Parkside 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 people had the best possible outcomes because their needs were assessed and care and treatment was provided in line with up-to-date best practice.

At our last inspection we rated this key question Requires Improvement.
At this assessment, the rating has changed to Good.

This is because:

• The practice usually took steps to make sure patients who had long-term conditions were monitored and reviewed in line with national guidance. However, the practice did not always identify when test results indicated a patient may have an undiagnosed long-term condition.

• Staff worked together and with other services to help make sure people received care that was safe and effective.

• Staff usually supported people to live healthier lives, including meeting national targets for the numbers of patients screened for the risk of cervical cancer, the numbers of children being immunised against various infectious diseases, and supporting carers. However, the practice did not always offer or complete health checks available for certain groups of people.

However, the provider needed to strengthen systems and processes to show staff always met the requirements of the Mental Capacity Act when appropriate, and chaperones were offered in a way that was in line with national guidance and the practice’s policies.
 

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

19% of patients registered with the practice had 1 or more long-term conditions, such as asthma, chronic kidney disease (CKD), diabetes or hypothyroidism.

The practice usually took steps to make sure patients who had long-term conditions were monitored and reviewed in line with national guidance, to make sure their health and medicines needs were being met. This included patients:

• whose test results suggested their diabetes could be better controlled and were at a higher risk of developing complications because of their diabetes

• who were prescribed medicines to help make sure their hypothyroidism was managed as well as possible

• who had more advanced CKD.

However, the provider's systems to identify people with previously undiagnosed conditions did not always work effectively. This meant the practice had not always identified and acted when test results indicated a patient may have an undiagnosed long-term condition. From the records we looked at for this assessment, the practice had not always informed the patient their test results indicated they had CKD. The practice had not always carried out further appropriate investigations or offered the patient the recommended treatment and ongoing reviews and monitoring to make sure the treatment was working as well as possible. The provider was aware and had assigned identifying and acting on possible missed diagnoses of CKD as a project to particular staff.

 

Systems were in place to help staff keep up-to-date with evidence-based best practice and guidance. Staff shared learning and experiences informally as well as in more formal team meetings. There were also 'Hot Topics' where a specific member of staff would share an update about a particular topic, such as prescribing certain medicines.

There were systems in place to help make sure patients were offered care and treatment that was in line with clinical guidance.

Prescribing data reviewed as part of our assessment showed staff prescribed medicines appropriately. These included antibiotics, which need to be used carefully to help prevent resistance to them, and certain medicines that need to be used carefully because a person’s body can change to tolerate them, creating a dependency on the medicine, and are known to be widely used illegally as drugs of abuse.
 

The different teams within the practice worked well together to help make sure relevant people had access to the information they needed to assess, plan, and deliver people’s care, treatment, and support.

The practice also worked with other teams and services to support people and to help provide safe care that met people's individual needs. For example, staff referred patients to other services and shared information with other staff and services on a case-by-case basis when it was appropriate.

This included offering people support from a social prescriber. Social prescribers connect people to a variety of services to help them to look after their physical and mental health and their wellbeing. Social prescribers can support a patient or carer to access groups and opportunities, for example to learn a new skill or meet people, improve health and wellbeing or manage a long-term condition. They can help people access advice, for example to help with money or housing concerns, loneliness and isolation, anxiety or low mood.

There were systems for sharing information with staff and other agencies to help make sure patients were offered safe care and treatment. These included multi-disciplinary meetings, which the practice held every 3 months. These included input from other services, such as health visitors, palliative care nurses, community nurses and the Integrated Care and Support Team. In these meetings, staff discussed and coordinated care for patients nearing the end of life or who had more complex needs.

 

The practice supported national priorities and initiatives, for example the practice website had information for those wishing to stop smoking or lose weight.

The website also had information about local and national support services, for example for those experiencing abuse, bereavement, drug and alcohol use, and links for local community groups such as parent and toddler groups and health walks. There was also information about maternity care and child health, elderly care, mental health, sexual health services and support for carers.

There was an area off the main waiting area where patients could take their own blood pressure, height and weight with privacy.

Information was available in the waiting areas, including about support for those affected by cancer, dementia or menopause, as well as about support for carers, veterans, young people and new families.

There was information about other NHS and private services such as support for mental health, stopping smoking, walking groups and prescription delivery services.

Information was available to help people live healthier lives, such as information about the signs of breast or prostate cancer, heart health, liver disease and lung health checks. There was also information about child and adult vaccinations and cervical screening.

One of the doctors at the practice was registered with the British Society of Lifestyle Medicine.

One of the doctors gave talks on various health topics, including menopause, kidney health, weight management and lifestyle, and cervical screening. Talks about cervical screening were planned for June 2026.

