Linden Medical Group

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The practice had effective systems to record and respond to incidents and complaints. We saw evidence of actions taken in response to incidents and complaints; learning and information regarding changes was disseminated. The practice operated effective systems to assess, monitor and continue to improve the quality and safety of service. There were processes for monitoring patients’ health in relation to the use of medicines including medicines that require regular reviews. The practice took swift actions to respond to areas identified during our remote clinical searches to ensure identified patients who required regular reviews were contacted and followed up.

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.

Patient feedback regarding learning culture was gathered during our interview with the practice Patient Participation Group (PPG). Information received was positive, with PPG stating the group felt listened to when raising concerns and changes were made when appropriate. PPG felt the practice was open and honest when things went wrong.

Staff told us of an open and honest working environment, where they felt supported and able to raise concerns, this aided the learning and development of the staff and service provided.

Information on how to make a complaint was displayed in the patient waiting area at both the main and branch site as well as on the practice website. Significant event reporting forms were available to all staff to access from the practice computer system. The practice provided staff with access to a Freedom to Speak Up Guardian. Staff and leaders were aware of their responsibilities and knew how to identify and report concerns and safety incidents. The practice demonstrated they managed significant events and complaints appropriately and staff were involved in identifying any learning. Feedback and learning from significant events and complaints was shared with staff via their managers and at staff meetings. Whilst complaint’s themes and learning were shared with the Patient Participation Group (PPG); incidents were not covered during PPG meetings. PPG members explained their awareness of the reasons for this which was due to data protection and the need to maintain confidentiality.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe and effective staffing during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

The GP patient survey results from the 2024 survey showed patients satisfaction about being involved in decisions regarding their care and treatment was 80% which is below the national average of 91%. During our engagement with staff, they told us that they involved patients in decisions about their medicines during reviews and assessments. We found that staff had good knowledge of current and relevant best practice and professional guidance. Our review of medical records showed patients received advice about their medicines and care plans where required were in place.

The practice ensured medicines were stored safely and securely with access restricted to authorised staff. Blank prescriptions were kept securely, and their use monitored in line with national guidance. Staff had the appropriate authorisations to administer medicines including Patient Group Directions or Patient Specific Directions. The practice held emergency medicines, and a system was in place to monitor stock levels and expiry dates. However, where medicines were not stocked, such as a specific medicine to treat pain, the practice had not provided evidence of a risk assessment which evidenced risks had been considered when deciding which medicines to stock. There was medical oxygen and a defibrillator on both the main and branch site as well as systems to ensure these were regularly checked and fit for use. Vaccines were appropriately stored, monitored and transported in line with UK Health Security Agency (UKHSA) guidance to ensure they remained safe and effective. The practice could demonstrate the prescribing competence of non-medical prescribers, and there was a regular review of their prescribing practice supported by annual appraisals, clinical supervision and training.

There was a process for monitoring patients’ health in relation to the use of medicines including medicines that required monitoring (for example, warfarin, methotrexate and lithium) with appropriate monitoring and clinical review for most patients prior to prescribing. The provider had recognised areas which required strengthening and had taken action to improve monitoring. We saw evidence of improvements made to improve the monitoring of patients with hypertension (when your blood pressure is higher than 140/90mmHg); this included implementing a hypertension pathway and recruitment of a pharmacist. During our remote interviews, clinical staff explained because of these changes; newly diagnosed patients commencing medication reduced from 70 days to 47 days. Clinical staff also explained the aim was to reduce this further to 28 days. The practice had a system for recording and acting on safety alerts. We carried out a remote review of the clinical record system and found appropriate actions had been taken in response to safety alerts received. People’s medicines were appropriately prescribed, supplied and administered in line with the relevant legislation, current national guidance or best available evidence, and in line with the Mental Capacity Act 2005. Accurate, up-to-date information about people’s medicines was available, particularly when they moved between health and care settings, in line with current national guidance, when transferring between locations or changing levels of care. The remote review of patients who were prescribed medicines that required monitoring demonstrated the majority of patients received appropriate blood monitoring prior to medicines being prescribed. Our searches did identify a minority of patients who did not attend for regular reviews. We saw the practice made efforts to contact these patients and when necessary, took additional steps, including discussions in clinical meetings to reduce risks to these patients.