Askern Medical Practice

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

At our previous inspection, the practice was rated good for providing a caring service. At this assessment we have rated the practice as requires improvement for providing a caring service. The GP National Survey data showed that patient experience was below local and national averages. Feedback received by CQC from patients and staff showed that patients were not always happy with their care in general. We had concerns of the ability of staff to deliver person centred care from their feedback on their well-being. However, the practice provided us with positive information from patients, via surveys and compliments about how caring the practice was. The NHS friends and family information was mostly positive. Our clinical searches showed that once seen patients’ needs were responded to.

This service scored 60 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

CQC received 6 complaints from patients prior to our assessment, regarding staff attitude being poor and in two of them, patients felt ignored by staff. In the previous 12 months to our assessment the NHS choices website received 3 items of feedback about the practice all one star the issues being telephone access, reception staff attitude and an unhelpful, appointment system. We received 10 items of feedback via our link on our website, on care. This was mixed, some stated that they had received a good experience at the practice. Some said they felt they were not looked after, results and medication reviews were not dealt with. The practice own surveys stated that 100% of patients were satisfied with service provision. They provided us with 13 examples of compliments they had received from patients and staff and partners. The practice provided us with NHS Friends and family information from 30/7/23 to 12/3/24. 1286 items of feedback. Of which 77%, very good/good, 7% neither good nor poor, 16% very poor/poor. Two members of the patient participation group told us they felt looked after, it could be hard to get through on the telephone to obtain an appointment and the doctor could be running late for appointments. The National GP Patient Survey results were below national average for example; Patients who stated that the last time they had a general practice appointment, the healthcare professional was good or very good at listening to them (01/01/2023 to 30/04/2023) 78.7% national average 85% Patients who stated that the last time they had a general practice appointment, the healthcare professional was good or very good at treating them with care and concern 78.8% national average 83.8% Patients who stated that during their last GP appointment they had confidence and trust in the healthcare professional they saw or spoke to 89.2% national average 93%.

Prior to our assessment and after we received feedback from whistle blowers and staff regarding kindness and compassion to patients. This included, insufficient time to see patients, patients having to wait for medication, letters not being answered. One of the managers told us that there had been issues with patients’ complaints about staff, patients were frustrated with access and staff interaction with them could be improved and this was in hand.

We did not observe any poor care during this assessment.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Independence, choice and control during this assessment. The score for this quality statement is based on the previous rating for Caring.

From our clinical searches patients’ needs were met positively. Our concerns were that they had difficulty getting through to the practice in order to be seen and responded to quickly. Complaints were not being handled in a timely manner, or at all.

We discussed with the lead GP and saw from our clinical searches that once a patient was seen their immediate and ongoing needs were fully assessed. This included their clinical needs and their mental and physical wellbeing.

Concerns raised by staff before our assessment were, the practice was short staffed and there was a closed culture (this means a lack of openness to learning from mistakes, failing to listen to the experience of staff, people, carers and loved ones). That CCTV was used in the practice in an inappropriate way. Feedback from staff questionnaires was mixed, some said there was a good team spirit and they worked well together. Most staff said the practice was difficult to work in, the atmosphere poor, staff were stressed. They were belittled and staff were in tears. Staff were not respected or supported. Moral was low and staff turnover high. They feared repercussions if they gave us feedback. Staff contacted us anonymously, via our give feedback on care portal. They told us they were afraid to speak up or complete our questionnaire as there was a closed culture at the practice and there were repercussions if staff spoke up. Senior managers were coaching staff in what to say when completing our questionnaires which we had sent out. Staff told us the CCTV in the reception area which we were told was to protect staff was used against them and that they were being watched to see what they were doing and it made them uncomfortable. They told us a lot of tasks were usually outstanding and sometimes deleted, urgent results and referrals are ignored. There was a bullying culture at the practice, staff were made to work extra hours for little or no extra pay. We received more than twice the amount of negative feedback about working at the practice following our assessment as we did positive. The provider told us at a presentation on our site visit day that the leadership at the practice was reflective, strong and decisive. They had a high level of constructive staff engagement. The practice gave us a ‘we said you did’ where they had implemented changes from staff feedback. They were to implement huddles every Monday to discuss management issues and improve morale.

The practice sent us staff rotas and the number of staff in post. The practice had a whistleblowing and freedom to speak up policy. The practice had a whistleblowing and freedom to speak up policy and the staff had access to a freedom to speak up guardian at another GP practice. However, feedback from staff indicated that staff were reluctant to use these due to fear of reprisal.