The practice identified people who may need extra support, for example unpaid or family carers. An unpaid or family carer is anyone who looks after a family member, partner or friend who needs help because of their illness, frailty, disability, mental health needs or drug or alcohol problem and cannot cope without their support. The care they give is unpaid. Just over 200 unpaid or family carers were on the practice’s register, about 2% of the patients registered with the practice. Five of these carers were ‘young carers’, meaning those under the age of 18.

A care coordinator maintained an up-to-date register of carers and patients with carers. The practice supported carers, for example by identifying if additional help was needed to help the patient access care and treatment.
 

The latest information from the UK Health Security Agency (UKHSA) showed, of the number of children registered with the practice, the number of children who were immunised against various infectious diseases met the minimum target of 90% and in some cases met the national target of 95%. Data from the UKHSA showed:

• 95% of children aged 1 had completed a course of immunisation for Diphtheria, Tetanus, Polio, Pertussis, Haemophilus influenza type b (Hib) and Hepatitis B (Hep B).

• 93% of children aged 2 had received a booster immunisation for Pneumococcal infection (PCV booster).

• 95% of children aged 2 had received a booster immunisation for Haemophilus influenza type b (Hib) and Meningitis C (MenC).

• 95% of children aged 2 had had their first dose of immunisation for measles, mumps and rubella (MMR).

• 92% of children aged 5 had had 2 doses of immunisation for MMR.

Patients aged between 40 and 74 are eligible for a NHS health check. The practice told us they had completed a health check with about 3% of patients registered with the practice who could have one.

The practice offered patients with a learning disability a yearly health check. The practice told us, at the time of this assessment, health checks had been completed in the last year with about 60% of the 78 patients registered with the practice who had a learning disability.

Cervical screening (a smear test) is one of the best ways to help protect against and prevent cervical cancer. The latest information from NHS England showed that on 30 June 2024, 72% of patients registered with the practice who were aged 25 to 49 and eligible for this screening had been screened adequately within the recommended time period of 3 years 6 months. 77% of patients registered with the practice who were aged 50 to 64 and eligible for this screening had been screened adequately within the recommended time period of 5 years 6 months. These were slightly below the national target of 80%.

The practice had taken steps to encourage patients to be screened, including:

• offering patients access to 'walk-in' clinics, where appointments were as long as the person needed, helping to remove any perceived pressure of needing to rush to fit in with an allocated appointment schedule

• offering patients pre-bookable appointments, up to 3 months in advance

• providing patients with links to information about screening and a link for the person to book an available appointment at a time that best suited them.

Practice leaders told us feedback from patients had been positive.

The practice kept a tracker for the numbers of patients who had been screened. Whilst CQC cannot verify the data, the practice provided information showing, at the time of this assessment, 91% of eligible patients had been screened.

The practice also sent a reminder message to the patient the day before their appointment, and also a link if the person needed to rearrange the appointment. The practice told us this had reduced the numbers of patients who did not attend for their appointment.

 

Clinical staff described how they would seek consent and would not proceed without having the appropriate consent.

Clinical staff showed an awareness of legal frameworks associated with consent, such as when assessing and treating children and the Mental Capacity Act.

Training records showed all clinical staff had completed training in the Mental Capacity Act.

However, for some patients, we did not see clinicians had clearly recorded how they had assessed a patient to lack the mental capacity to make a particular decision at that time, in line with the Mental Capacity Act. This included when a decision had been made in the patient's best interest following a discussion with the patient's relatives or care home staff not to attempt Cardio-Pulmonary Resuscitation (CPR).

Leaders acknowledged our feedback and told us they would share our findings with staff in the practice.

Patients were advised chaperones were available. A chaperone is an impartial observer present during an examination or consultation when a patient may feel vulnerable, for example during an intimate examination. A chaperone acts to protect both the patient and the member of staff.

The provider shared with us their learning from a recent event where a chaperone had not been present during an intimate examination.

The practice's website said the impartial observer will be a practice nurse or health care assistant who is familiar with the procedure. This is in line with national guidance and the practice’s policies.

However, as well as nurses and health care assistants, other staff told us about times in the last year when they had acted as a chaperone. This included non-clinical staff. Leaders told us the preference was for non-clinical staff to carry out the chaperoning role, as they were often more readily available than clinical members of staff. Clinical staff also told us it was now mostly non-clinical staff who acted as chaperones. This was not in line with the statement on the practice’s website nor national guidance.

Although staff we spoke with described following a suitable chaperoning procedure, and training records showed all non-clinical staff had completed chaperoning training, we were not assured all staff who acted as a chaperone had the required familiarity of the procedures being carried out.