Voyager Family Health

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

At the last inspection, the provider was rated requires improvement due to some patient records not being coded accurately, patients overdue routine monitoring tests and some patients with long term conditions not always receiving care in line with current national guidance. At this inspection we found patients records being coded accurately, patients overdue routine monitoring tests were being actively invited to attend monitoring and when not attending after 3 letters were having the amount of medication prescribed reduced. Patients with long term conditions received care in line with current national guidance. However, our patient searches found some areas for improvement for a small number of patients, in relation to a more consistent approach in following up patients who had received treatment for an exacerbation of asthma or hypothyroidism and a drug used to treat neuropathic pain. The practice was aware it needed to strengthen its safety netting in ensuring patients attended for monitoring and reviews and sent us their action plan detailing how patients were encouraged to attend annual reviews. We found there were systems and processes to ensure the premises were safe for use. There was a culture of learning including from incidents, complaints, and significant events. The practice had systems and processes to keep clinicians up to date with current evidence-based practice. We saw evidence of audits carried out to ensure patients care was appropriate. Communication needs of patients were considered, and we saw that the provider could support patients with translation requirements, or hearing or visual disabilities. The needs of carers of patients were also considered.

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.

Results from the National GP Patient Survey showed 2024 positive results. Patient feedback from the National GP Patient Survey showed that 82% of patients said last time they had a general practice appointment, the healthcare professional was good or very good at treating them with care and concern. The national average was 84%. The National GP Patient Survey showed that 85% of patients said the healthcare professional was good or very good at listening to them. The national average was 86%. The National GP Patient Survey showed that 95% of patients said they had confidence and trust in the healthcare professional they saw or spoke with. The national average was 92%.

During staff interviews we were told how staff supported patients with translation requirements, or hearing or visual disabilities. Interviews with clinical staff showed the culture in the practice was that patients were cared for and treated based on need and the provider took account of patient’s age, gender, race, and culture as appropriate. Staff and leaders were aware of the needs of their local population. Reception staff used digital flags within the care record system to highlight any specific individual need. For example, some patients required longer appointments.

The practice had systems and processes in place to ensure patients’ immediate and ongoing needs were assessed. Patient’s treatment needs were routinely reviewed. For example, there were regular health reviews for people who have a learning disability. We saw no evidence of discrimination when staff made care and treatment decisions. People who were the most clinically vulnerable were prioritised and the practice worked with other healthcare professionals to deliver coordinated packages of care. Clinical audits were completed to check on the quality of care and treatment to ensure it was meeting people’s assessed needs and to identify improvements. For patients with the most complex needs, the GPs worked with other health and care professionals to deliver a coordinated package of care. The practice identified patients with caring responsibilities and had signposting and policies in place to support their needs. Assessments considered the persons health, care, well-being, and communication needs, to enable them to receive care or treatment that has the best possible outcomes.

The National GP Patient Survey does not have questions specific to this question. We received 362 CQC Give Feedback on Care forms from patients. A large number were extremely positive about the provider; however, we did not receive specific details about this key question.

Staff we spoke with told us they had regular learning opportunities. They told us there were systems and mechanisms in place to ensure that clinicians stayed up to date with evidence-based practice. This included amongst others, reviewing National Guidelines and Updates, Continuous Professional Development, in-house educational sessions, clinical audits, peer review and multidisciplinary meetings. The practice was an accredited training practice, and the educational and clinical supervisors were actively involved in keeping up to date with evidence to provide teaching. Nurses were able to access training to keep up date with their skill base. GPs and clinical staff were able to access information regarding National Institute for Health and Care Excellence (NICE) guidance.

Our review of the clinical record system for the sample of people whose care and treatment we looked at, indicated that people received care, treatment and support that was evidence-based and in line with good practice standards. The series of searches we completed showed patients prescribed high-risk medicine or medicines that required regular monitoring was, in most cases, completed according to best practice guidance. The results of the clinical searches for the management of patients living with long term conditions were good overall and did not identify any significant gaps in the monitoring of patients. However, some areas for improvement were noted in relation to a more consistent approach for following up patients who had received treatment for an exacerbation of asthma and patients prescribed thyroxin.

Feedback by patients from CQC Give Feedback on Care showed that most patients experienced a service where referrals to other organisations were made promptly. However, we received a few complaints where referrals were delayed, and patients had to chase. We received some comments about the time from the referral to the appointment with the other organisation. However, this was out of the practice’s control.

