GP Hub Parkway

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

There was a positive learning and safety culture in which incidents were investigated, and learning was embedded to promote good practice. Staff were open and honest when things went wrong and when they identified risks. Staff provided safe care and treatment. The environment was managed and maintained by another organisation and the service had a good working relationship with them to secure repairs and maintenance. Staff were trained and competent and had the right skills to meet people's needs. They had the opportunity to learn and gain experience. Safeguarding procedures reflected the nature of care, and the local population and staff were skilled in protecting people from harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff reported concerns about safety and investigated and recorded incidents using the provider’s electronic reporting system. The senior leadership team had remote access to this and reviewed reports immediately. They shared outcomes from investigations with colleagues at all levels to implement learning and improvement.

Staff were confident about raising concerns and reporting incidents. These were taken seriously, people were involved in investigations if they wanted to be, and reports of the event were shared with them. Staff gave patients, or those who represented them, an apology if appropriate and an explanation of the event, in line with the provider’s expected timeframes.

Staff had effective systems to raise concerns both formally and informally. The senior team analysed incident reports and implemented risk management processes as a result. For example, staff reported an incident whereby the 111 service had made an inappropriate out of hours referral to the service, which they could not address. The team escalated this appropriately, liaised with their counterparts in the 111 team, and implemented a revised referral policy as a result.

In the previous 12 months, staff reported 27 minor incidents, none of which were serious or resulted in patient harm. This figure was reported across both GP hubs and reflected an incident rate of less than 0.5% in relation to the number of patients seen. In the same period staff at this site reported 6 serious incidents. Of these, 3 related to IT problems, 1 to flooding, and 2 to medical emergencies. The medical emergencies referred to patients who collapsed in the waiting room. In both cases, receptionists acted quickly, within their training, and used the escalation process to make sure patients received medical attention quickly.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The service provided same-day care for minor illnesses and injuries. Staff training, equipment, and treatment protocols reflected this. Staff held basic life support (BLS) training, and the clinic had emergency equipment such as an anaphylaxis kit, emergency oxygen, and an automatic external defibrillator (AED). Equipment was clearly signposted and all staff we spoke with knew its location.

The provider had service level agreements with local urgent treatment and emergency care services that enabled staff to refer patients without the need for them to start the process from scratch. For example, staff could refer patients to the same-day emergency care unit or the emergency department at the local acute hospital. They could also refer directly to paediatric consultants in the local NHS hospital and to some specialties, such as ophthalmology. These were for urgent use only.

Processes were in place to support patients who repeatedly presented at the hub seeking medicines or who were looking for long-term condition management as a replacement for their registered GP service. Staff used an alert on the electronic booking system to notify clinicians such patients needed more complex support.

Patients who presented as acutely unwell, or those who deteriorated while in the clinic, were outside of the scope of care. Staff made sure they were comfortable and safe and arranged for transfer to hospital. Where patients needed long-term care or referral to a medical specialty, staff referred them to their registered GP to make onward arrangements.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety free from avoidable harm and neglect. The provider shared concerns quickly and appropriately.

The senior team and clinical staff were trained to level 3 in adult and child safeguarding and non-clinical staff were trained to level 2. This met national standards and was appropriate to the services provided. The clinical lead and service manager were designated safeguarding leads and 1 was always on call whenever the service was open. The service had access to level 4 training safeguarding leads in the provider and the commissioning trust.

Staff understood how and when to take urgent action by contacting the local authority safeguarding team or other agencies. They documented all safeguarding referrals on the provider’s incident recording system. They understood how to contact different professionals based on need, such as health visitors, school nurses, social workers, and safeguarding staff in NHS trusts.

The electronic patient records system included an alert function for patients known to have safeguarding needs. We saw this in practice with a patient who regularly attended the service. Staff made sure they were comfortable and safe, maintained their dignity, and prioritised their care with the first available clinician.

Safeguarding was a standing agenda item in quarterly clinical education forums. Staff used case studies from colleagues across the urgent and emergency care system to identify good practice and learn from outcomes. Case studies reflected good information sharing practices between GP hubs and the ED, including with children and young people. The clinical lead advocated for safeguarding as an embedded aspect of all types of care and treatment.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Receptionists had a continuous view of patients in the waiting room and a good understanding of when to urgently contact a clinician for help, such as if a patient became unwell or complained of ‘trigger’ conditions such as chest pain.

Patients who walked in to the service without booking through 111 were offered an appointment on the same day if their needs were within the scope of the service. This reflected a consistent focus on risk management.

GPs, and advanced nurse practitioners (ANPs) with specific competencies, provided care and treatment to infants under the age of 2. The reception team knew which clinical staff could see this patient group and made sure patients had the most appropriate timeslot.

Clinical staff carried out prioritisation of patients referred to the service and identified whether they should be reviewed by a GP or ANP. The team used exclusion criteria to make sure referrals were appropriate. For example, the service did not have an X-ray facility and could not carry out blood tests.

Feedback from patients sometimes reflected their frustration at not being prescribed antibiotics or being able to access ‘all-in-one’ healthcare in 1 visit. This included patients who found it difficult to access their registered GP service and sought care for long-term conditions through the hub. The team met with such patients and helped them navigate the care system, including helping them understand why this was not the best service to provide extended condition management.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The environment was clean although in need of repair and refurbishment. The waiting room was shared with multiple other services and staff explained how they controlled the area to make sure people were comfortable. Where patients were anxious or distressed, or had needs relating to autism or learning difficulties, staff provided a private waiting room.

