in relation to blood tests and annual reviews being overdue. Medication reviews were not effective, medical records were not accurate and not following evidence based national guidance.

The CWP included actions to improve the monitoring peoples’ care and treatment and had been commenced at the time of our second visit in April 2025. The CWP had not been completed and further work was required to cover all aspects of care delivery.

National data showed that all 5 indicators for childhood immunisations and the uptake of women attending for cervical screening were below the minimum national target. The service had undertaken quality improvement activity to identify potential barriers to the uptake of immunisations and cervical screening and had plans to address these. This included discussion with families and pregnant women when attending for other medical issues to promote the immunisation of children and cervical screening. Staff trained in immunisation had increased and themed days aimed at children to encourage attendance had been run.

The service sought consent for procedures and made people aware of risks. The service had a good understanding of how to gain consent and documented this. We reviewed 5 randomly selected ReSPECT forms which were mostly well managed. One form which documented a lack of capacity and had representative involvement did not have evidence of a capacity assessment included.