Ilford Lane 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 monitored people’s care and treatment and supported them to live healthier lives. At our last assessment, we rated this key question as good. At this assessment, the rating remains the same.

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.

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

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

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 supported people to manage their own health through health education integrated into almost every consultation, covering smoking cessation, diet, and medication adherence, and through opportunistic care. For example, a patient attending for one appointment with time available would have other due checks, such as a blood pressure reading or overdue vaccination, offered in the same visit. The practice had invested in bringing services in-house to widen access, including its own centrifuge to allow evening blood test appointments, and its own spirometer after referral waiting times became unmanageable, with the nurse trained to run spirometry clinics.

Staff understood and adjusted for individual needs. For example, reasonable adjustments to appointment timing were made for people with learning disabilities or other disabilities. Where possible, patients were seen by a clinician who shared their language or cultural background for non-emergency care, and an interpreter service was used, with appointments automatically extended when a language need was flagged on the patient record. Condition-specific flags on the clinical system gave staff the information they needed to understand the needs of an individual.

People at risk were identified and followed up. For example, a learning disability register of 33 patients received structured annual health reviews, and an end-of-life register, held by a named lead doctor, included annual reviews of care plans, advance care planning, and arrangements to prioritise death certification for families with religious or cultural needs.

The practice supported national priorities individually and, increasingly, through the primary care network, including a family health event, a diabetes event, and learning disability health promotion, and used targeted text messaging to raise awareness of screening programmes such as bowel cancer screening.

The practice served a population in the third most deprived decile nationally on the Index of Multiple Deprivation (3 of 10). It therefore focused on offering health checks whenever possible, making diagnostic tests easier to access and encouraging people to attend screening.

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

Long-term condition monitoring followed defined clinical thresholds. For example, cancer care followed a comparable review cycle at twelve to eighteen months from diagnosis, covering medication review, onward referral, and patient-raised concerns. Recent cancer diagnoses were reviewed at practice meetings as a shared learning opportunity.

The practice ran a programme of targeted quality improvement using its own data. For example, a five-year, ongoing audit of repeat HbA1c testing in diabetic patients, an audit of the appropriateness of accident and emergency attendances. Screening and immunisation performance was reviewed monthly against practice lists, with action agreed when a drop was identified, and audit findings judged concerning were discussed at a clinician-only forum before being brought to the wider practice meeting.

Cervical screening uptake had improved to 81.5%, above both the NHS's 80% optimal performance standard and the World Health Organization's 70% coverage target, and around 12 percentage points above the current national average of 68.8%. This was achieved by changes made in direct response to monitoring data, including moving the first annual invitation round from June to April, adding a third invitation round for persistent non-responders, extending Wednesday screening appointments to 6.20pm, and introducing HPV self-sampling as an alternative to a speculum examination.

Childhood immunisation uptake did not meet the 95% World Health Organization target. At 94%, this was the closest the practice came to target across three of the twelve-month vaccines. Coverage for measles, mumps and rubella stood at 88% for the first dose at twenty-four months and 89% for both doses by age five. The practice was open about this being a longstanding and difficult area they monitor, citing significant anti-vaccination sentiment locally and vaccine hesitancy that had extended from COVID-19 vaccination into childhood programmes. Patients who actively declined were coded accordingly, which understated true uptake in some national reporting comparisons. The practice had escalated to public health for support, introduced weekend vaccination clinics through the primary care network, and was planning a themed clinic event aimed at making attendance more appealing to children.

The practice served a population in the third most deprived decile nationally on the Index of Multiple Deprivation (3 of 10). This was relevant when considering the below-target childhood immunisation rates and the practice’s continued work to improve uptake.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.