Wrenbury Medical 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

Patients and the wider community consistently experienced better outcomes than expected when compared with similar services. Feedback about the service’s effectiveness, received from patients directly to the Care Quality Commission and through Friends and Family responses was overwhelmingly positive, often described as exceptional and distinctive. Leaders fostered a strong culture of improvement, where understanding outcomes and exploring best practice was deeply embedded. Learning was actively shared and used to make meaningful changes.

People were actively involved in assessments of their needs and decisions about their care and treatment. The team worked collaboratively with other services to ensure easy access to additional support when needed. Assessments were regularly reviewed, considering people’s communication, personal, and health needs. People received care and treatment that supported healthier lives, including encouragement to participate in national screening programmes and vaccinations. Those requiring monitoring had regular health checks. Both clinical and non-clinical audits were conducted to help improve patient outcomes.

The practice’s performance was in line with or better than other local services and above local and national averages for child immunisations and cervical screening. Documentation and alerts, such as those for ‘Do Not Attempt Cardiopulmonary Resuscitation’ assessments, were appropriately recorded in patient records and staffworked closely with all agencies to ensure the best outcomes and smooth transitions between services.

This service scored 79 (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 reflected in the National GP Patient Survey, exceeded both local and national averages. Of those who responded, 98% felt involved in decisions about their care and treatment, compared with 93% across the Integrated Care System (ICS) and 92% nationally. Similarly, 98% of patients reported having confidence in the healthcare professionals treating them, again exceeding the ICS and national averages (93% and 92% respectively). In addition to the survey results, CQC received over 650 positive responses through the "Give Feedback on Care" platform, reflecting strong overall patient satisfaction.

The practice demonstrated a strong commitment to inclusion and accessibility. Support was available for individuals with additional or communication needs, including patients from the travelling community, those requiring interpretation services, and people with learning disabilities. A high percentage, 97%, of patients said their needs were met during their last appointment, compared with 91% across the ICS and 90% nationally.

Relevant information was routinely shared with other professionals when planning care and treatment, and patient records were updated promptly to reflect any changes. Those living with long-term conditions or learning disabilities were invited for regular reviews, supported by structured templates to ensure care was comprehensive and consistent.

The provider had effective systems in place to identify patients with potentially undiagnosed conditions, such as diabetes or cancer. Clinically vulnerable individuals were prioritised, and the practice worked closely with other healthcare professionals to deliver well-coordinated care. Feedback from affiliated healthcare professionals was overwhelmingly positive, further reflecting the quality and effectiveness of the service provided.

Reception staff triaged appointment requests using thorough care navigation training. Patients reporting symptoms suggestive of a clinical emergency were prioritised for same-day appointments or directed to a more appropriate service.

Following consultations, patients were given clear guidance on when to seek further help and what to do if their condition worsened. Staff could refer patients with social needs, such as those facing isolation or housing issues, to a social prescriber. Immediate access to a physiotherapist was also available.

The service demonstrated a proactive, consistent, and positive safety culture based on openness and honesty. Clear processes were in place for reporting incidents, near misses, and safety events, and these were followed by all staff without exception. Leadership consistently listened to safety concerns, thoroughly investigated issues, and ensured transparent reporting over time.

The practice included a dispensary and provided clear evidence of learning from all dispensary errors. Staff consistently reported feeling comfortable raising concerns, quoting a blame-free environment where safety and learning were prioritised to prevent recurrence.

Patient complaints were infrequent, and feedback was actively encouraged, systematically documented, and thoroughly investigated. All patient feedback was reviewed to identify trends and themes that could drive improvements. Evidence showed that incidents, complaints and any negative feedback were routinely discussed in Protected Learning Time (PLT) meetings, with the full team involved in reviewing outcomes to maximise learning and support change. Verbal complaints were also documented and responded to. We saw evidence of consistently documented clinical learning events over 3 years. In addition, a peer-to-peer referral scheme, systematically evaluated to ensure improvement and shared learning.

Staff had access to the information needed to assess, plan, and deliver care effectively. The practice maintained an open-door policy with the district and Macmillan nursing teams and participated in a Better Care Fund (BCF) project, collaborating with community services to review patients at high risk of hospital admission. They collaborated closely with the local nursing home, including joint work with the medicines management care home team.

Staff demonstrated good working relationships with all the local NHS Trusts and used those relationships to support patients to navigate the complex health and social care system. For example, assisting patients when making outpatient appointments. The practice regularly hosted speakers at protected learning events to raise awareness of partner services and delivered internal sessions to help staff understand how external contracts were funded and delivered.

Further partnerships included work with several local charities to support local carers workshops, travelling families, and a volunteer group assisting with transport and social support such as coffee mornings. The practice also worked with the local food bank to help patients in need to access essential support.

The service supported people to lead healthier lives and manage their own health and wellbeing. Staff took a proactive approach to identifying risks to patients’ health, including those in the last 12 months of life, individuals at risk of developing long-term conditions, and those with caring responsibilities. They contributed to both local and national health priorities, such as smoking cessation, and actively encouraged uptake of national screening programmes. Positive outcomes were evident through high participation rates. Cervical screening uptake exceeded the national target of 80%. Patients were also encouraged and supported to make healthier lifestyle choices to promote their wellbeing and prevent deterioration.

There was strong oversight of urgent referrals, with robust failsafe systems in place to ensure patients attended their two-week wait appointments. Individuals living with long-term conditions were regularly monitored and, where appropriate, referred or signposted to local services offering information, education, and tailored support. We saw clear evidence of collaborative work with the Primary Care Network to support local initiatives, including those related to learning disabilities, cancer, and immunisations.

A review of the clinical record system confirmed that patients were receiving care and treatment aligned with healthier living. The practice had also made a significant investment in staff training to support these aims.

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 exceeded local and national percentages of 92% and showed that 98% of respondents felt they had all the information they needed and 98% felt involved as much as they wanted to be in decisions about their care and treatment.

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 undergone training in the Mental Capacity Act and clinical 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.

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 exceeded local and national percentages of 92% and showed that 98% of respondents felt they had all the information they needed and 98% felt involved as much as they wanted to be in decisions about their care and treatment.

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 undergone training in the Mental Capacity Act and clinical 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.