Sidcup Medical Centre

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We looked for evidence that people were protected from abuse and avoidable harm.
At our last assessment, we rated this key question as Good. At this assessment, the rating has changed to requires improvement.
The service was in breach of legal regulation in relation Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment.
 

This service scored 56 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. We saw the service had an active risk register, which they monitored regularly and were following up areas of concern.
People felt supported to raise concerns and felt staff treated them with compassion and understanding. Representatives from the Patient Participation Group (PPG) felt the provider took concerns seriously and proactively made improvements to the service. Managers encouraged staff to raise concerns when things went wrong. During staff meetings, the whole team discussed and learnt from clinical issues. Staff felt there was an open culture, and that safety was a top priority. The provider had processes for staff to report incidents, near misses and safety events. There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support. Learning from incidents and complaints resulted in changes that improved care for others.
The complaints policy was reviewed in January 2026. The practice had received 71 complaints in the last 12 months. The significant event policy had been reviewed in March 2026. Staff reported a learning culture where staff were encouraged to report significant events which would foster learning and help prevent the recurrence of similar incidents in the future. The lead GP went through a significant event that they used as a learning event where processes were changed as a result of the event. This demonstrated that they had systems in place to review and learn from events when things went wrong or concerns were raised.
 

The service worked with people and healthcare partners to establish and maintain safe systems of care. Whilst they managed and monitored people’s safety and ensured there was continuity of care, including when people moved between different services. On the day of the site visit we identified that several clinical systems had backlogs in terms of tasks needing to be processed and completed, the practice could not provide us with assurance, via an audit trail, that the tasks were completed. When we raised this with the practice, they explained these backlogs were on their risk register and they had been working with an external company for the last 6 months to clear the backlog, but they still had a lot of work to do.
There were systems in place for processing information relating to new patients. The service worked with other providers to deliver shared care and when patients moved between services. In most cases referrals and test results were managed in a timely way. The practice had a designated team who were responsible for managing referrals, we saw urgent referrals were logged and managed and the majority completed. We received patient feedback noting that they had experienced delays with referrals. The practice told us they operated a duty doctor system, and any urgent emails, tasks and test results were processed the same day. The practice was responsible for 9 care homes we received feedback that sometimes there were delays in processing changes after medicine reviews and request for medicine adjustments were not always actioned promptly.
 

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately.
Policies were in place, we saw a separate adult policy (reviewed in January 2026) and child policy (reviewed in February 2026), however the policy mentioned staff training levels which did not align with intercollegiate guidance or the Royal College of General Practitioners (RCGP) guidance around safeguarding training levels. When we checked the staff training matrix and a sample of 7 staff files, we identified that the service did not consistently ensure that specific staff groups received training in line with best practice guidance. For example, some staff who acted as chaperones had not been trained to the level specified in the most recent intercollegiate and RCGP guidance. When we raised this with the practice, they said they would review their policy, and staff would be trained to appropriate levels.
The practice maintained a list of vulnerable people however we identified that the safeguarding list was not reviewed on a regular basis, only when there was an issue. Most staff were aware who the safeguarding lead was.
 

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.
Emergency equipment was available and maintained. Staff checked medicines and equipment and maintained logs of their checks. Staff could recognise a deteriorating patient and knew of action to take. For example, reception and care coordinator staff had been trained to identify and deal with certain conditions such as chest pains and sepsis. If there were any concerns they were escalated to the duty doctor to action, as necessary. We saw Sepsis posters in the waiting areas. We saw that basic life support and sepsis training had been completed for most staff. Patients were advised on risks related to their condition and actions to take if their condition deteriorated. At each of the 5 sites we saw oxygen and emergency medicines and a defibrillator were available.
 

At most sites the service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.
Contracts were in place to ensure the premises were maintained. Health and safety risk assessments and audits had been undertaken, risks identified had not always been addressed. For example, at one branch we saw a fire risk assessment had been completed by an external company in May 2025 however some of the recommendations had not been completed for example servicing the fire shutter and having it inspected every six months and retaining the evidence or modifying the fire exit door, nominating fire wardens and training them. At another branch a fire risk assessment had been completed by a staff member who was the designated fire warden however they had not completed fire warden training and fire safety signage was not seen on site. When this was raised the practice said this was on their risk register and they would ensure all fire wardens completed fire warden training and the risk assessment would be reviewed. Although the practice was undertaking daily water flushing, at some branches this had only recently been documented, and all 5 sites were overdue Legionella risk assessments. When we raised this the practice, they said they were in the process of getting Legionella risk assessments redone for all branches within the next few weeks.
 

