Wickham Park Surgery

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• 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 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. For example, GP Patient Survey data showed that 88% of patients felt they were involved as much as they wanted to be in decisions about their care and treatment during their last appointment.

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. Our clinical searches showed evidence of good management of long-term conditions. For example, people with diabetes and asthma had their needs assessed and reviewed at the appropriate intervals and when required action taken to maintain conditions.

The provider had effective systems to identify people with previously undiagnosed conditions. For example, NHS health checks were caried out and they were able to identify new conditions or the risk of conditions developing.

Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber. In the past 12 months 5 patients had been referred to the service. Staff told us patients had positive outcomes including for example support to access certain benefits that they had not been aware they were entitled to.

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. For example, we saw that when treating asthma patients GPs followed asthma guidelines. The incorporation of best practice had led to improvements in asthma care.

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 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 such as district nursing and pharmacists to ensure continuity of care, including where clinical tasks were delegated to other services.

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. They actively contacted and carried out blood tests for patients at risk of developing diabetes for example people with hypertension, overweight or pre-diabetes blood results.

Staff supported national priorities and initiatives to improve population health, including stopping smoking and tackling obesity. The GPs told us they referred patients to weight management services and smoking cessation clinics.

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 practice generally met national targets for screening and immunisations. They had systems in place to identify and invite patients who were due for screenings such as cervical and bowel cancer. When patients did not respond to initial invitations, systems were in place to identify these patients and send additional invitations.

The practice manager told us that whilst they had met the target for the percentage of children aged 5 who have received immunisation for measles, mumps and rubella (two doses of MMR), achieving 96.5%, they were aware that they were slightly below some of the other targets for children’s immunisations. For example, they achieved 88% for the percentage of children aged 2 who have received immunisation for measles, mumps and rubella (one dose of MMR)), compared to the target of 90%. They gave examples of how they worked with families and patients who they knew were hesitant and they employed strategies such as providing additional education and offering opportunistically when at the practice.

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 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. For example, when they carried out reviews of patients with learning disabilities, they always ensured they had appropriate support and obtained consent, and discussions were documented well in their records.

Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation. GPs described the palliative care process during our discussions, and their processes were in line with guidance and our expectations. Appropriate mental capacity assessments had been carried and documented clearly.