The Osmaston Surgery Also known as Dr I R Shand & Partners

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

There had been some improvements in how staff cared for patients since our previous assessment. Systems to support carers and the recently bereaved were now in place. Feedback from patients showed patients were treated as individuals and patients were supported in their choices near the end of their life. We observed staff interactions with patients and found that staff were polite and respectful. Staff were able to give examples of when they had responded to patient’s immediate needs. A talk for staff regarding mental health and well-being had been arranged and staff had access to a mental health and wellbeing service. However, we found ongoing concerns in the quality statements for kindness, compassion and dignity and workforce wellbeing and enablement. We received a mixture of negative and positive feedback from patients regarding the attitude of clinical and non-clinical staff. An action plan to evidence that the practice had reviewed the results of the national patient survey and formulated an action plan to make improvements was still not in place. Feedback from staff indicated that not all staff felt valued or involved in the running of the practice.

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.

The latest GP National Patient Survey data showed that 71% of respondents stated that health care professionals were good at treating them with care and concern. This was slightly below the local average of 85% and the national average of 84% and comparable with data at our previous assessment. We spoke with 3 patients registered with the practice. They told us that the GPs and staff were very kind, caring, welcoming and friendly and that staff had worked very hard to keep the service going after 5 GP partners left the practice. However, feedback provided by Healthwatch was mixed. Eleven responses were negative regarding the care provided by reception staff and 8 were positive. Some patients stated that reception staff lacked understanding and acceptance of patients’ situations, were insensitive, unhelpful, indifferent, rude and disrespectful. Other patients described the reception staff as very good and brilliant. Seven responses were negative and 8 were positive regarding clinical staff. Some patients described clinical staff as insensitive, unhelpful, patronising, failed to listen and several patients stated they were unhappy with their consultation. Other patients described the GPs as kind and caring and stated they were satisfied with the outcome of their consultation.

Staff who chaperoned had completed chaperone training and were aware of their role and responsibilities when providing this service. They told us if patients attending for reviews were accompanied, they ensured the patient was happy for the other person to remain in the room.

We observed staff interactions with patients and found that staff were polite and respectful. Staff were mindful of being overheard by patients sat in the reception areas. However, an action plan to evidence that they have reviewed the results of the national patient survey and formulated an action plan to make improvements was not in place.

The practice had received 11 compliments in the last 12 months. Six of the compliments related to a named GP. Patients stated the GP was kind, empathetic, professional, listened and very understanding. Four compliments related to the reception team stating they were kind and helpful and 2 related to the care provided to patients with a learning disability by a member of the nursing team.

Staff at the practice worked with the social prescribers and told us they often referred patients to them for support, especially patients with a learning disability. They told us they explained how the social prescribers could support them and asked their permission to refer them. They told us the social prescribers usually made contact with the patient within 2 weeks and notified the practice if patients had chosen to engage or not.

There was a policy in place to provide support and guidance to staff supporting bereaved relatives. It included helping the bereaved, a bereavement letter template, religious beliefs, practices and rituals after death and a bereavement guide.

We spoke with a patient with a visual impairment. They told us that they preferred to receive telephone consultations due to their disability and the practice supported this.

End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable. The minutes from meetings held at the practice to review the care and support provided to this group of patients showed patients had been supported by the practice to die in their chosen location for example, at home or in hospital.

There was a policy in place to support a multi-disciplinary approach in the co-ordination of care for patients who received end of life care. The aim of the policy was to support personalised care plans to support choice in care options at the end of patients’ lives. Systems were in place to review the care of patients at the end of their lives every 2 months within a multidisciplinary team and weekly within the practice.

The latest national GP patient survey results showed that 86% of patients had confidence and trust in the last healthcare professional they saw or spoke to. This was slightly below the local average of 94% and the national average of 93% and comparable with data at our previous assessment. We spoke with a representative of a care home where the practice provided care and treatment. They told us that a GP visited out of hours if they were concerned about the health of a person living in the home.

Staff were responsive to patients’ needs and took action to minimise discomfort, concern or stress. A clinical member of staff shared an example of how they had escalated concerns when a patient attended for a routine blood pressure check and disclosed they had chest pain. This was escalated immediately to a GP, who reviewed the patient and arranged for the patient to be taken to the local accident and emergency department. A non-clinical member of staff shared an example of how they escalated concerns when a patient attended on the wrong day for an appointment. The patient was unwell, so the staff member sought advice from the duty GP who promptly assessed and treated the patient. The practice was equipped to respond to medical emergencies and held emergency medicines.

Feedback from staff indicated that not all staff felt valued or involved in the running of the practice. They commented they were discouraged from speaking with the practice manager, the partners were controlling, not open to feedback or suggestions regarding improvements and there was a blame culture within the practice. However, they told us the majority of staff were respectful to each other and teams generally worked well together. Leaders had recognised the risk associated with lone working in an annex to the practice and as a result of this, made the decision that staff would only work from the main building. Staff told us the practice operated a zero tolerance procedure if a patient was aggressive towards them or acted inappropriately. There were systems in place to request assistance in an emergency. Patients received a warning letter if their behaviour was unacceptable.

Staff management policies and procedures were stored electronically and accessible to all staff. Relevant policies were summarised and provided to all staff in the Employee Handbook. Team meetings were held monthly to update staff and provide the opportunity for staff discussions. The practice had organised a talk for staff regarding mental health and well-being. Staff had access to a Mental Health and Wellbeing service.