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. However, the service did not consistently ensure that safe recruitment practices were followed. For example, we sampled 7 staff records and identified gaps in recruitment: 3 out of 7 staff records checked did not have a signed contract, 3 out of 7 staff records did not have a reference, 1 staff member did not have a CV or application, 1 staff member did not have evidence of proof of identity and 4 staff files did not have an induction checklist. We identified that several staff members had not had an appraisal in the last 12 months. When we raised this with the practice, they said this was on their risk register and appraisals were work in progress.
There were a range of clinical and non-clinical roles within the practice. We found generally training was up to date, learning needs and development of staff was managed appropriately, and staff were working within their agreed areas of competence.
The lead GP told us supervision supporting non medical prescribing was provided through embedded, real time GP oversight rather than separate scheduled supervision sessions. All non medical prescribers had immediate access to the duty GP during every clinical session.
 

The service did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly.
The practice had a designated infection, prevention and control lead and all staff had had relevant training. Cleaning schedules were in place and followed. Risk assessments and audits were completed, and actions taken to mitigate risks.
On the day of the site visits we identified infection control concerns that had not been reflected in the infection control audits, for example a ripped patient couch in the patient waiting area, and a ripped examination couch in the nurse room.
We also identified that the practice did not have complete immunity records for all staff, and they had not completed risk assessments if staff did not have all of the recommended vaccinations. The practice was not always consistently recording this for all staff. When we raised this concern, the practice informed us this was on their risk register, and they were in the process of getting complete accurate records for all staff.
We saw cleaning schedules were in use, however the practice only had records from February 2026 when the Operation Coordinators for all branches started their role, prior to this records were not kept. The practice did show us a declaration from a cleaning company stating it was identified that during the period from January 2025-April 2026 a signed hard copy of cleaning schedules was not in place however they had undertaken cleaning during this period.
We did not see cleaning schedules for specific equipment at all sites. We were given a blank sample template; however, it was not completed with details of any equipment having been cleaned.
 

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.
Staff involved people in reviews of their medicines and helped them understand how to manage their medicines safely. People knew what to do and who to contact if their condition did not improve or they experienced any unexpected symptoms. Staff received regular training, were competency assessed on medicines optimisation, and felt confident managing the storage, administration and recording of medicines. Staff managed prescription stationery appropriately and securely. We reviewed the process and saw that systems were in place to identify if prescriptions were being misused.
Staff followed protocols to ensure they prescribed all medicines safely, and ensured people received all recommended medicines reviews and monitoring. Medicines including controlled drugs were stored securely and at appropriate temperatures.
Generally daily records of the maximum and minimum temperatures of the fridges were recorded; however we did identify at one site the practice told us they entered temperatures onto an electronic system, and this was checked once daily, however the data logger was not functional as the logs we were shown were from 2025. When this was raised the practice said they would investigate. Staff were aware of what to do if any fridge had temperature readings outside of the required range. All fridges were lockable to ensure only authorised staff could access them.
Staff regularly checked the stock levels and expiry dates for all medicines, including emergency medicines, vaccines, and controlled drugs. Waste medicines were recorded and disposed of appropriately including medicines returned by patients. Staff stored medical gases, such as oxygen, safely and completed required safety risk assessments. The practice did not have an effective system to manage and respond to historical Medicines and Healthcare products Regulatory Agency (MHRA) safety alerts. For example, 1 search identified 20 patients prescribed a medicine used to treat depression/anxiety had not had the safety alert actioned. We sampled 5 out of 20 patient records and found with all 5 patients, the prescribers were not aware of the dose requirement in relation to the safety alert. We did not see any systematic process for actioning safety alerts. When we raised this with the practice, they said this was joint responsibility with the PCN pharmacist and lead GP.

Staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring. Staff took steps to ensure they prescribed medicines appropriately to optimise care outcomes, including antibiotics. There was a programme of regular clinical audits of prescribing that focused on improving care and treatment.