During an assessment under our new approach
Date of Assessment: 31 July 2026. Castle Medical Group is a GP practice and delivers services to approximately 18,000 people under a contract held with NHS England. According to the latest available data, the ethnic make-up of the service area is approximately 96% White, 1.3% Asian, 1.5% Mixed, 0.5% Black and 0.2% Other. Information published by the Office for Health Improvement and Disparities shows deprivation within the service population group is in the 9th decile (9 of 10). The lower the decile, the more deprived the service population is relative to others.
This was a focused assessment. We undertook this assessment due to the length of time since our last assessment. We assessed 12 quality statements from across all 5 key questions. This assessment considered the demographics of the people using the service, the context the service was working within and how this impacted service delivery. Where relevant, further commentary is provided in the quality statements section of this report.
The assessment identified significant concerns regarding the safe management of medicines, patient monitoring and clinical oversight. Reviews of patient records found examples where patients continued to receive treatment despite overdue monitoring requirements, medication reviews had not always been completed appropriately, and follow-up actions were not always undertaken when concerns had been identified. Concerns were also identified in the management of medicines subject to national safety requirements. As a result, patients were exposed to a risk of avoidable harm, and we identified a breach of safe care and treatment which resulted in the issue of a Warning Notice to the provider.
Although the service maintained a clean and safe environment, managed infection prevention and control effectively and ensured equipment was appropriately maintained, medicines were not always managed safely, and people did not always receive care and treatment in line with current evidence-based guidance and best practice. Systems for monitoring patient outcomes had not always operated effectively and risks were not consistently identified, monitored or acted upon.
Patient feedback was generally positive and people described staff as kind, caring and respectful. Performance data demonstrated positive outcomes in some areas, including childhood immunisations and cervical screening. The service had also taken steps to support equitable access and reduce barriers for people with additional needs. However, some patients reported difficulties accessing the service and contacting the practice when required.
Leaders had a clear vision for the service and had begun implementing improvements in response to the concerns identified. However, governance and clinical oversight arrangements had not been effective in identifying and addressing risks relating to medicines management, patient monitoring, follow-up arrangements and staff training compliance. The concerns identified through the assessment had not been recognised through the provider's own systems, which meant leaders could not be assured that patients were consistently receiving safe and effective care and treatment.