The Steven Shackman 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

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 in 2016, we rated this key question as good. At this assessment, the rating remains the same.

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 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. 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 translation services. 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. The provider had effective systems to identify people with previously undiagnosed conditions. Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber.

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.

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 service worked with other services 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. Staff supported national priorities and initiatives to improve population health, including stopping smoking and tackling obesity.

Leaders had developed tools to support people with or at risk of high blood pressure, high cholesterol and heart, liver, kidney and diabetes conditions.

A health event led by clinicians was being organised to support people with diet, getting active, smoking cessation and insomnia.

The service did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

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.

Childhood immunisations were carried out in line with the national childhood vaccination programme. According to the UK Health Security Agency (UKHSA) published data, the practice had met the World Health Organisation (WHO) target of 95% for 3 out of 5 childhood immunisation indicators measured in 2024/25, which were recorded at 83.3%, 95.2%, 95.2%, 96.4% and 92.4% respectively.

According to the NHS England published data (30 June 2024), the practice population uptake rates for cervical cancer screening programme were below the NHS cervical screening target of 80%. They achieved 66.8% cervical cancer screening rates for women aged 25-49 years and 75% screening rates for women aged 50-64 years old. The practice was working proactively to increase smear uptake however the actions implemented had not yet brought uptake in line the NHS target of 80%. Breast screening coverage for women aged 53 to 70 years old measured in 2024/25 was recorded as 74.2% compared to a national average of 70.4%.

Bowel cancer screening coverage for people aged 60 to 74 years old measured in 2024/25 was recorded as 72% compared to a national average of 71.8%.

The service provided examples of multi-cycle clinical audits which demonstrated sustained outcomes for patients. The examples were:

• Teratogenic drugs (medicines that interfere with normal foetal development) and contraception.
• Minor surgery audits (including post-operation infection rates, general infection prevention and control and subdermal implants).
• Steroid card audit (assessment of patients prescribed steroids to determine whether they require an emergency steroid card).

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. Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation, including the Mental Capacity Act 2005.