Linkway 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

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, 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.

During the remote clinical review, we carried out a search to identify people with asthma who had been prescribed 2 or more courses of rescue steroids in the past 12 months. The search identified 47 people. We reviewed a random sample of 5 clinical records and found 4 patients had not had a follow up review following an exacerbation. We discussed the findings with the clinical team who provided assurances that a review of the clinical search would be undertaken to ensure all patients were reviewed appropriately.

We carried out a clinical search on patients who had hypothyroidism and had not received the appropriate monitoring in the past 18 months. The search identified potentially 13 people. We reviewed 5 clinical records and 1 patient had been reviewed appropriately, 2 patients’ prescriptions had been reduced in line with best practice to ensure patients followed clinical guidance for monitoring and 2 patients were no longer being prescribed medicines for this health condition.

Further reviews of the clinical system identified people with diabetes who had a HbA1c of 75 and over. A haemoglobin A1C (HbA1C) test is a blood test that shows your average level of blood glucose over time. We reviewed a random sample of 5 clinical records and found the appropriate reviews had been completed.

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 a translator to be present. 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.

Systems were in place to identify individuals with caring responsibilities, who were offered an annual review. All patients with a learning disability were invited to attend an annual health assessment.

The service always 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. They worked to develop evidence-based good practice and standards.

The clinical leadership team were consistently reviewing clinical guidelines to ensure patients were receiving high quality personalised care. We found the team had been proactive in reviewing the prescribing of gabapentoids, a group of medicines used to help with neuropathic pain. In February 2025, an audit had been completed to identify the number of patients currently being prescribed these types of medicines as there were potential risks to long term continued use. The audit identified 29 patients. A review of each patient was carried out which included risk factors and the benefits of the patient continuing on these medicines. Following the review the practice found 28 patients were on the appropriate medicines to treat their health conditions. Further follow-ups were planned to ensure safe and appropriate prescribing was in place in line with clinical guidelines.

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 told us that they had access to the information they need to appropriately assess, plan and deliver people’s care, treatment and support and they had enough information to plan and refer people and receive subsequent results and information following referral. The practice worked with other services to ensure continuity of care, including where clinical tasks were delegated to other services.

There were systems and processes in place to enable information to be shared between the provider and services to ensure continuity of care. Regular meetings were held with multi-disciplinary teams to ensure care was co-ordinated effectively.

The Primary Care Network (PCN) helped to support the practice by providing links to pharmacists, physiotherapists and social prescribers. People were able to receive co-ordinated care between the practice and the PCN.

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.

The practice had made reasonable adjustments to provide support to vulnerable patients. This included home visits for patients who were unable to attend the practice.

The practice had been involved in a range of initiatives. This included:

• The practice had worked with the PPG members on a range of organised events. This included manning stalls to raise money for various charities. For example, Birmingham Children's Hospital jumper day.
• The practice had hosted a women’s wellbeing event in June 2025. The event was held to provide information to females in the local community on menopause support, education and weight management. A range of community services joined the event, for example public health and the breast screening service. The practice organised a tombola and raffle and staff provided cakes. A menopause café was also set up to provide an area for patients to come together. Information was provided by 2 of the practice GPs. Atotal of 36 patients attended the menopause café session. The practice raised nearly £400 and this was given to the women’s refuge.
• The practice had organised a range of events to provide information and support to patients. This included in May 2026, the set up of a plant stall to raise money for dementia support and awareness. The practice raised over £100.
• During the last 3 years the practice had organised a Macmillan coffee morning. A range of stalls with cakes, books, children’s games and clothes were available to purchase to raise funds. The staff had donated all of the items and the money raised was donated to cancer awareness. The practice had raised nearly £800 each year, totalling over £2000 in the 3 years the practice had organised this event.
• To encourage patients to come together, a yearly carol service was organised by the practice.
• The practice nursing team organised a Christmas Carers morning. This gave carers the opportunity to speak with someone, take part in the organised activities, for example, bingo and Christmas crafts. A raffle was also organised. On average 40 people attended the event.

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.

The practice was below the national target of 80% uptake for cervical screening with the practice having achieved 58.7% for people aged between 25 to 49 years of age and for people aged 50 to 64 years, had achieved 68.2%. To encourage people to attend their appointments, appointments were available at different times throughout the week to provide choice and a range of availability. The practice had held a well women's event to encourage patients to attend for screening and to discuss any concerns they had.

The practice had not achieved the 5 national targets for childhood immunisations. For example, the latest data available showed the practice had achieved 77.8% for children aged 5 who have received immunisation for measles, mumps and rubella. This was below the 80% minimum target. Patients that failed to attend appointments were followed up and information was shared with the health visiting team.

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.

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.