Daybrook 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

At our last assessment, we rated this key question as good. At this assessment, the rating remains the same. This meant people’s outcomes were good, and people’s feedback confirmed this. 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.

This service scored 75 (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 healthcare, wellbeing, and communication needs with them.

Reception staff were aware of the needs of the local community. Digital flags within the care records system were used to highlight any specific individual needs, such as the requirement for longer appointments or for a translator to be present.

Feedback from people using the service was mostly positive. People felt involved in assessments of their needs and felt confident that staff understood their individual needs. Staff had a good knowledge of the local community.

Staff checked people’s health, care, and wellbeing needs during health reviews. Clinical staff used templates when conducting care reviews to support people’s wider health and wellbeing. Staff could refer people with social needs, such as those experiencing social isolation, housing difficulties, and homelessness to a social prescriber.

All staff had completed learning disability and autism training, and people with complex health needs were given longer appointments with both a nurse and doctor to review their complex needs. The practice offered a quiet place for people to sit whilst waiting for their appointments who may be anxious to wait in a busy and noisy room.

The provider had systems to identify people with previously undiagnosed conditions. For example, people whose blood tests results showed they had pre-diabetes were offered appointments to advise them how they could prevent it developing into diabetes.

The practice had considered the Accessible Information Standards and made adaptations in line with this. For example, a hearing loop for people who were hard of hearing, and parking for disabled people.

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.

People were involved in decisions about their care, including what was important and mattered to them, for example, end of life care.

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. For example, we reviewed medical records for five people with diabetes. All five people had received invitations to attend for a review of their diabetes. One person had not attended for their review despite numerous invitations, and a home visit had been attempted to review the person.

Staff had access to local and national guidelines which could be accessed easily through online platforms with links to guidance also available through their clinical system. Updates to guidance were shared with all relevant staff at meetings whose minutes were circulated to ensure all staff were aware.

Staff we spoke with told us they held clinics to support people with long term conditions such as asthma, diabetes and chronic heart disease. They told us they used local and national guidelines and kept up to date through training and updates were circulated within the practice.

Clinical audits were conducted to ensure care was delivered in line with legislation and recommended guidelines. For example, the practice carried out regular audits of women of childbearing age receiving topiramate (a medicine used to treat epilepsy and bipolar disorder which if taken during pregnancy, can cause birth defects). Women identified were contacted and consulted regarding contraception advice or medication changes if they wanted to get pregnant.

The service worked well across teams and services to support people. They shared 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. People had access to services provided by the primary care network (PCN), including physiotherapy, social prescribers and extended access appointments. Mutual support and learning were shared across the PCN.

Referrals to other services were audited to ensure that appointments were created for people in a timely manner, for example, when people were referred for suspected cancers. The medical secretary regularly checked that people referred to suspected cancer services had received an appointment from the hospital. The practice regularly held multidisciplinary meetings with community nurses, palliative care nurses and specialist nurses, to review vulnerable people’s holistic care and treatment, including people with a cancer diagnosis.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

The service did not meet national targets childhood immunisations. National data collected on 31 March 2024 showed all 5 indicators for childhood immunisations were below the 95% World Health Organisation based target for uptake, and below the minimum uptake expected by the NHS for these immunisations. The service did not meet the 80% national target for cervical cytology screening uptake. National data collected in 2024 showed that the service were below the minimum rate of 80%, achieving 73.9% for women aged 25 to 49 years of age and 76.6% for women aged between 50 to 64 years. However, the provider demonstrated how they continually worked towards achieving and exceeding these targets. The service implemented robust systems to invite people, in their preferred method of contact and language. Interpreters were utilised to reach out to marginalised people to encourage them to attend for smear appointments and childhood vaccinations. The service provided flexibility for people to book appointments for childhood immunisations and cervical cytology screening at evenings and on Saturdays. The nurses rang parents when children were not brought for their immunisations and will ring parents in advance of an appointment to remind them. There were effective systems in place to follow up people who failed to attend for these appointments.

The service carried out regular audits to monitor and improve care as well as participating in their Primary Care Network (PCN) and national audit activities.

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.

The practice had effective processes for recording consent within the medical record and guidance was accessible on the practice’s website.

The staff had good knowledge of gaining and assessing consent options allowing the delivery of person-centred care and treatment which was in the person’s best interest. This included young people and people who did not have capacity to consent to care and treatment.

The practice kept records of lasting power of attorney and consent to treatment forms were in place where people had mental capacity. We reviewed three records which showed Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation.