Halcyon Medical Centre

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We assessed all 5 quality statements under the caring key question. We looked for evidence that the practice involved people and treated them with compassion, kindness, dignity and respect. This is the first inspection for this practice since its registration with CQC. This key question has been rated as good.

We found people were treated with kindness, empathy and compassion. Staff understood that people’s experience was important and how people are treated and supported matters. People’s privacy and dignity was respected. Every effort was made to take their wishes into account and respect their choices, to achieve the best possible outcomes for them. This included supporting people to live as independently as possible. Staff talked passionately about caring for people, providing high quality services and putting people’s needs first. Staff understood and respected the diverse needs of their population and the practice had made significant improvements to its referral pathways, access arrangements and partnership working in order to meet these needs.

This service scored 80 (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 was good at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. All people we spoke to said they were listened to and treated with kindness and compassion. Several people described how they had been supported by staff at the practice. National GP patient survey data showed people felt listened to and treated with kindness. Members of the PPG we spoke with described friendly, caring staff.

Most reviews on Healthwatch and the NHS websites were positive and words used to describe staff included supportive, helpful and compassionate. Leaders told us they gather a range of people’s feedback including their ongoing in-house patient survey. In 2024 they received 100 responses (0.6% of the practice population which is slightly above the response rate as for the national GP patient survey for this practice) and 86% of people said they were treated with care and concern.

All the staff we spoke with during our assessment were passionate about providing high-quality care and identified the importance of making healthcare personalised and specific. For example, advocating for a person seeking asylum whose living conditions were exacerbating to their medical condition. We observed staff treating people with kindness and courtesy, supporting a person to register, coming in person to call patients from the waiting room and giving a cup of tea to an older person whilst they waited for their appointment. Privacy and dignity were respected with male and female chaperones available, privacy curtains in all clinical rooms and a mobile screen kept in reception for emergencies. There were arrangements to ensure confidentiality at reception, a private room was available and there was a separate quiet waiting area for people who required it.

Staff ensured reasonable adjustments were recorded and observed for people with protected characteristics or specific wishes for example, some transgender people preferred for their name not be displayed on the screens in the waiting room. We observed a culture of kindness and respect between colleagues.

The practice treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. People were treated with respect and dignity and supported to manage their health in a way that made sense to them. Comments made by people we spoke to suggested that staff took account of their individual circumstances during consultations. Staff explained how they assessed, understood and recorded people’s needs and preferences to make sure their care and treatment was individualised and tailored to their circumstances. This was corroborated in our record reviews. People’s personal, cultural, social and religious needs were understood and met. Staff used alerts on the clinical systems to make sure they were aware of any protected characteristics that required reasonable adjustments or communication needs. To accommodate these needs staff had access to interpreters, extended appointments, and chaperones. Staff told us they had recently learned about the British Sign Language video interpreting app and were encouraging their hearing-impaired patients to download it. People who were neurodiverse or had a learning disability could use a separate quiet waiting area. The nursing team described the need for open, frank but sensitive conversations as they worked with survivors of female genital mutilation (FGM) and transgender people who may still require cancer screening relating to the gender they had been assigned at birth. Transgender care was an important area for the practice and they had recently audited blood test monitoring for people having masculinising hormones which had resulted in an improvement from 76% to 100%. All staff had been given training on equality and diversity as well as autism and learning disabilities.

The practice promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing. Staff told us that they supported people who are not from the UK to understand what they are entitled to on the NHS and how the system works. The practice provided a choice of face to face or telephone appointments with a variety of healthcare professionals including nurses, advanced nurse practitioners, clinical pharmacists, a first contact physiotherapist and a social prescriber. The practice offered evening appointments until 8pm and Saturday morning appointments (when they offered cervical screening clinics routinely). Home visits were available and were assessed on an individual basis by the duty doctor.

The practice population included people who were asylum seekers and / or homeless and leaders described how they worked closely with local organisations to reduce health inequalities. A recent quality improvement project they had carried out resulted in all of this group of people being booked an initial appointment with a healthcare assistant as soon as they registered with the practice. This enabled a thorough assessment of both health and social care needs to be done immediately and suitable referrals made for example to the social prescriber.

Results from the national GP patient survey showed that 62% of people were offered a choice of day when booking their appointment which is above the national average of 53%. As a training practice there were appointments with GP trainees, people told us they were offered choice as to whether to see a trainee or not. Leaders told us that they had promoted the “Right to Choose” pathway amongst adults seeking referral for ADHD and Autism assessments of which, given the nature of their population they had significant numbers, this that meant people could choose which NHS mental health provider they were referred to.

The practice listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. The practice had a duty doctor system that ensured people with immediate needs had access to services. Staff we spoke with knew the process for referral to emergency support, including mental health crisis teams and had access to immediate verbal or written advice and support if required. All reception staff had training on signposting to other services such as Pharmacy First, identifying urgent conditions such as sepsis and understood when it was appropriate to book people with a clinician other than a GP. The reception and administrative teams were supported in dealing with concerns by office supervisors and the practice leadership team. People we spoke with felt their needs had been met by the practice and this was reflected in the national GP patient survey results.

We reviewed a random sample of staff training records and saw all staff had appropriate training in emergency procedures such as fire and basic life support. Staff understood the emergency procedures and their role in them. The practice held regular fire drills. Our remote searches of the practice’s clinical systems showed that staff were providing safety-netting advice ensuring people knew what to do should their symptoms worsen and this was recorded accordingly. Staff explained that because the practice is based in the city centre, homeless people who were not registered with the practice would walk in seeking medical assistance and they would be seen and supported appropriately.

The practice cared about and promoted the wellbeing of their staff and was exceptional at supporting staff to always deliver person-centred care. Leaders told us that when they took over the practice, they identified opportunities for growth in building relationships between staff and leaders. To address this, an independent company was employed to do a culture review. This gave all staff the chance to speak confidentially and openly about any issues. Following this review, actions were taken that improved the working relationships and culture significantly, evidenced by a reduction in staff turnover and numerous requests for trainees who had worked at the practice to return as substantive members of staff. An employee of the month scheme has been well received, a room has been converted into a staff lounge and the team had an away half-day in September 2024, giving staff space to talk in a neutral environment away from their work duties. A staff survey to evaluate the effect of the culture review and its outcomes was undertaken in November 2024, 50% of staff responded and it showed an overall satisfaction score of 8.7 out of 10 (10 being most satisfied).

The new management team had built positive relationships and worked hard to embed an open, honest and respectful culture which is now shared by all staff. Communication has been improved with the introduction of daily 10-minute huddle meetings and a staff ‘WhatsApp’ group. Staff told us they have been supported by the practice to develop their careers. For example, one HCA who joined as an apprentice is progressing on to a nurse associate training program. Salaried GPs also told us that they were supported to explore and develop their own areas of interest such as minor surgery. All staff knew who their freedom to speak up guardian was, said they felt confident to speak up and felt that their concerns would be acted upon. Staff we spoke with said they felt valued and that the practice was supportive, open and “like a family”.