Archived: Eltham Palace Surgery

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• 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. At the last inspection we rated this key question as Requires Improvement. At this inspection the rating has remained the same.

We found patients with long-term conditions were managed appropriately. We found the provider did not have clear systems in place for sharing information with relevant organisations. We saw evidence of a poor working relationship between the practice partners and the negative impact of this on staff working in the service

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We found that patients received appropriate monitoring and review of their long-term conditions.

At previous inspections in May 2023 and March 2024, we found patients requiring high dose steroid treatment for severe asthma exacerbations were not always followed up in line with national guidance to ensure they received appropriate care and that treatment had been effective. At this inspection in February 2025, we saw improvements had been made as patients now were being followed up in line with National Institute for Health and Care Excellence (NICE) guidance.

The provider’s processes for providing medical information to relevant organisations were unclear. A medical form had been completed by the practice which was required to be shared with the police regarding a patient. There were a number of alerts relating to diagnoses of concern on this patient’s record; when asked, the provider was unable to confirm the nature of these diagnoses. The patient had not engaged with the practice for over 3 years and had not been reviewed by the practice since the initial request for the medical form. We did not see evidence that the provider had considered or decided to share this information with the police. Therefore, there was a potential risk of serious harm or injury to this patient or others.

Following our inspection, the provider carried out a clinical record review of this patient. The provider notified the appropriate organisations, coded the patient and recorded their decision rationale on the patient record. The provider also completed an audit on all patients in the practice with the same medical form. We saw evidence that action had been taken for the identified patients.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

At our previous inspections in May 2023 and March 2024, we found there had been a breakdown in the partnership between the 2 GP partners which had impacted staff and patients. This was particularly demonstrated through recruitment issues at the practice. At this inspection in February 2025, we found these concerns remained. There had been an attempt at mediation between the partners; however, this had not resulted in a successful outcome. At the time of our inspection, it was unclear what further steps had been taken to encourage the partners to have a successful working partnership, or details of any future plans to assist in remedying the relationship.

Staff had raised concerns to the practice and directly to CQC. A member of staff had referenced the relationship between the 2 partners in an exit interview, saying that the relationship between the partners made it difficult to know the correct process to follow, as the 2 partners disagreed on approaches. Many staff we spoke to said they found it difficult to approach one of the partners and would often only go to the other partner with queries or concerns. Each partner worked 3 days per week. There were concerns that issues relating to patient safety may not be acted on immediately if staff did not feel comfortable raising them with one partner and instead delayed seeking appropriate assistance or guidance until the other partner was in work.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.