Hightown Village 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 that 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. This is the first inspection for this service since its registration with CQC. This key question has been rated as good.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Support was available and accessible for people with additional needs or communication needs. For example, people who required the services of an interpreter or patients with a learning disability. Sensory tool kits were available for people with Autism or ADHD. Leaflets were available in reception in easy read format. Patient experience of the service as indicated in the national GP Patient survey showed that 61% of patients felt they knew what the next steps would be after contacting the service and 89% had confidence and trust in the healthcare professional they saw or spoke to. Both indicators were below local and national averages. People who reported symptoms that could be considered a clinical emergency could be seen on the day or be signposted to a more appropriate service. Following appointments 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. A social prescriber isa healthcare professional who helps patients identify and connect with non-medical resources and activities in their community to address social, emotional, and practical needs that impact their health and well-being.

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. For example, our clinical searches identified 12 of the 104 patients diagnosed with diabetes had a HbA1C (blood test to check glucose levels) above 75 mmol. We reviewed 5 records, and all had attended a comprehensive review including a review of their medicine, except for 1 patient who had been invited but had not attended.

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. Some partners reported that communication with the practice had been challenging and that the service had not always been as responsive as they would have liked in meeting individuals’ needs.

Staff told us there was an open culture and the leadership team were approachable and supportive. However not all staff felt concerns were addressed fully or communicated effectively.

Staff told us teamwork was good and they enjoyed working at the practice. Staff told us they were confident and comfortable approaching the management team for any reason.

The service supported people to live healthier lives and manage their health and wellbeing. Staff focussed on identifying risks to patient’s 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 start 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. The percentage of persons eligible for cervical screening were below expected targets for patients aged 25 to 49 years old (expected 80%, observed 69.4%) and aged 50 to 64 years old (expected 80%, observed 70.5%). Childhood immunisation uptake was below the World Health Organisation targets. Children aged 2 with Haemophilus influenza type b and Meningitis C booster vaccine (expected 95%, observed 85.7%). Children aged 2 with Measles, Mumps and Rubella vaccine (expected 95%, observed 85.7%) and children aged 2 with pneumococcal conjugate booster vaccine (expected 95%, observed 78.6%).

We discussed this with the provider who demonstrated that people who had not attended for cancer screening or child immunisation were followed up and encouraged to attend.

The service routinely monitored people’s care and treatment to continuously improve it. People who required monitoring underwent regular checks on their health. 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. Staff told us they had engaged proactively to contact patients to encourage them to attend their cervical cancer screening.Regular searches of patient’s medicines were undertaken. Extra help to manage long-term conditions, advice for those on multiple medicines and better access to health checks were offered depending on the results.

People who used the service felt they could make an informed decision about their care and treatment because they had been provided with information they needed to support them to do so. The National GP Patient Survey results showed that 87% of respondents felt their healthcare professional had all the information they needed and 89% of respondents felt involved as much as they wanted to be in decisions about their care and treatment. Both indicators were in-line with 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 staff had undergone training in the Mental Capacity Act. Staff understood the requirements of legislation and guidance when considering consent and decision making.

We sampled 3 patient records with a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision. All records contained the information expected. The letters where the decision had been made were available and a copy of the DNACPR had been given to the patient.