Park 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.

People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on latest evidence and good practice. Staff worked with all agencies involved in people’s care for the best outcomes and smooth transitions when moving services. Staff made sure people understood their care and treatment to enable them to give informed consent. Staff involved those important to people took decisions in people’s best interests where they did not have capacity. Our clinical searches identified a small number of areas for improvement which were fully actioned, implemented by the practice and reviewed by our GP

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.

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 felt involved in any assessment of their needs and felt confident that staff understood their individual and cultural needs. 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 provider had effective systems to identify people with previously undiagnosed conditions. There were 16 patients identified by our clinical searches as having the potential for a missed diagnosis of diabetes. We reviewed 5 of the 16 and found these to be satisfactory.

Our clinical searches found of the total number of patients with diabetes and a high blood sugar monitoring result (HbA1c >75mmol/l) was 123 out of 896 patients. We sampled 5 of the records and found these to be satisfactorily monitored and reviewed.

There were 12 patients with hypothyroidism that our clinical searches identified as having the potential for not having had thyroid function test monitoring for 18 months. We sampled 5 out of the 12 records. Four out of 5 patients appeared overdue blood monitoring. These were not excessively overdue and had been identified and invited for monitoring.

We reviewed the record of the1 patient record our clinical searches identified with chronic kidney disease at stage 4 or 5, who had the potential to have not had bloodtest monitoring in the last 9 months. We found the patient had dissented from any further blood tests.

The total number of patients with asthma who had been prescribed 2 or more courses of rescue steroids, was 43. We sampled 5 of the 43 records and these were all found to be satisfactory.

Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a 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. For example, the clinical search records we reviewed for people who received treatment following an exacerbation of their asthma demonstrated they were followed up within 48 hours, recalled if they did not respond and had evidence of safety netting advice.

Clinical records we saw demonstrated care was provided in line with current guidance.

The practice operated a proactive recall system to support preventative health interventions for patients reaching key age milestones, such as turning 65 or 70. Monitoring patients health reviews included pulse rhythm checks for atrial fibrillation screening, a frailty assessment, blood pressure monitoring, and vaccination eligibility for pneumococcal and shingles vaccines.NHS Health Checks were provided to eligible patients aged 40 to 74 through a commissioned programme. Invitations were issued systematically, supporting early identification of cardiovascular risk factors such as raised blood pressure, diabetes and pre-diabetes.

The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

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, including where clinical tasks were delegated to other services.

The service held a continuity of care approach ethos, with GPs including salaried GPs having their own patient lists to encourage patient rapport and trust. The clinical team had contributed to some bespoke clinical templates and care plans for individualised support. They had a centralised specific pharmacy and medicines management optimisation team. The service provided staff training and development opportunities which included career progression.

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

Staff focussed 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. Staff supported national priorities and initiatives to improve population health, including stopping smoking and tackling obesity with referrals made to a commissioned service.

Park Medical Centre participates in the local C-Card scheme, providing confidential access to free condoms and sexual health advice for eligible young people. This supports prevention of sexually transmitted infections and unplanned pregnancy, and formed part of the practice’s wider commitment to proactive health promotion and early intervention.

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.

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 practice met national 90% targets for childhood immunisations. In fact, all but 1 met the World Health Organisation 95% target and this 1 was extremely close to that target at 94.9%.

Cervical screening uptake NHS England data from 30/06/2024 showed that the cervical screening uptake of the eligible female population aged 25 to 49 years old was 71.2% of the 80% target. The cervical screening uptake NHS England data from 30/06/2024 showed that the cervical screening uptake of the eligible female population aged 50 to 64 years old was 73.1% of the 80% target. The practice had a robust strategy to improve uptake where able. This included:

• A strengthened proactive recall system
• Making every contact count approach with opportunistic screening opportunities
• Behavioural science informed invitation wording to review and redesign the wording of cervical screening invitation letters.
• Primary Care Network level monitoring and benchmarking
• The development of a reception call script to understand barriers.
• Continued support for health awareness topics with the practice Patient Participation Group waiting room noticeboard to highlight this screening.

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

Staff understood and applied legislation relating to consent. Capacity and consent were clearly recorded. Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation.

We randomly sampled a selection of the Recommended Summary Plan for Emergency Care and Treatment form (ReSPECT) forms. We looked at the systems in place to support patients in documenting their preferences supported by family/advocate/carers. A ReSPECT form is a personalised plan created through conversations between the individual, their family, and healthcare professionals, detailing what treatments the person would or would not want in an emergency when they may not be able to communicate their wishes. All the forms we reviewed demonstrated a patient-centred approach, including reviews following discharge from acute illness in secondary care. One of the forms we reviewed was a patient without capacity, but whose preferences were documented in the first person. The person with power of attorney (POA) was noted but despite the practice requesting a copy there was no record held on file. The person noted as POA was not the person with whom the ReSPECT form was completed. The practice advised this would be reviewed and they will consider as a team any potential changes. Subsequent to the inspection Park Medical Centre commenced the process of transferring ReSPECT forms to a digital format. This facilitated sharing important clinical information and patient's wishes with other relevant healthcare providers contributing to consistency in care.

Bereavement support included condolence, the offer of face-to-face appointments, signposting to supportive local groups and alerting front line staff of recent bereavements and appropriate electronic coding.