The Blundellsands 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

People were involved in the assessment of their needs, and staff made sure they were included in decisions about their care and treatment. They were offered advice and support throughout. Staff worked well together and in partnership with other services to help people access the support they needed without unnecessary delays.

Assessments were regularly reviewed and considered people’s communication preferences, personal circumstances, and health needs. Care and treatment was focused on helping people live healthier lives, including support to take part in national screening programmes and vaccinations. Chronic disease was well managed.

Both clinical and non-clinical audits were carried out to help improve outcomes for patients. The practice was performing in line or above local and national averages for required indicators.

Our review of a sample of patient records showed that care and treatment followed evidence-based guidance. We highlighted areas where improvements could be made and immediate action was taken by the provider to rectify concerns identified.

Regular multi-disciplinary meetings were held to review and plan care for people with complex needs or those approaching the end of life. Where relevant, ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNACPR) decisions were clearly recorded in the patient records and supported by appropriate documentation.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Patient experience of the service as indicated in the National GP Patient survey showed that 98% of patients who responded felt involved in decisions about their care and treatment and 99% had confidence in the healthcare professionals treating them. These scores were higher than local and national averages. Support was available for people with additional needs or communication needs, for example, people who required the services of an interpreter or patients who had a learning disability.

Of patients who responded to the National GP patient survey, 97% said their needs were met during their last appointment, higher than local and national averages. Requests for appointments were triaged by the reception staff who had received care navigation training. People who reported symptoms that could be considered a clinical emergency could be seen on the day or be signposted to a more relevant service. Patients were advised when to seek further help and what to do if their condition deteriorated. Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber.

Relevant information was shared with other professionals when planning care and treatment and treatment records were updated to reflect any changes made.

People living with a long-term condition and those with a learning disability were invited for regular review of their health, care and treatment and staff used templates for this to ensure the reviews were appropriately detailed and recorded.

The provider had effective systems to identify people with potentially undiagnosed conditions, for example diabetes and cancer. People who were the most clinically vulnerable were prioritised and the practice worked with other healthcare professionals to deliver coordinated packages of care.

Systems were in place to ensure staff were up to date with national guidance, evidence-based good practice and required standards. Staff attended meetings, training, educational sessions and underwent regular appraisal.

We looked at the workflow for managing clinical correspondence within the clinical patient record system and tasks and found these were mostly up to date on a daily basis. We observed a high number of outstanding tasks that were being used as reminders for staff, however, there were also some clinical tasks that had been overlooked. The provider took immediate action, raised a learning event and discussed improvements to ensure that the system for managing both clinical and non-clinical tasks was effective and free from risk.

Clinical staff had time factored into their days to deal with administrative tasks. In addition, they were using artificial intelligence to help transcribe consultations and free up clinical time.

Our review of the clinical record system for the sample of people whose care and treatment we looked at, indicated that people received care, treatment and support that was evidence-based and in line with good practice standards. The results of the clinical searches for the management of patients living with long term conditions were good and any gaps we identified in the monitoring of patients were dealt with immediately by the provider.

Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. The practice worked with other services to ensure continuity of care. Leaders and staff worked closely with colleagues in the local primary care network (PCN) to meet the needs of the patient population.

Multi-disciplinary meetings were held on a regular basis so that when people received care from a range of different staff, teams or services, such as those in the affiliated care home, this was co-ordinated.

Staff demonstrated good working relationships with the local NHS Trusts and used those relationships to support patients to navigate the health and social care system. Shared care agreements were in place to ensure that prescribing arrangements between primary and secondary care were well managed.

The service supported people to live healthier lives and manage their health and wellbeing. 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. People were called in for regular checks on their health when they were living with a long term condition.

Staff supported local and national priorities and initiatives to improve population health, including smoking cessation and encouraging patients to take up national screening programmes.

People living with long term health conditions underwent regular monitoring. Staff referred or signposted them to local support services for information, education, advice and support linked to their needs. The practice contacted patients who did not attend cervical screening and child immunisation programmes to encourage uptake. People were also encouraged and supported to make healthier choices to help promote and maintain their health and wellbeing and prevent deterioration.

The percentage of persons eligible for cervical screening as of 31/06/2023 who were screened was 77% which was slightly lower than the expected target of 80%. We discussed this with the nurse who demonstrated that people who had not attended for cancer screening were followed up and encouraged to attend. Childhood immunisation uptake was above the 90% World Health Organisation targets in all except one age categories. The practice nurse explained the reasons for any poor uptake and demonstrated the efforts the practice made to educate patients around the importance of immunisation and encourage uptake.

The service routinely monitored people’s care and treatment to continuously improve it. They sought assurance through a series of key performance indicators and quality improvement activity. The practice was able to demonstrate improvements through audits which they shared during the assessment.

Positive outcomes were demonstrated through patient experience and GP practice indicators.

From the clinical records we reviewed, we found that people who used the service experienced positive outcomes in line with best practice guidance.

Leaders demonstrated that monitoring and improving outcomes for patients was important to them and they used information and data to drive improvement. There was evidence of clinical, non-clinical and medicines audits carried out as a means to improve outcomes for patients. CQC data showed the practice was in line with other services within the locality and nationally for outcomes for patients.

People who used the service felt they could make an informed decision about their care and treatment because they had been provided with the information they needed to support them to do so. The National GP patient survey results showed that 99% of respondents felt the health professional they saw had all the information they needed and 98% felt involved as much as they wanted to be in decisions about their care and treatment. These results were significantly higher than local and national averages.

Staff we spoke with demonstrated the importance of ensuring that people understood what they were consenting to and the importance of obtaining consent before they delivered care or treatment. Clinical and non-clinical staff had completed training in the Mental Capacity Act. Staff understood the requirements of legislation and guidance when considering consent and decision making.

We looked at a sample of ‘Do not attempt cardiopulmonary resuscitation’ (DNACPR) decisions in patient records. Appropriately completed documents were available and had been shared with other relevant services and alerts had been added to the patient record system. Relevant documentation was also demonstrated in the care records of patients who did not have capacity to make decisions.