The Village Surgery

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 with 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. The rating remains good following this assessment.

This service scored 63 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s experience of the service as indicated in the national GP Patient survey showed that 94% of patients (national average 91%) felt involved in decisions about their care and treatment and 92% (national average 90%) felt their needs were met during their last appointment.

There were systems in place to ensure people’s immediate and ongoing needs were assessed and people who required monitoring were recalled for checks on their health. Our review of the clinical record system for the sample of people whose care and treatment we looked at, indicated that people’s long-term conditions were being appropriately managed overall. We identified that improvements were needed to the process for identifying people with 1 long-term condition to ensure these patients had access to the required monitoring. Following the assessment the provider told us how this would be addressed.

Staff worked with other healthcare professionals to assess people’s needs and deliver coordinated packages of care. The provider had systems to identify people with previously undiagnosed conditions. Staff and leaders were aware of the needs of the local community. The provider used registers to identify people with specific needs, for example, people with learning disabilities, mental health conditions, long term conditions, palliative care needs and carers to ensure that needs were assessed and managed appropriately.

The practice had systems and processes to keep clinicians up to date with current evidence-based guidelines and the use of clinical tools. The provider monitored the timeliness for managing clinical correspondence and tasks.

Leaders and staff told us they 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, for example, there was regular information sharing with external health and social care professionals. The provider worked with colleagues in the local primary care network (PCN) to meet the needs of the patient population.

The service supported people to live healthier lives and manage their health and wellbeing. 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 people’s health, including smoking cessation and weight management. People living with long term health conditions were referred or signposted to local support services for information, education, and advice linked to their needs. Members of the clinical team provided patients with information and support to manage their health, care and wellbeing. People were also encouraged and supported to make healthier choices to help promote and maintain their health and prevent deterioration. People could be referred to a social prescriber for support with issues impacting on their health such as social isolation, life changing events and housing. Educational events to improve awareness of health issues such as breast cancer and health check services were provided by the provider and through the PCN.

Staff and leaders told us how people were supported to manage their health and wellbeing and where possible reduce their need for future care and treatment. They advised people when they needed to seek further help and what to do if their condition deteriorated. They identified people who may need extra support and directed them to relevant services. We saw that people were able to get test results and were referred to other services without delay.

People had access to appropriate health assessments and checks. People were encouraged to attend cancer screening and take up vaccinations offered as part of national programmes. The most up to date published data for cervical cancer screening (NHS England 30/06/2024) showed the practice attainment was below the expected target rate of 80%. More recent, unverified data provided to us by the practice indicated an improvement with figures at 80%.

The most up to date published data for childhood immunisations (UK Health Security Agency 01/04/2024 – 31/03/2025) showed immunisations for children were below the World Health Authority recommended target rate of 95% (practice attainment for children aged 1, 2 and 5 ranging from 79.1% to 79.6%). Unverified data provided by the practice showed figures from the same period ranged from 79% to 89%. The practice had a low number of children registered as patients which also had an impact on attainment.

The provider told us how uptake of childhood immunisations and cervical screening was being monitored and the steps they had taken to improve uptake. This included contacting people directly to provide information about their importance, flexible appointments and patient education. The PCN was also supporting increasing uptake. For example, they had recently carried out a survey of patients not having cervical screening to find out what the barriers were so that these could be addressed. The provider should continue to take steps to improve the uptake of childhood immunisations.

Staff told us how people were provided with information about their care and treatment to enable them to make an informed decision. Staff had undertaken training in the Mental Capacity Act to enable them to understand the requirements of legislation and guidance when considering consent and decision making. Some staff had completed this as part of safeguarding training and the provider told us that they were planning to introduce a specific training course for all staff to complete. We looked at a sample of ‘Do not attempt cardiopulmonary resuscitation’ (DNACPR) decisions in patient records. These were not always as required in terms of having the full paperwork available on the patient record system. The provider told us they were reviewing all people with a DNACPR, and this would be addressed during this process. They told us a revised protocol would also be put in place as the current one did not include informing out of hours and the ambulance service.