- GP practice
Larksfield Surgery Medical Partnership
Report from 4 March 2024 assessment
Contents
Ratings
Our view of the service
Date of assessment: 04 March to 26 April 2024 We carried out this assessment in response to concerns and risk we identified through our ongoing monitoring of the service. We found one breach of the regulations, in relation to governance. The practice’s governance arrangements and processes for identifying and managing risks, issues and performance were not always effective. These included risks relating to fire, Legionella, infection prevention and control, medical emergencies, the appropriate and safe use of medicines, and for making sure staff had the skills, knowledge, and experience to carry out their roles safely and effectively. The systems the practice had in place to make sure staff had the information they needed to deliver safe care and treatment were not always effective. Patients’ needs were not always assessed, and care and treatment were not always delivered in line with national guidance. People could not access the care and treatment they needed when they needed it. Services were not organised and delivered in ways that met patients’ needs, offered individuals continuity and person-centred care, and overcame barriers in accessing care and treatment. The practice culture did not promote the delivery of high-quality sustainable care. People told us they felt complaints were not listened to use to make improvements. Staff were not always supported to implement the learning and changes identified in response to significant events and complaints. Compassionate, inclusive, and capable leadership was not evident at all levels. Staff told us they felt able to speak up but that their voice may not be heard. There was no clear vision for the practice that had been shared with staff. In instances where CQC have decided to take enforcement action, we will publish this information on our website after any processes have been concluded.
People's experience of this service
We received 560 responses through Give Feedback on Care from people who use the service for this assessment. The most significant concern was inability to access the practice. The two main barriers were a lack of available appointments and booking processes. People experienced long queues and difficulty contacting the practice by phone. People often were directed to, or sought out, care and treatment from elsewhere, such as A&E. Other issues included poor contact and communication from the practice and issues accessing prescriptions for medicines. For those patients who had been able to get an appointment, positive experiences were reported in their interactions with clinical and non-clinical staff. However, several people described negative interactions, citing rude clinical staff and reception staff who were rude or unhelpful. This often was in relation to trying to make an appointment. There were also general comments about poor attitudes and a lack of care. Some comments described issues with staffing at the service, both in terms of the numbers and type of staff available. People told us about insufficient numbers of staff to serve the needs of patients. Some felt a lack of administrative staff contributed to difficulties making appointments. Others felt the lack of appointment availability was due to not having enough doctors working at the practice. This often resulted in seeing a different clinician other than a GP, for example, several comments noted appointments with pharmacists, health care practitioners, or a paramedic. However, they were often not able to provide the treatment required such as prescriptions, resulting in the need for a further appointment. Data from the GP patient survey 2023 showed the practice was significantly below the local and national averages for patient satisfaction in respect of access.