Millcroft 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

People were involved in the assessment of their needs whilst staff ensured they were involved in decisions about their care and treatment and offered advice and support throughout. Staff regularly reviewed assessments and took account of communication preferences, personal circumstances, and health needs. Care and treatment promoted healthier lives, including support for national screening programmes and vaccinations, and staff managed chronic disease effectively. Both clinical and non-clinical audits were carried out to help improve outcomes for patients. The practice was performing in line or above local and national averages for most required indicators, specifically those relating to medicines.

A review of patient records showed care and treatment followed evidence-based guidance. Where improvements were identified, the provider took immediate action.

Staff worked closely with all agencies involved in a person’s care to ensure the best outcomes and smooth transitions when people moved between services.

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.

Patient experience of the service as indicated in the National GP Patient survey showed that 80% of patients who responded felt involved in decisions about their care and treatment and 90% had confidence in the healthcare professionals treating them. These scores were lower than local and national averages. Support was available for people with additional needs or communication needs, for example, people who required the services of an interpreter or patients who had a learning disability. Of patients who responded to the National GP patient survey, 75% said their needs were met during their last appointment, lower than local and national averages. The provider was aware of the lower-than-average scores and were responding to try to make improvements.

Requests for appointments were triaged by an experienced triage team who were either trained nurses or advanced care practitioners. People who reported symptoms that could be considered a clinical emergency could be seen on the day or be signposted to a more relevant service. Patients were advised when to seek further help and what to do if their condition deteriorated. Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber. Relevant information was shared with other professionals when planning care and treatment and treatment records were updated to reflect any changes made.

People living with a long-term condition and those with a learning disability were invited for regular review of their health, care and treatment and staff used templates for this to ensure the reviews were appropriately detailed and recorded. The provider had effective systems to identify people with potentially undiagnosed conditions, for example diabetes and cancer. People who were the most clinically vulnerable were prioritised and the practice worked with other healthcare professionals to deliver coordinated packages of care.

Systems were in place to ensure staff were up to date with national guidance, evidence-based good practice and required standards. Staff attended meetings and received supervision. We looked at the workflow for managing clinical correspondence within the clinical patient record system and tasks and found these were up to date on a daily basis. Clinical staff had time factored into their days to deal with administrative tasks. However, there were historical tasks that required review and deletion to ensure nothing was missed.

Our review of the clinical record system for the sample of people whose care and treatment we looked at, indicated that people received care, treatment and support that was evidence-based and in line with good practice standards. The results of the clinical searches for the management of patients living with long term conditions were good and any gaps we identified in the monitoring of patients were dealt with immediately by the provider.

Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. The practice worked with other services to ensure continuity of care. Leaders and staff worked closely with colleagues in the local PCN to meet the needs of the patient population.

Multi-disciplinary meetings were held on a regular basis so that when people received care from a range of different staff, teams, or services, such as those in the affiliated care home, this was co-ordinated.

Staff demonstrated good working relationships with the local NHS Trusts and used those relationships to support patients to navigate the health and social care system. Shared care agreements were in place to ensure that prescribing arrangements between primary and secondary care were well managed.

However, staff reported that teams within the services could be regularly working in silo and communication could be improved throughout.

The service supported people to live healthier lives and manage their health and wellbeing. Staff focused on identifying risks to patients’ health, including those in the last 12 months of their lives, patients at risk of developing a long-term condition and those with caring responsibilities. People were called in for regular checks on their health when they were living with a long-term condition.

Staff supported local and national priorities and initiatives to improve population health, including smoking cessation and encouraging patients to take up national screening programmes.

People living with long term health conditions underwent regular monitoring. Staff referred or signposted them to local support services for information, education, advice and support linked to their needs. The practice contacted patients who did not attend cervical screening and child immunisation programmes to encourage uptake. People were also encouraged and supported to make healthier choices to help promote and maintain their health and wellbeing and prevent deterioration. We identified inconsistent follow up in some patients with asthma following rescue steroids and asked the provider to review these.

The percentage of persons eligible for cervical screening as of 30/06/24 who were screened was 66% which was lower than the expected target of 80%. Childhood immunisation uptake was below the 90% World Health Organisation targets in 2 of 5 age categories.

The service routinely monitored people’s care and treatment to continuously improve it. They sought assurance through a series of key performance indicators and quality improvement activity. The practice was able to demonstrate improvements through audits which they shared during the assessment. Positive outcomes were demonstrated through patient experience and GP practice indicators. From the clinical records we reviewed, we found that people who used the service experienced positive outcomes in line with best practice guidance.

Leaders demonstrated that monitoring and improving outcomes for patients was important to them and they used information and data to drive improvement. There was evidence of clinical, non-clinical and medicines audits carried out to improve outcomes for patients.

People who used the service felt they could make an informed decision about their care and treatment because they had been provided with the information they needed to support them to do so. The National GP patient survey results showed that 87% of respondents felt the health professional they saw had all the information they needed and 80% felt involved as much as they wanted to be in decisions about their care and treatment. However, these results were lower than local and national averages.

Staff we spoke with demonstrated the importance of ensuring that people understood what they were consenting to and the importance of obtaining consent before they delivered care or treatment. Clinical and non-clinical staff had completed training in the Mental Capacity Act. Staff understood the requirements of legislation and guidance when considering consent and decision making.

We looked at a sample of ‘Do not attempt cardiopulmonary resuscitation’ (DNACPR) decisions in patient records. Appropriately completed documents were available and had been shared with other relevant services and alerts had been added to the patient record system. Relevant documentation was also demonstrated in the care records of patients who did not have capacity to make decisions.