Friargate Surgery

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

Systems and processes were in place to monitor the treatment of people with long term conditions in line with national guidance.

Feedback from people indicated not everyone thought their needs were being met or their concerns heard. Feedback from partners indicated the approach taken by the GPs did not always meet the needs of people living in the care home and there was a lack of engagement with relatives. However, the results of the 2024 National GP Patient Survey were positive for confidence and trust in health care professionals.

However, we found a breach of the legal regulation in relation to person centred care. The uptake of immunisations was below the national target of 90% for 4 out of the 5 childhood immunisations, and the uptake of cervical screening was significantly below the national target. Following the inspection the practice provided data to support improvements in uptake of childhood immunisations and cervical screening. Although the data has not been verified, it demonstrated improvement in uptake.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Feedback from people using the service was mixed. Some people told us they thought the practice met their needs, whilst others felt they did not because they were not offered the treatment and / or medicines they requested. They did not feel that they concerns about their health were always listened to or heard when they spoke with GPs.

Staff who carried out reviews of people with long-term conditions had received appropriate training to carry out this role. For example, the practice nurse had completed a diploma in asthma management. Systems were in place to provide mental health reviews and NHS health checks.

Systems in to place monitor people with long-term conditions. GPs and nursing staff used clinical templates when carrying out reviews. They discussed the challenges of getting people to attend for blood tests and when booking appointments, staff took into account social aspects that may impact on attendance.

Clinical staff used templates when conducting care reviews to support the review of people’s wider health and wellbeing. The provider had effective systems to identify people with previously undiagnosed conditions. Our remote clinical searches demonstrated appropriate assessments for those people whose records were sampled.

Feedback from people using the service was mixed on whether people felt confident with how their care was managed. However, the results of the national GP patient survey 2024 indicated that 91% of people had confidence and trust in the health care professional they saw or spoke to.

Clinical staff followed best practice guidance and standards and used evidence based clinical templates to support the care and treatment of people. GPs attended on line training designed specifically for primary care.

Our remote clinical searches demonstrated that national guidance was followed in the management of people with asthma, hypothyroidism and diabetes to ensure care and treatment was evidenced based.

Systems were in place to act upon Medicines and Healthcare products Regulatory Agency (MHRA) alerts and other safety alerts. Our remote clinical searches showed that action had been taken where required and people had received information in relation to specific safety alerts. However, details of any additional precautions were not clearly recorded in people’s records.

Feedback from a representative of a care home where the practice provided care and treatment indicated the GP who predominately provided this service refused to engage with the rapid response team, to support people to remain in the care home. Following the assessment the provider told us they aware of one incident that had occurred but felt the right clinical decision had been made at the time for the person concerned. They also told us there were other examples which demonstrated working closely with the rapid response team to provide patient care in care homes.

The GP partners participated in multi-agency meetings to support vulnerable members of the community.

Commissioners shared information which demonstrated a care home had chosen to discontinue receiving care and treatment provided by the practice. When people were reviewed this was carried out remotely rather than face-to-face and included reviews of do not attempt cardiopulmonary resuscitate plans. This approach did not meet the needs of the people living in the care home and the care home transferred all of their residents to another GP practice.

Feedback from a representative of a different care home where the practice provided care and treatment indicated that practice staff were sometimes rude and unprofessional. Although the practice provided a weekly review of people living in the home, the visiting GP providing the service did not discuss the care of people living in the home with relatives when requested, which had upset both people living at the home and their relatives.

The GPs attended multidisciplinary meetings to ensure continuity of care for those people who were discussed. For these people, care was delivered and reviewed in a coordinated way when different teams, services or organisations were involved. The care co-ordinator and practice staff signed posted people to services in their local community for additional support. However, processes were no longer in place to engage with the local primary care network, resulting in patients missing out on services provided by the network.

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.

Our remote clinical searches demonstrated that people with asthma, who had received 2 or more courses of rescue steroids to treat an asthma exacerbation, had been followed up appropriately to monitor that the treatment had been effective.

There were systems in place for following up children who failed to attend for immunisations and women who failed to attend cervical screening. Following the inspection, the practice told us these had been successful in improving uptake.

There was an effective system in place to review certain health conditions such as hypothyroidism (a condition where the thyroid does not produce enough hormones) and diabetes.

The practice identified people with prediabetes and invited them to book one to one sessions with a specialist provider to gain a greater understanding of how to stay healthy and discuss available support.

A post ear irrigation audit had been completed, and no post irrigation complications were identified. However, that audit identified that a standard operating procedure pertaining to ear irrigation which included the process of cleaning and accurate record keeping of cleaning schedule needed to be developed.

The practice had undertaken a piece of work specially targeting improving the uptake of the MMR vaccine following the national measles outbreak. The practice identified people eligible for the vaccine and employed a variety of different methods to contact and invite them to book appointments. Between 01 December 2023 and 31 March 2024, 1,025 people had received their 1st dose and 714 people received their 2nd dose, with a further 432 2nd dose appointments booked during April 24. The practice had rerun the searches to identify any remaining people who had not received an MMR vaccine, so they could be invited in for their vaccine.

People with long-term conditions had an annual review to check their health and medicines needs were being met.

However, processes to achieve the national targets for the uptake of childhood immunisations and cervical screening were not effective. The uptake of cervical screening was 67.5% which was significantly below the national target of 80% (30 June 2023). National data showed the practice had not achieved the 90% minimum target in 4 of the 5 childhood immunisations for 2022/2023. Following the inspection the practice provided data to support improvements in uptake of childhood immunisations and cervical screening. Although the data has not been verified, it demonstrated improvement in uptake.

The practice had introduced a self-booking link for cervical screening appointments. The practice was aware of the transient nature of the practice population and that many people had their children immunised in their home country. Staff encouraged parents to bring in proof of immunisation status when registering at the practice.

We did not collect evidence to score this category.

Clinicians understood the requirements of legislation and guidance when considering consent and decision making.

There were policies in place to support staff when obtaining consent from adults, children and people that lacked mental capacity. There were systems in place to ensure appropriate staff received mental capacity training.