Trinity Medical Centre

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, we rated this key question as good. At this assessment, the rating remains the same.

This service scored 83 (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.

Care navigation was used as a point of contact tool and to ensure patients accessed the service most appropriate to their needs. Staff had received care navigation training to support them and followed a detailed care navigation protocol. Additional assessments were also undertaken by other parts of the organisation such as clinical assessment service also operated by the provider (CAS). The CAS is an essential part of the GP Care Wakefield operational delivery process and offers a remote consultation model, which uses telephone assessments, supported by the ability to view submitted images, to stream and direct patients to appropriate care. Assessments were undertaken by experienced clinicians who had been trained in remote assessments. Standardised assessment tools were utilised by clinical staff to identify need and care and decide on treatment options. The CAS was subject to a separate assessment outside the scope of this report.

The service had developed a pathway with Yorkshire Ambulance Service which allowed paramedics to contact GP Care Wakefield to discuss patients with GPs to avoid admission to hospital. In the previous 12 months from 209 of these contacts, 102 patients had been assessed and supported, and avoided being conveyed to hospital.

The service took into account patient flows and demands, and provided care in a flexible manner. For example, in the summer more pre-bookable appointments were offered, and in the winter more same-day appointments. In addition, during the summer 8 hours (or 32 appointments) were converted every weekday to routine pre-bookable GP appointments. During the winter these appointments were changed back to same-day to account for the additional same-day demand and pressures felt by practices. The service also supported local primary care networks (PCNs) with additional assessment capacity when these were under pressure. Over the past 12 months 151 additional clinics were delivered to support PCNs with additional capacity, which represented 1,661 additional appointments.

The extended hours service also delivered long-term condition reviews such as those for chronic obstructive pulmonary disease, asthma and diabetes. Capacity for these was driven by local need. For example, we saw that the spirometry offer (a common breathing test that evaluates lung strength and helps to diagnose chronic conditions) had been expanded in west Wakefield to meet practice waiting list demand.

We spoke with 1 patient during our onsite visits, and they told us they were involved in their care and were asked for their opinions on decisions about their treatment.

With the permission and consent of patients the service utilised an AI tool to capture patient-clinician conversations, and which the service felt enabled the clinician to spend more time with the patient directly assessing needs and delivering treatment.

Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to social prescribers and other support services should they identify other patient unmet needs.

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 and clinical records we saw demonstrated this. For example, the service used standardised clinical templates which were linked to national guidelines.

New guidance and updates to current guidance were shared with staff via a variety of ways. These included emails, the use of a cloud-based communication and collaboration channel, and their monthly staff bulletin. The service also supported staff learning such as by organising learning forums and educational sessions.

Adherence with guidance was assessed via a programme of audits and clinical supervision processes.

The service worked well across teams and other services to support people. They shared assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

The service worked well across teams and with external providers, including the patients’ own GPs, to ensure that appropriate care and treatment was provided. The service had developed effective communication routes with GP practices, and this was set out in their extended hours information manual. We saw that record sharing was in place across all Wakefield practices allowing both parties to see patient records and entries. When GP Care Wakefield had a concern which required a follow-up or recall for additional support, they were able to task the patient’s own GP to undertake this if appropriate. Similar processes were in place with another local provider should a patient require a home visit, or if they needed a face-to-face appointment if GP Care Wakefield had reached capacity. The service also maintained close links with their local walk-in service.Care navigators from the service were placed in Accident and Emergency when requested by the local secondary care provider. Over a 4 month period 302 patients were offered redirection from Accident and Emergency with 222 booking appointments in GP Care Wakefield, reducing pressure on hospital services.

Patients had access to the service via several routes including direct booking via diverted calls, but also via partners such as NHS 111.

We saw that the service worked closely with the constituent primary care networks and looked to develop projects to enhance local care and tackle identified need. This included services within this assessment such as acute respiratory infection hubs, and the provision of additional capacity during winter months.

