East Park Medical Centre - R P Pandya

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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 thatstaff involved people in decisions about their care and treatment and provided them advice and support. At our last assessment, we rated this key question as requires improvement. At this assessment, the rating has changed to good. This meant staff regularly reviewed people’s care and worked with other services to achieve this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The practice made sure people’s care and treatment was effective by assessing their health, care, wellbeing and communication needs with them. There were systems in place to identify patient’s needs and preferences. For example, people’s specific needs were recorded, such as requirement for a longer appointment or the need for a translator. The practice met the accessible information standard as the practice adhered to people’s communication preferences. The patient participation group (PPG) were a key asset to the practice, who often engaged with patients to understand their individual needs and informed the practice to ensure this was addressed.82% of patients that completed the National GP Patient Survey agreed that they felt their needs were met during their last GP appointment. This was lower than the national average of 90%. However, 95%felt the healthcare professional they saw had all the information they needed about them during their last GP appointment which was above the national average of 92%.

The practice did not always deliver care and treatment in line with current evidence-based good practice and standards. They planned and delivered people’s care and treatment with them, including what was important and mattered to them. Meetings were held to ensure staff were updated with the latest information, guidance and changes within the practice.

The clinical searches we undertook of the practice’s clinical records system showed the monitoring of people with long-term conditions was mostly followed in line with National Institute for Health and Care Excellence (NICE) recommendations. For example, one of our clinical record searches reviewed the number of patients with asthma who had been prescribed two or more courses of rescue steroids in the last 12 months. We identified a total of 21 patients and reviewed a random sample of 5 patient records. All 5 patients had inconsistent follow up appointments to check their response to the treatment. The practice acknowledged this feedback and leaders quickly provided evidence that they had updated their policy to ensure patients are followed up appropriately within the suggested timeframe.

We reviewed monitoring of people with hypothyroidism (when the thyroid gland does not produce enough thyroid hormone that can lead to tiredness and weight gain). A total of 503 patients were identified, and we reviewed a random sample of 5 patient records. All patients were monitored appropriately.

We reviewed patients with chronic kidney disease (CKD) stages 4 or 5. A total of 100 patients were identified. Only 1 patient was overdue the appropriate blood test monitoring in the last 9 months, but the practice provided evidence that this blood test was booked in the for next day.

We reviewed the monitoring of diabetes care and found that all but 1 patient received their annual review.

The practice shared evidence of clinical audits that evidenced improved patient care.

Leaders and staff worked well across teams and services to support patients. Information was shared between teams and services to ensure patients experienced a smooth transition between services without the need to repeat their history.

Staff worked collaboratively with other services to ensure continuity of care to ensure people had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. The practice had monthly meetings, including regular multidisciplinary team meetings within the primary care network to ensure all teams were up to date with relevant information for patients in the community. The practice had implemented an open-door approach to encourage open communication among staff. This enabled queries and concerns to be addressed in a timely manner and supported a positive and collaborative working culture.

The practice always supported people to manage their health and wellbeing to maximise their independence, choice and control. They encouraged patients to take an active role in reviewing their health and recognise changes in their own health and wellbeing by sharing advice and guidance. Staff took a proactive approach to identifying and managing risks to patients’ health. This included patients approaching the end of life, those at risk of developing long-term conditions, and patients with caring responsibilities. The practice also supported national health priorities and initiatives aimed at improving population health outcomes, including smoking cessation and obesity management. During the onsite visit, we observed lots of health leaflets on display to encourage people to live a healthier lifestyle.

Findings from the clinical search records indicated that the practice routinely monitored people’s care and treatment to improve and ensure that both clinical and patient expectations were met. At the time of our assessment, the latest published information from the UK Health Security Agency (UKHSA) showed that the practice met the World Health Organisation target of 95% for the number of children immunised against various infectious childhood diseases. The latest published information from NHS Digital showed the practice’s uptake for cervical cancer screening for women was below the 80% national target. Cervical screening uptake for women aged 25 to 49 years old was observed at 60.8%. Cervical screening uptake for women aged 50 to 64 years old was observed as 75.6%. Leaders told us they had taken steps to improve cervical screening uptake. For example, they offered extended-hours clinics on Mondays, and staff also used opportunities during routine consultations to encourage eligible patients to attend and raise awareness of the importance of screening.

The practice told patients about their rights around consent and respected these when delivering care and treatment. Staff understood and applied legislation relating to consent. Patients received information about care and treatment in a way they could understand. Patient’s capacity and ability to consent was considered and clearly recorded. Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation.