Severn Valley 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 patients in decisions about their care and treatment and provided them advice and support. Staff routinely reviewed patients 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 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 practice had systems and processes in place to identify patients’ needs and preferences during the registration process. The practice 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 patients’ health, care, and wellbeing needs during health reviews. Doctors used templates when conducting reviews to support the assessment of patients’ wider health and wellbeing. Staff could refer patients with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber.

The majority of feedback from patients using the service was positive. Patients felt involved in assessments and felt confident that staff understood their individual and cultural needs.

There were systems in place to ensure staff were up to date with relevant legislation, evidence-based practice and required standards. The remote clinical searches we undertook of the practice’s clinical records system included reviewing the monitoring of people with long-term conditions to assess if National Institute for Health and Care Excellence (NICE) recommendations were followed.

For example, we identified 172 patients with diabetes whose last blood glucose reading was over 75. We reviewed a random sample of 5 patient records and found all patients had their diabetes and diabetic medication reviewed following this blood glucose result.

One of our clinical records searches reviewed the number of patients with asthma who had been prescribed two or more courses of rescue steroids in the last 12 months. We identified a total of 93 patients and reviewed a random sample of 5 patient records and found all patients had been followed up appropriately and had received an adequate annual asthma review which included providing the patient with an asthma care plan.

For patients with hypothyroidism, our clinical records searches identified 38 patients who had not had thyroid function test monitoring for 18 months of which we reviewed a random sample of 5 patient records. From these 5 records, we were not assured appropriate monitoring had been checked by GPs prior to issuing prescriptions and we identified issues with coding on the clinical system for hospital blood tests being undertaken.Following our assessment the practice provided us with evidence from the Integrated Clinical Environment (ICE) system to demonstrate patients had received the necessary blood tests, however we were not assured these blood test results were checked by the clinician prior to prescribing as there was no evidence documented within the EMIS system that this had been done.

The practice worked well across teams and services to support patients. Staff had access to information they needed to assess, plan, and deliver patients’ care, treatment, and support. Systems were in place to share information about patients electronically with other services. The practice worked with other services to ensure continuity of care and held regular multi-disciplinary team meetings. For example, the practice had a palliative care clinical lead who attended regular meetings with local district nurses. Patients had access to services provided by the primary care network (PCN), including social prescribers and extended access appointments.

The practice supported patients to manage their health and wellbeing to maximise their independence, choice and control. Staff supported national priorities and initiatives to improve population health such as the NHS Stop Smoking programme. The practice website contained information to support health initiatives.

The practice routinely monitored patients’ care and treatment to continuously improve it. Staff endeavoured to ensure that outcomes were positive and consistent, and that they met both the clinical expectations and the expectations of patients. Staff focused 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.

Published national data showed the practice had achieved the 95% World Health Organisation based target for 4 out of 5 childhood immunisation indicators. The percentage of children aged 5 who had received immunisation for measles, mumps and rubella (two doses of MMR) was 89%.

Breast and bowel cancer screening coverage was above national averages. Published national data for the uptake of cervical screening showed the practice had achieved 71.4%, which was below the national target of 80%.

As part of our assessment, we reviewed the practice audit programme. We found audits had been undertaken; however, these were only one-cycle audits which made quality improvement difficult to assess. Staff explained that they had planned to undertake a second cycle of the audits following our assessment.

The practice told patients about their rights around consent and respected these when delivering person-centred care and treatment. A consent policy was in place to ensure appropriate consent was obtained from patients when receiving care and treatment. Staff understood the requirements of legislation and guidance when considering consent and decision making.

Patients were offered a chaperone for care and treatment where this was appropriate. Chaperone posters were on display at the practice to inform patients of this service and staff who provided this service had completed chaperone training.