Parkway

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 people’s care, treatment and support achieved good outcomes, based on best available evidence. At our last inspection we rated this key question as good. At this inspection the rating has remained as good.

People who used the service were involved in assessments of their needs. Staff reviewed service users’ assessments and made sure they understood their care and treatment, and followed consent procedures.

However, arrangements for staff supervision were not always implemented.

This service scored 75 (out of 100) for this area.

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.

This section was partly assessed using findings that apply to the whole Parkway site, which are included in the appropriate section of the surgery report.

Following initial consultant triage of referrals, nursing staff completed a pre-assessment appointment for service users. Nursing staff shared information about the type of procedures that service users were due to have and documented any relevant information they disclosed, including their medical history and advice for any pre-procedure treatment, such as the need for any fasting. Consultants reviewed the information again at the time of service users’ appointments for their procedure. Records we reviewed showed that there was a holistic assessment of individual needs, which was reviewed and clearly documented at each appointment.

This section was partly assessed using findings that apply to the whole Parkway site, which are included in the appropriate section of the surgery report.

Staff were experienced and qualified and had the right skills and knowledge to meet the needs of the people attending the service.

The service followed appropriate guidelines from the Joint Advisory Committee for Gastroenterology (JAG) and the British Society of Gastroenterology. Staff we spoke to were aware of current guidelines and completed competencies in accordance with JAG requirements. Data received from the provider confirmed that more than 70% of registered nursing staff had completed full endoscopy competencies for training others in practice. The remaining 30% of registered nursing staff were either competent in the activities or were new and returning to the service and completing their experience. Over 90% of the required nursing and support staff had completed their competencies for decontamination.

This section was partly assessed using findings that apply to the whole Parkway site, which are included in the appropriate section of the surgery report.

We observed the most recent records we received for the endoscopy user group meeting, which were dated January 2024, with no meeting held since. Therefore, staff did not have opportunities to meet and discuss the performance of the service.

This section was partly assessed using findings that apply to the whole Parkway site, which are included in the appropriate section of the surgery report.

Service users were given appropriate advice about diet, including nutrition and hydration following procedures. They were provided with general information about healthy living.

There was an audit programme for the service which included an annual review of referrals, decontamination audits, scope tracking, the environment, the consent process and any onward referrals to secondary care.

JAG did not currently provide access to the audit portal for independent providers as this was not yet fully established within secondary care. However, to ensure local quality and safety measures were in place, a system of annual retrospective review of all colorectal cancers diagnosed locally had been implemented.

To date there had been no incidents where the service had recorded a diagnosis of colorectal cancer (adenocarcinoma) after an endoscopy had been performed, where no cancer was diagnosed in a preceding procedure.

The service monitored sedation rates for endoscopy and comfort during procedures. Audit results indicated no concerns in relation to sedation rates, which were in accordance with current recommendations. There were no occasions where a reversal agent needed to be used.

This section was partly assessed using findings that apply to the whole Parkway site, which are included in the appropriate section of the surgery report.

The service identified a withdrawal of consent policy for endoscopic procedures, appropriately reflecting current evidence-based best practice guidance.