Dr Bouch and Partners Also known as Bridge Road 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 advice and support.

This key question has been rated as good.

People were involved in assessments of their needs and staff reviewed people’s communication, health, and wellbeing needs. Care and treatment was based on latest evidence and good practice and was regularly reviewed. Staff worked with a range of partner agencies involved in people’s care for the best outcomes and smooth transitions when moving services. People were supported to live healthier lives. Staff made sure people understood their care and treatment to enable them to give informed consent. Staff involved those important to people and took decisions in people’s best interests where they did not have capacity. From our review of the clinical searches, we found that the service delivered evidence‑based care. However, arrangements for reviewing people with potentially undiagnosed conditions required strengthening.

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.

Our review of the clinical searches found the service delivered evidence‑based care. However, arrangements for reviewing people with potentially undiagnosed conditions required strengthening.

The service had systems to identify people who may have a possible missed diagnosis of chronic kidney disease (CKD) stage 3, 4 or 5. However, our search identified 122 people still needed to be reviewed. The service had already identified improvements were needed and had worked to review people. Following the site visit, the service submitted an action plan, had secured additional resource to complete this work, without impacting on existing clinics, and advised 20 people had already been reviewed.

Care home representatives and people we received feedback from were positive in relation to how their needs were assessed by clinicians and the clinical care and treatment they received. Arrangements were in place to ensure people’s needs were assessed by a GP when they moved in.

Staff told us they had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. Staff involved people and their carers in assessments where appropriate. Systems were in place to identify people with caring responsibilities. The service held a carers’ registerand 4.3% of people were registered as carers.

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. Clinical staff used templates when conducting assessments and care reviews to support the review of people’s wider health and wellbeing.

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 practice.

Care home representatives and people we received feedback from were positive in relation to the clinical care and treatment they received, which included long-term condition reviews.

Arrangements were in place to invite people for their review. Tests were completed before review appointments, so results were available at the time. People who missed appointments were followed up to ensure they continued to receive appropriate care and treatment.

We observed from the clinical searches that care was aligned with evidence-based practice. For example, there were effective systems for monitoring people with chronic kidney disease stages 4 or 5, and people with hypothyroidism. We reviewed people with asthma prescribed emergency steroids. From a sample of 5 people’s records, an adequate assessment was undertaken at the time of prescribing, although the process of follow up was not always effective. We raised this with the provider who submitted a protocol for follow up arrangements, so people were consistently followed up in a timely way.

Staff told us they were supported by leaders to stay up to date with current guidance and evidence-based practice through training days, clinical meetings, and learning from audits.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People gave positive feedback in relation to the registration process, and timely, appropriate referrals being made.

Protocols were in place to manage the flow of work. People’s correspondence which was deemed urgent, for example urgent blood results, were prioritised. Arrangements were in place to ensure required actions were reviewed and authorised by an appropriate clinician. We reviewed the tasks lists on the clinical system which showed they were managed in a timely way. Audits of the work of non-clinical staff were completed by leaders and issues identified were discussed and learning undertaken.

Referrals and test results were managed in a timely way. Staff who were involved in making referrals were clear about their role and checks were in place to ensure referral requests had been actioned. A range of audits were in place, for example to ensure people had been seen, results received, and follow up arrangements were in place.

The service worked with other services to deliver shared care and when people moved between services. Partner agencies who provided feedback for this assessment gave positive feedback for this area.

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.

A self-testing health pod was available in the waiting area where people could carry out a variety of health checks to monitor their wellbeing. Results were automatically entered into the person’s clinical record. Arrangements were in place to escalate results which were outside of the agreed range to a clinician for review.

Staff supported national health priorities and signposted to services to support, for example, smoking cessation and obesity reduction. The health and wellbeing coach was trained to lead monthly wellbeing walks for people from local practices and supported local park runs to encourage people to improve their physical activity.

Processes were in place to identify and support people at risk of developing a long-term condition. The service had arrangements in place to offer NHS health checks to eligible people. People with a learning disability were contacted and invited for a health check. An easy‑read booklet was available to explain what would happen. Staff told us it was mainly used for people who were new to the service, as they had already developed supportive relationships with existing people with a learning disability. Reasonable adjustments were in place to support people’s attendance.

The care coordinator supported people with social needs, such as those experiencing social isolation or housing difficulties, to contact organisations able to provide appropriate help. Social prescribing link workers were also based at the service.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and 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. People and care home representatives gave positive feedback in relation to the clinical care and treatment they received.

The service performed in line with the national average for breast and bowel cancer screening. Childhood immunisation rates exceeded national targets. Cervical screening uptake was slightly below the 80% target in both the 25 to 49 and 50 to 64 age groups. Actions were being taken to improve uptake. For example, the service had supported 2 nurses to complete cervical screening training and planned to increase clinic availability. The service had an effective recall system. Flexible appointment booking options and extended hours were available, which included appointments on Saturday. Follow-up arrangements were in place for people who did not attend, and reasonable adjustments were made to support access, including pre-visit introductions and explanations.

The service monitored and improved outcomes for people by carrying out clinical audits.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

People were appropriately informed when making care and treatment decisions. People’s feedback demonstrated they felt listened to.

The service had systems and processes in place to obtain consent to care and treatment in line with legislation and guidance. Staff had completed training and understood and applied legislation relating to consent. Clinicians told us they always obtained consent from people, and they recorded this on the clinical system. Posters were displayed at the service and information was on their website to inform people that a chaperone was available if needed.