Castlegate & Derwent Surgery

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

People were involved in decisions about their care. The service provided information people could understand. People knew how to give feedback. People received fair and equal care and treatment. People were involved in planning their care and understood options around choosing to withdraw or not receive care.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The latest national GP survey carried out in 2024 showed a decline in patient satisfaction at the surgery both against local and national averages.

Since our last assessment the practice had implemented electronic prescribing based on patient feedback. The practice had implemented total triage only a few weeks prior to our assessment, leadership told us that this had given patients more choice around appointments. Patients told us that waiting times were too long, we received information from one patient who said they waited for 90 minutes before being seen. Patients provided positive feedback via the friends and family survey regarding clinicians when they were seen.

The service did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs. We saw received evidence from patients indicating that some patients do not feel listened to. We received positive feedback regarding the social prescriber who had assisted a patient in setting up a local fishing group and local care homes provided positive feedback for the paramedic based at the practice.

There were some shortfalls in how the service understood the diverse health and care needs of people and their local communities. Leadership told us they still needed to carry out an analysis of patient demographics. At our last assessment the practice told us that they hoped to re-commence a support group for local farmers, at the time of this assessment this had not happened. We saw the practice had begun working in partnership with other services such as care homes to ensure more positive episodes of care were provided to residents. Patients also told us they felt that it was difficult to get a face-to-face appointment.

Information to promote the take up of screening and immunisation programmes was available in a range of languages. The practice had access to interpreter services, including British Sign Language. Information provided by the service met the Accessible Information Standard. Patients were informed as to how to access their care records. The Patient Participation Group told us they felt they were informed appropriately of any changes upcoming. The practice regularly updated social media to provide patients information where required. The practice also had posters in the waiting room which provided information on services and external support patients may require.

The service did not always make it easy for people to share feedback and ideas., Since our last assessment the practice manager had taken over the handling of complaints within the practice. They did not always involve people in decisions about their care or tell them what had changed as a result. The patient participation group told us that they felt any opinions they had put forward were considered.

We saw complaints were managed in line with the practice’s policy. Learning from complaints and significant events was not evident and leaders did not give an example of leaning going beyond a significant events meeting. There was no auditing or clinical oversight of policy changes. It was unclear how leadership were assured that staff at all levels had understood learning from significant events.

The National GP Patient Survey data told us that 37% of patients found it easy to access the practice via telephone and 39% via the website. These were both lower than local and national averages.

Since the survey total triage had been implemented in the practice and leaders at the practice told us this had improved access due to its infancy we could not assess how beneficial this was to patient care during this assessment. The practice made adjustments where required to accommodate patients who may have needed a longer appointment time. Patients told us more recently that telephone systems had begun to improve. Patients told us of instances where referrals had been delayed and reported a lack of continuity in the care they had received.

At our last assessment patients told us that they struggled to access care at the practice in a reasonable timeframe, at this assessment improvements were in early stages, patients however still felt they waited too long and did not have choice over the clinician they got to see.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. Feedback provided by people using the service, both to the provider as well as to CQC, was both positive and negative, patients told us that the attitude of staff was good on the whole, but we did review some negative feedback. Patients did feel they had to wait a longer than expected time for an appointment. Patients also told us that there were delays in referrals, and a lack of continuity meaning they had to tell staff more than once the reason for an appointment. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers. Staff used appropriate systems to capture and review feedback from people using the service, including those who did not speak English or have access to the internet.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Our records review showed people were supported to consider their wishes for their end-of-life care, including cardiopulmonary resuscitation. This information was shared with other services when necessary. We saw evidence of the practice failing to maintain communication with palliative patients in one specific case this was a period of 12 months.