As part of the respiratory project, we heard that consultants from the partnering secondary care provider worked alongside primary care clinicians as part of a multidisciplinary approach which saw over 100 patients discussed from across Wakefield practices, with 60% maintaining primary care-led management, and with others being fast-tracked into secondary care clinics.
 

The service supported people to manage their health and wellbeing to maximise their independence, choice and control, as well as offering guidance to people to live healthier lives and where possible, reduce their future needs for care and support.

The extended hours service and projects offered by Conexus Healthcare CIC actively supported a number of national priorities via their activities. This included NHS health checks, community vaccinations, cervical screening outside usual operating hours, support for women’s health including intrauterine system and pessary fitting clinics, respiratory clinics including FeNO testing (fractional exhaled nitric oxide - a quick, painless breathing test to diagnose and manage conditions like asthma), and outreach vaccination clinics. As examples of service commitment and impact, we saw that 40 staff had completed pessary theory training, and that 10 staff had received practical sign-off to deliver care. Since its introduction secondary care pessary waiting times had reduced locally by 34%. In addition, vaccination clinics delivered by the service allowed patients (including children) to attend for their vaccination outside of school and working hours. In the last 12 month 190 vaccination appointments had been delivered.

The service was involved in establishing a pilot site for NHS England’s Women’s Health Centre of Excellence programme. As part of this work the service planned to launch, in October 2026, menopause group consultations for women aged 40 to 55. Sessions will include important healthy lifestyles messages and support.

Staff had been trained, and could refer or signpost patients with specific needs to other organisations. Working within their constituent primary care networks, the service could support patients to access social prescribers and health and wellbeing coaches.

The service monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

The service had developed extensive and effective methodologies to monitor and improve services and outcomes for patients. This included a programme of audits which included audits of consultations and prescribing for clinical staff, call handling, and specific activities such as spirometry. This linked to other quality improvement work including thematic trend analysis for complaints and incidents. We saw that performance and outcomes had management oversight and were subject to frequent reviews. Reviews of audits and records showed that patients who used the service experienced positive outcomes as set out in legislation, standards, and evidence-based clinical guidance.

Patient outcomes for specific services delivered by the service were positive. For example, the respiratory care transformation project delivered by Conexus Healthcare CIC in conjunction with a local Hospital Trust from September 2025 to April 2026 saw 274 diagnostic tests delivered with 68 new chronic obstructive pulmonary disease diagnoses and 22 new asthma diagnoses. All these patients were now in receipt of medication and had self-management plans in place. This project also saw improved local training outcomes for clinical staff, with 49 staff receiving spirometry update training and 15 staff receiving new-initiate training.

Following the establishment of their women’s health services Conexus Healthcare CIC reported to us that specialist menopause referrals fell by 72%, and urgent 2-week referrals for unscheduled bleeding for women taking hormone replacement therapy fell by 30%.

Key contractual performance indicators we also closely monitored, and we saw as an example that the service had exceeded their performance target for urgent care provision achieving 14.8 minutes per 1,000 population against a target of 12.5 minutes per 1,000 population, and 64.2 minutes per 1,000 population for enhanced access against a target of 60 minutes per 1,000 population.

The service told people about their rights around consent, and respected these when delivering person-centred care and treatment.

As part of our assessment, we spoke with a range of clinical and non-clinical staff. From these discussions we found that they had a full understanding of consent principles and practices. Staff considered consent issues when providing care to children and young people, and the need to assess the mental capacity of patients to give their consent to care and treatment including referrals on to other services.Staff supporting patients who were to undergo FeNo testing (fractional exhaled nitric oxide) used a bespoke template to support the assessment of Gillick competence, specifically to ensure honest conversations around smoking status.
 

We saw that staff had received appropriate training in the requirements of mental capacity legislation including the Mental Capacity Act training. Staff had also received information governance training, and were aware of consent processes for the sharing of patient information and records. Consent, mental capacity and best interest decisions were routinely captured in patient records and were subject to scrutiny during audits.