Staff had access to all the equipment they needed and were trained to use it. All staff completed moving and handling training.

People were kept safe while waiting to be seen. The reception team had a view of the waiting room and knew what to do if someone became unwell or needed help, including in relation to welfare and safeguarding issues.

The service managed hazardous and clinical waste, including sharps and chemicals, safely and in line with national standards.

The service was co-located with multiple other services, and an NHS trust was responsible for maintenance and repairs. The maintenance team provided a 24/7 on-demand response service, which staff said worked well. Staff maintained emergency equipment such as oxygen, masks, and adrenaline injections for anaphylaxis, and an automatic external defibrillator (AED) was available in the waiting area. The AED was shared between the different services in the building and the GP hub team carried out their own daily checks of the equipment as part of safety assurance.

The team shared fire safety responsibility with the NHS provider responsible for the building under a clearly defined arrangement. Staff completed local fire and evacuation training and carried out daily checks of exits and fire extinguishers. The trust carried out fire audits and regular fire drills and systems checks and provided this service with assurance of safety.

Similarly, the NHS provider managed water safety in line with national standards, including periodic checks for Legionella. Staff carried out twice weekly flushing of each tap and documented this with the trust as part of safety monitoring.

The provider made sure there were enough qualified, skilled, and experienced staff, who received effective support, supervision, and development. They worked together to provide safe care that met people’s individual needs.

An advanced nurse practitioner (ANP) was on shift 10am to 8pm and a GP from 8am to 8pm. The service employed 1 substantive GP, and other clinical staff were employed on locum contracts. Locum staff held long-term relationships with the provider and scheduled their shifts 3 months in advance. Reception, administrative, and support staff were employed permanently. All staff worked across both of the provider’s hub locations, which supported consistent practice and care.

Each locum GP was in a substantive NHS post in another practice. They undertook an annual appraisal with their NHS England-appointed appraiser. This provider monitor appraisals and made sure all GPs were up to date.

The senior team scheduled staffing based on continuous monitoring of demand. They increased clinical cover during periods of predicted high demand. The clinic had additional clinical space to increase GP or nurse cover at short notice. As almost all care was pre-booked the day before, this system was rarely needed.

Staff felt workload was about right and they felt supported by senior colleagues in the event of delays or unexpected pressures on the service.

Staff kept up to date with mandatory and role-specific training. They had effective supervision and annual reviews of their work, and discussions about future learning and development opportunities. At the time of our site assessment, over 99% of staff were fully up to date.

The current GP staffing model was based on learning from a previous recruitment campaign that attracted few suitable candidates. The senior team recognised the importance of staff having lived knowledge of Croydon and its communities, which they identified as key to providing quality care.

The clinical lead and salaried GP observed at least the first 4 sessions of each new locum who joined the service, with the option to extend if needed.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Clinical staff cleaned clinical equipment between patient consultations using antibacterial wipes and followed appropriate hand hygiene and personal protective equipment standards of practice. Monthly audits showed consistently good practice from staff and swift action by the service manager if standards fell short.

An external contractor was responsible for other aspects of cleanliness, including maintenance of toilets and hygiene supplies. Daily cleaning records were up to date and during our site visit accurately reflected the condition of the environment.

The estate needed refurbishment in many areas and clinical spaces reflected significant periods without repainting and reflooring. While the risk to patients was low, it reflected challenges the provider experienced in securing improvements from the building operator. Staff mitigated daily risk through the effective use of cleaning products and good infection prevention and control (IPC) practices.

The service manager carried out a 6 monthly whole-clinic IPC audit, including the environment and a review of daily and weekly cleaning audits completed by staff and the cleaning contractor. The most recent audit took place in March 2025 and reflected broadly good practice, with an action plan for improved standards of work in some areas by the contractor. The service manager planned to assess improvements in June 2025.

The provider made sure medicines were managed safely and met people’s needs and preferences.

Staff provided same-day care and treatment for minor injuries and illness and did not manage long term conditions. As a result, there was limited medicine stock on site, restricted to pain relief, local anaesthetic, and antibiotics for common conditions.

Staff received regular training on medicines management and followed national standards in storage, administration, and recording.

Staff regularly checked stock levels, temperature of storage areas, and expiry dates. Medicine fridges were equipped with electronic temperature recording devices that provided automatic monitoring. The system alerted staff if temperatures exceeded the manufacturers safe threshold. This system ensured chilled medicines were managed in line with the provider’s cold chain policy.

Staff managed medicines-related documentation appropriately and securely, including for the disposal of expired medicines.

The provider acted on safety alerts and medicine recalls. Staff followed established processes to ensure people prescribed medicines with specific risks received recommended monitoring by referral to their usual GP.

The clinical lead carried out monthly prescribing audits to assess compliance with the provider’s protocols and to monitor potential misuse of medicines. This was an effective safety system and identified opportunities for reduced prescribing quantities in some instances.

The team used a quarterly clinical education forum to monitor seasonal trends in prescribing. Safety protocols to make sure treatment was appropriate included limits on the quantities of prescription medicine and a requirement for patients to engage with the most appropriate health service.