Staff told us they were proud of how the team worked well together to ensure patients received high quality healthcare. They told us they were engaged with the leaders to be flexible and adaptable to meet their patient’s needs.

We did not receive any concerns from commissioners or other system partners about how staff, teams and services worked together at this practice.

Systems were in place to ensure the service worked effectively across teams and services to support people. All relevant staff, teams and services were involved in assessing, planning and delivering people's care and treatment and staff worked collaboratively to understand and meet people's needs. Information about patients’ needs was shared effectively when they were referred to different services. There were regular meetings attended by all relevant health care personnel and the practice staff with the minutes documented and shared. The practice continued to work in partnership with other healthcare professionals and all documentation was recorded and shared accordingly.

The feedback we received did not show any concerns about people’s experience regarding supporting people to live healthier lives.

Members of the clinical team provided patients with information and support to manage their own health, care and wellbeing where possible. People were also encouraged and supported to make healthier choices to help promote and maintain their health and wellbeing and prevent deterioration. Staff identified patients who needed extra support and directed them to relevant services. This included patients in the last 12 months of their lives, and patients at risk of developing a long-term condition and carers.

Our review of the clinical record system indicted patients received care and treatment that supported them to live healthier lives. Patients were encouraged to attend cancer screening and take up vaccinations offered as part of national programmes. Patients who did not attend were contacted by the practice to encourage uptake of these services. Data about outcomes for patients was used to monitor the effectiveness of the service. For patients with learning disabilities, there were alerts on patient notes if they required additional support. The practice tried to ensure that the patient was seen by the same nurse each time and could provide longer appointment times if necessary. There were also quiet areas for patients if needed.

The family and friends test (FFT) showed a high satisfaction rate by patients. For example, in October 2024, 1,101 patients had responded to the FFT regarding their experience at the practice - 1,055 patients responded as very good or good, 26 as neither good nor bad and 20 patients as poor or very poor.

We interviewed staff members including health care assistants, Nurses, clinical pharmacists, reception staff, and administrators, as well as leaders and GPs. They told us that their involvement in meetings, including clinical meetings, and attending training ensured they were kept up to date with best practice. Staff told us that safety alerts were discussed at meetings and where necessary audits created. They also told us they were involved in the investigation of significant events and outcomes were discussed at team meetings for shared learning.

There was a structured system in place for inviting patients in for their long-term condition annual reviews and there were designated administration staff who had oversight of this. We saw the practice had a system for reviewing patients test results in a timely manner. The provider had a comprehensive programme of quality improvement activity and reviewed the effectiveness and appropriateness of care provided. The provider had arrangements for following up failed attendance of children’s appointments. For example, childhood immunisation. There were effective approaches to monitor patients care and treatment and their outcomes. We found there was a comprehensive programme of clinical audit and second cycle audits.

As part of the inspection a number of set clinical record searches were undertaken by a CQC GP specialist advisor remotely. The results from the searches demonstrated there were mostly effective processes in place to monitor people’s care and treatment. This meant that continuous improvements were made to people’s care and treatment. We reviewed clinical records for patients who had been prescribed medicines which required routine monitoring. Our review showed that medicines were managed safely overall and the approach to medicines reflected current and relevant best practice and professional guidance. Our review showed a small number of people who had either failed to attend the service to undergo the required checks when they had been invited or were overdue their monitoring. However, we were assured by the practice and saw evidence, of an action plan to encourage non-compliant patients to attend for regular monitoring and reviews and a list of patients who were being contacted to book in their review.

Patient experience of the service as indicated in the National GP Patient Survey showed that patients felt involved in decisions about their care and treatment. We did not receive any concerns from patients regarding consent to care and treatment. Our observations and evidence raised no concerns.

Staff were aware of the requirements to gain patient consent to care and treatment and had been provided with training where relevant to their role. Staff understood the importance of ensuring that people understood what they were consenting to and the importance of obtaining consent before they delivered care or treatment. Staff had undergone training in the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). Leaders and staff understood the requirements of legislation and guidance when considering consent and decision making.

Patients were offered a chaperone when carrying out examinations, we saw posters displayed in the practice informing patients of this. Staff who carried out chaperone duties were trained for the role and had received a disclosure and barring (DBS) check. There were systems and practices to ensure people understood the care and treatment being offered or recommended.