Canberra Old Oak 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.

At our last assessment in November 2022, we rated this key question as Good. At this assessment, the rating remains the same.

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.

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 who commented on the quality of the service felt their needs were being met. Reception staff were aware of the needs of the local community. 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. Clinical staff used templates when conducting care reviews to support the review of people’s wider health and wellbeing.

The service had effective systems to identify people with previously undiagnosed conditions. We found some inconsistency in the way that the service was coding symptoms and markers of diabetes which could potentially delay the diagnosis of diabetes. However, the service reviewed its coding protocols immediately following the assessment.

Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber.

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.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

The service monitored people’s care and treatment to ensure that outcomes were positive and consistent. However, they were failing to meet targets for childhood immunisations and cervical screening coverage.

There was an established programme of clinical audit and quality improvement activity to review the effectiveness and appropriateness of the care provided. From the clinical notes we reviewed, we found that people who used the service experienced positive outcomes as set out in legislation, standards, and evidence-based clinical guidance.

The service encouraged people to participate in population screening (such as the cervical screening programme) and families to attend for childhood immunisations in line with the UK immunisation schedule. However, the service was performing markedly below national targets in all these areas. Low coverage increases the risk that people could develop associated (and preventable) conditions.

The uptake rate for cervical screening was 64% for eligible women aged 50 to 64 years old and 51% for eligible women aged 25 to 49 years old (June 2024 snapshot data). The national screening target is 80%. The provider was achieving 47-73% childhood immunisation coverage for the 5 routine childhood vaccinations (2024/25). The minimum target is 90%.

The service had identified cervical screening and childhood immunisations as areas for improvement and identified local barriers to uptake, including cultural attitudes to immunisation and screening and a highly mobile population including a proportion of people who spent periods of time abroad.

The service had implemented a range of measures to increase uptake. These included access dedicated nurse-led cervical screening clinics on Saturdays; following up with non-responders; using a variety of communication methods to engage people and their families and providing targeted education on the benefits of screening and immunisations. At the time of this assessment, the service was planning to hold an outreach event on women’s health and screening in the community. The service also provided catch-up HPV immunisations for people who had missed this at school. The HPV virus is linked to the development of abnormalities in cervical cytology. While we observed evidence of initiatives to increase uptake, their impact was not yet reflected in nationally reported data.

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.