Peak & Dales Medical Partnership Also known as Bakewell Medical Centre

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 with 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 requires improvement. At this assessment, the rating has changed to Good.

This service scored 67 (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 mostly made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We found people with long-term conditions were mostly provided with the care and monitoring they required. For example, people with hypothyroidism. However, we found a small number of people with a missed diagnosis of diabetes. The provider explained this had been impacted by a reporting error in the local laboratory equipment.

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. Data from the national GP survey showed that 97% of respondents stated that during their last appointment they were involved as much as they wanted to be in decisions about their care and treatment. This was above the national average of 91%.

We received feedback from 2 care homes where the service provided care and treatment. They told us there was a dedicated GP who provided ward rounds on a weekly basis at the home and they were very responsive to the needs of people living in the home. They told us a care co-ordinator maintained regular contact with the home ensuring their queries were directed to the most appropriate professionals.

The practice had employed a dedicated diabetic nurse specialist to support people with diabetes. One care home was extremely positive about the support provided by the diabetic specialist nurse. They told us the nurse carefully monitored and adjusted insulin regimens until they were fully optimised, which made a significant difference to the health and quality of life for people with diabetes. Unverified data provided by the service showed that since the specialist nurse had been in post many people’s overall blood glucose levels had lowered across the diabetic population. The specialist nurse had also introduced training to staff to support with diabetic reviews. For example, diabetic foot checks and blood pressure monitoring.

The service mostly 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. We found a small number of areas where current guidance had not been followed. The provider was able to explain and justify their rationale for taking these decisions in some cases and took into account people’s best interests.

However, people with asthma who had been prescribed 2 or more courses of rescue steroids in the last 12 months for an acute exacerbation of their asthma had not been followed up within 48 hours in line with National Institute for Health and Care Excellence (NICE) guidance. We reviewed the records of 5 of these people and found that 4 had not been followed up within 48 hours as recommended by NICE. Following our assessment, the provider sent to us a draft policy they planned to put in place to ensure staff followed this NICE guidance and minutes from their clinical meeting which showed that clinicians had been made aware of the need to follow up this group of people within 48 hours. The service also raised the issue with the Local Medical Committee and Primary Care Network so the learning could be shared with other practices across Derbyshire.

Systems were in place to ensure staff were up to date with evidence-based guidance and legislation. Clinical records we saw demonstrated care was mostly provided in line with current guidance.

The service worked well across teams and services to support people. Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. The practice worked with other services to ensure continuity of care, including where clinical tasks were delegated to other services. For example, the Primary Care Network and the wider multidisciplinary team. Staff told us that teams worked well together and that staff were friendly and kind.

The service mostly had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

There was a system to record and investigate complaints. When things went wrong, staff apologised and gave people support. We looked at 7 complaints and found they had all been acknowledged by the provider. The provider told us they had responded to all of the complaints. However, they could not evidence that a formal written response had been provided to 4 out of the 7 complaints or, that these complainants had been signposted to the Parliamentary and Health Service Ombudsman (PHSO).

The provider had processes for staff to report incidents, near misses and safety events. Managers encouraged staff to raise concerns when things went wrong. Significant events and complaints were standard agenda items at practice meetings. Staff were able to give examples of learning from significant events and felt there was an open culture, and that safety was a priority. Learning from incidents and complaints resulted in changes that improved care for others. There were systems in place to summarise and analyse trends in significant events and complaints to monitor that changes had been 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 met both clinical expectations and the expectations of people themselves.

National screening data for cervical screening showed that the number of women that had received this screening was very slightly below the national target of 80%. There were systems in place to follow up on people that did not attend this screening. National childhood immunisation uptake data showed that out of the 5 indicators, 2 indicators had achieved the WHO target of 95% and 3 were just 1% under the minimum target of 90%.

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.