Dr Rajiv Goel Also known as The Riverside Practice

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.

We found that patients were regularly assessed, and care and treatment were delivered in line with current legislation and evidence-based guidelines. The service had a programme of quality improvement activity and routinely reviewed the effectiveness and appropriateness of the care provided.

At our last assessment, 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 maintained up-to-date patient assessments and ensured staff understood individuals’ current health and care needs. Vulnerable patients were prioritised, with annual health checks offered to those with learning disabilities and reasonable adjustments made to support attendance. A carers register was maintained, and collaboration with an on-site social prescriber helped connect patients to community support.Care and treatment were regularly reviewed, with attention to wellbeing and communication preferences. Feedback was positive, with patients feeling involved and understood. Reception staff used digital flags to highlight specific needs, such as interpreter support or extended appointments. The provider had systems to identify previously undiagnosed conditions, and staff referred individuals with social challenges, such as isolation or housing issues, to the social prescriber.

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.

The service worked collaboratively across teams to support patients, ensuring assessments were shared so individuals didn’t need to repeat their stories. Staff had access to all necessary information, supported by clear policies and procedures. Systems enabled safe information sharing both internally and with external agencies.Regular liaison with community teams, including health visitors and mental health practitioners, supported coordinated care. Referrals to specialist services were well documented, included all required details, and were actively monitored to avoid delays.

The service empowered individuals to manage their health and wellbeing, promoting greater independence, choice, and control. It aimed to support people in leading healthier lives and, where possible, reduce their future need for care and support.Staff focused on identifying health risks, including those affecting individuals in the last year of life, those at risk of developing long-term conditions, and people with caring responsibilities. They actively supported national health priorities and initiatives, such as smoking cessation and obesity reduction, to improve overall population health. As part of its work to reduce health inequalities, the provider told us they have focused on improving blood pressure control and statin prescribing for Afro-Caribbean patients with a QRISK score (a cardiovascular risk assessment tool used in the UK). It estimates a person’s risk of developing a heart attack or stroke over the next 10 years at 10% or more over the past two years. They have also increased the number of housebound diabetic patients receiving a full annual review, including retinal screening. In addition, last year and this year, they have targeted men under 50 to attend NHS Health Checks.

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

The service was situated in an area where vaccine hesitancy was notably high among some communities. Between 1 April 2023 and 31 March 2024, the service did not achieve the WHO national target of 95% for all five key childhood immunisation indicators. Uptake ranged from a high of 90% to a low of 69%.

Similarly, the national targets of 80% for cervical screening uptake (based on NHS Digital data dated 30 May 2023) for the eligible population aged 25- to 49-year-olds and 50 to 64 years old were not met.

In response, leadership acknowledged these shortfalls and implemented a targeted action plan following an ICB review of the immunisation process. Key measures included appointing a GP vaccination lead and introducing a clinical recall lead to oversee the recall system. This involved following up with patients who missed appointments and contacting those with vaccine hesitancy to address their concerns. Administrative staff sent text messages containing information and a self-booking link to encourage participation. The practice was registered to become a 'No Fear' cervical smear practice and offered alternative options for patients who decline or experience difficulty undertaking an in-surgery cervical smear. This included referral to community gynaecology services, hub weekend appointments, and early morning and evening weekday appointments to provide greater flexibility for patients. The service also plan to introduce double appointment slots for cervical smears where clinically appropriate, to improve patient comfort and uptake.

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.

Clinicians understood the requirements of legislation and guidance when considering consent and decision-making. Consent was documented, and clinicians supported patients in making informed decisions. Where appropriate, mental capacity assessments were carried out and recorded.

A review of five DNACPR decisions confirmed they were made appropriately and in line with legislation. Clinical staff had completed training on the Mental Capacity Act.