London Street 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 found improvements had been made following our last inspection to how people’s needs were assessed and met. Staff involved people in decisions about their care and treatment and provided them with advice and support. Patients felt listened to and were referred to other services promptly for tests and investigations. Staff worked well together and collaboratively with other services to make sure patients could access other services. Multi-disciplinary meetings were held on a regular basis where the needs of patients with complex needs could be discussed and reviewed. Our rating for this key question is good.

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.

Feedback from people using the service was positive. People felt involved in their care and treatment and were confident that staff understood their individual health and cultural needs.

Staff indicated that the practice encouraged and supported them to learn about new and innovative approaches that can improve the way they deliver care. Nurses told us they used templates to plan and manage patient care for long term condition.

There were updates to clinical templates when national evidence based guidance changed. This ensured patients were assessed appropriately prior to care planning.

We did not receive any concerns from patients about evidence-based care and treatment.

Feedback from leaders and staff indicated that staff understood how to manage care related correspondence and tasks. Staff received training on national evidence based guidance to deliver appropriate care.

Our review of the clinical patient record system for the sample of patients showed that care and treatment generally had been delivered in line with evidence-based guidance overall. Patients with long-term conditions mostly received appropriate monitoring and reviews. Where patients had not been reviewed in line with guidance, the practice responded to CQC findings to mitigate risks to these patients.

We did not receive any concerns from patients about how staff, teams and services worked together.

We received positive feedback through staff questionnaires about staff working together as a team. Nurse prescribers received supervision and support, but this was not formalised via formal supervision meetings with audits of treatment.

The practice told us they attended regular multidisciplinary team (MDT) meetings with external partners such as district nurses, social workers and community healthcare staff to discuss patients’ needs and plan their care holistically.

Staff told us there were clear policies and procedures in place, which were easily available to use. There were appropriate referral pathways to make sure that patients’ needs were addressed. Referrals to specialist services were documented and there was a system to monitor the timeliness of referrals.

We did not receive any concerns from patients about how the practice supported them to live healthier lives.

Patients were able to access social prescribers through the Primary Care Network (PCN). They assist patients with signposting to community organisations or schemes to help support health and wellbeing.

The practice identified patients who may need extra support and directed them to relevant services. This included unpaid or family carers. At the time of this assessment, the practice had 38 unpaid or family carers on the register. Staff encouraged and supported patients to be involved in monitoring, managing and improving their own health. Information was available on the practice’s website, for example about maternity care, child health and annual health reviews. The practice had completed annual health checks for 60% of the patients with a learning disability for 2024/25 so far. The practice did not meet the expected target for cervical screening. Leaders told us that the practice was continuously working on contacting these patients and booking Saturday appointments to help improve attendance, however, was finding it difficult to increase uptake. The practice shared some unverified real time data that showed some improved numbers. The practice population was transient and this affected the ability to manage cervical screening. Childhood immunisation data for the practice did not meet the national WHO (World Health Organisation) target of 90% in 4 of the 5 categories for 2023/24.

Patient feedback indicated the practice had made several improvements to access, prescription requests and specialist referrals. The feedback suggested care tasks were continuously monitored

Feedback from leaders indicated that practice had a system of automated and scheduled searches which generated a reminder message to patients to come in for medicine reviews based on risk. The platform was successfully piloted and showed improvements in chronic disease management since the last inspection.

We found there was a process in place to manage complaints and significant incidents. Learning was shared with staff to ensure improved outcomes for patients. Although the practice was able to provide some examples of clinical audits, we found there were no clinical quality improvement audits t to enable identification and delivery of improvements to care where needed.

There was an overall improvement to the management of repeat prescribing and long terms conditions. However, there were still concerns about the coding and monitoring of some patient groups. The coding issues limited the practice’s ability to effectively monitor patients care.

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

All non-clinical staff were trained to carry out chaperone duties at the practice and had received a Disclosure and Baring Service (DBS) check. Staff we spoke with had a good understanding of consent and had received appropriate training.

Staff were aware of the processes and the importance of making sure a patients consented to their care. Staff received training in legal requirements related to consent, such as the Mental Capacity Act (2005).