Cradley 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 staff involved people in decisions about their care and treatment and provided them advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this. At our last assessment, we rated this key question as good. At this assessment, the rating remains the same. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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 service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Feedback from people using the service was positive. People felt involved in any assessment of their needs and felt confident staff understood their individual and cultural needs. The National GP Patient Survey found 94% of patients at the practice who responded felt their needs were met during their last general practice appointment which was above the national average of 90%.

Reception staff were aware of the needs of the local community and knew many of the patients well. Reception staff used digital flags within the care records system to highlight any specific individual needs, such as the requirement for longer appointments or for a translator to be present. Staff checked people’s health, care, and wellbeing needs during health reviews. The provider had effective systems to identify people with previously undiagnosed conditions. Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber or a wellbeing coordinator provided by the primary care network.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Systems were in place to ensure staff were up to date with evidence-based guidance and legislation. Clinical records we saw demonstrated care was provided in line with current guidance. However, one area showed inconsistent results. This related to patients with asthma who had been prescribed 2 or more courses of rescue steroids for acute flareups. These patients should receive follow up from the practice within 1 week of each course. While follow up had occurred in some cases, this had not happened consistently for the 5 patients we examined in detail. The practice acted promptly to address this by immediately reviewing the care of all affected patients. Learning from this review was used to strengthen processes, and actions were implemented to ensure consistent and appropriate follow‑up in future, in line with national guidance.

Leaders and staff worked effectively across teams and services to support people. They ensured individuals only needed to share their story once by appropriately sharing assessments of need when people moved between different services.

Staff had access to the information required to assess, plan, and deliver people’s care, treatment, and support. The practice worked collaboratively with other services to ensure continuity of care, including when clinical tasks were delegated. They worked closely with other practices within the primary care network and met regularly with the frailty team who supported people who were housebound.

Staff took part in regular meetings focused on safeguarding, frailty, and palliative care. These meetings included discussions with other agencies such as community nurses and health visitors, supporting coordinated and joined-up care.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff focussed on identifying risks to patients’ health, including those in the last 12 months of their lives, patients at risk of developing a long-term condition and those with caring responsibilities. Staff supported national priorities and initiatives to improve population health, including management of diabetes and tackling obesity.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and they met both clinical expectations and the expectations of people themselves.

The practice worked towards national targets for screening and immunisations. From the clinical notes we reviewed, we found people who used the service experienced positive outcomes as set out in legislation, standards, and evidence-based clinical guidance.

Published national data for the uptake of cervical screening was below the national average however, the practice had taken steps to improve these results. The social prescriber, funded through the primary care network, had facilitated a pilot to look at the barriers for people accessing the practice for screening such as cervical screening. This had supported the practice to make improvements including making it easier for people to have an appointment at a time which suited them.

Published national data showed the practice was above the World Health Organisation 95% minimum targets both for children aged 2 and aged 5 with 100% completion rate. The practice had a process in place for following up children who missed vaccinations and exploring why this was the case.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff understood and applied legislation relating to consent. Capacity and consent were clearly recorded. Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation.