Beaumont Park 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

We looked for evidence that staff involved people in decisions about their care and that treatment was delivered in line with current legislation, standards and evidence-based guidance. At our last assessment, we rated this key question as good for providing an effective service, now we have rated the practice as requires improvement . Patients care and treatment was not always provided in line with evidence-based guidance. We found patients with long term conditions needed improved monitoring and care and treatment was not always delivered in line with current legislation, standards and evidence-based guidelines.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The national GP patient survey carried out from January to March 2024 found that from the people that responded to the survey, 93.9% of patients stated the healthcare professional was good at listening to them, 94.3% of patients stated they were involved as much as they wanted to be in decisions about their care and treatment and 96.3% of patients had confidence and trust in the health care professional they saw or spoke to.

Staff told us the practice would use an alert on the patient record to highlight people’s communication needs or specific individual needs where reasonable adjustments were needed, such as offering late morning or late afternoon appointments for patients with sensory impairments, so the waiting area would be quieter. We were informed the practice did not have a hearing loop in reception for patients with hearing impairments, and staff would lower the volume on the radio and the telephone ringer to help support the patient with communication.

The practice was taking part in The North East and North Cumbria Integrated Care board (NENCICB) Carer's award scheme. The practice identified patients with caring responsibilities. There were 360 carers on the practice’s register and the practice had signposting in place to help support their needs. This information was available through notice boards and leaflets. Registers were kept of patients with different health requirements and leaders told us that all patients with a learning disability were offered an annual health check.

We did not receive patient feedback on this quality statement. However, our observations raised some concerns regarding evidence-based care at the service.

Staff told us that they followed protocols and National Institute for Health and Care Excellence (NICE) guidelines to ensure safe care and treatment was delivered. However, we found that systems were inadequate to ensure effective monitoring of patients care and treatment. We found long term condition monitoring still required strengthening to ensure patients were monitored effectively.

The remote clinical searches that we undertook of the practice’s clinical records system showed the monitoring of people with some long-term conditions were not in line with National Institute for Health and Care Excellence (NICE) recommendations. Our searches demonstrated, systems did not work effectively to support safe and effective care for patients prescribed high-risk medicine or medicines that required regular monitoring. For example: Clinical searches identified 14 patients with a diagnosis of hypothyroidism were not being monitored appropriately but medicines were still being prescribed without reviews having taken place. There was a significant lack of oversight of patient’s currently prescribed a direct oral anticoagulant (DOAC) medicine. Out of 191 patients currently prescribed a DOAC, 175 (91%) did not have the correct monitoring done in the last year. Leaders told us in response to this feedback immediate action was taken. There had been no recent clinical audits, to improve patients care, this included audits of patient consultations.

We did not receive feedback from patients about how the provider worked with other services.

At this assessment staff told us they attended regular multidisciplinary team (MDT) meetings with other health and social care professionals to enable them to deliver safe care and treatment. We saw examples of meetings where patients were discussed with external partners such as health visitors, social prescribers and district nurses. We discussed with leaders the processes for how they worked together with other teams and services, for example, the GP explained to us the process for processing 2 week wait appointments for patients. However, staff told us that the practice does not hold regular staff meetings.

We did not receive feedback from partners about how the provider worked with other services.

The practice told us that regular multidisciplinary team (MDT) meetings were held where safeguarding concerns would be discussed, however, we were not assured that safeguarding concerns were a consistent standard agenda item because the records we reviewed did not support this. Leaders told us that patients with a palliative diagnosis would be discussed in the monthly MDT meetings. We discussed how palliative patients’ health could change rapidly. Since our assessment the practice told us they held an MDT meeting with MacMillan Nurses, District Nurses and a Palliative Care Consultant and re-introduced an identification system which can be used to quickly prioritise those patients with the most pressing clinical needs. There were policies in place for referral letters and how to summarise patients notes, however we could not be assured the information was up to date or accurate. After the assessment the provider informed us that the policies were reviewed in 2022, but this was not recorded within the policies and there was no date on the policies for the next review.

We did not receive feedback from patients about how the provider supported patients to live healthier lives.

Staff told us that there were 52 referrals to social prescribing this financial year and verbal consent was obtained and documented on their clinical system before making the referral.

The practice identified patients who may need extra support and directed them to relevant services. This included patients who were carers. The practice had registers on their systems for people with learning disabilities and people receiving palliative care. We saw information about mental health services and other health services in the reception area.

We did not receive feedback from patients about their treatment received. However, our observations raised some concerns regarding monitoring and improving outcomes.

The GP explained the process for monitoring clinical outcomes at the practice. We discussed our clinical searches with the GP and found the practice’s systems were not sufficient to ensure safe care and treatment. For example, our review highlighted 34 patients living with asthma had received 2 or more courses of steroids in the last 12 months and were not offered a steroid card. The consultation records for people with asthma were of a poor quality and there was little documentation to justify the issue of the steroids.

There was lack of processes established to ensure long term conditions and high-risk medicines were monitored regularly or robustly. We found quality improvement activity did not always take place. There was lack of clinical audits to improve outcomes for patients and the practice had no audits or reports to review unplanned admissions to secondary care.

We saw that monitoring of patients with some long-term conditions and certain types of medications needed to improve. We found the practice’s systems were not sufficient to ensure those patients who required ongoing monitoring were actively being reviewed. Our clinical searches showed potential missed patients that required monitoring and reviewing to ensure they had received the appropriate care. However, our monitoring showed that the practice was above national averages in terms of screening for cervical cancer and with childhood vaccination rates.

We did not receive any concerns from patients relating to consent to care and treatment.

The practice told us that consent was obtained by verbal communication and then documented in the consultation. For example, consent was obtained prior to making a referral and Do Not Attempt (DNACPR) orders were completed with the involvement of the individual or the appropriate use of best interest decision making.

The practice had a chaperone policy in place and patients were offered a chaperone when carrying out examinations. Staff who carried out chaperone duties had received a disclosure and baring service (DBS) check. However, we could not be assured the information in the chaperone policy was up to date or accurate. After the assessment the provider informed us that the policies were reviewed in 2022, but this was not recorded within the policy and there was no date on the policy for the next review.