Trinity 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 have rated the practice as good for providing effective services as care was based on latest evidence and good practice and patients were involved in assessments of their needs. Staff worked with all agencies involved in patients’ care for the best outcomes and smooth transitions when moving services. Staff made sure patients understood their care and treatment to enable them to give informed consent. Staff took account of people’s communication, personal and health needs.

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 practice made sure patients’ care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. 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. From a selection of patient records reviewed, we saw that overall patient consultations contained appropriate information and demonstrated that care and treatment was being delivered in a safe way.

The practice planned and delivered patients’ care and treatment in line with legislation and current evidence-based good practice and standards. Staff told us they were kept up to date with current guidance through clinical meetings and in practice protected time. Clinicians we spoke with told us they used a clinical decision support tool integrated into the clinical system, which allowed easy access to the latest evidence-based guidance resources and templates. Clinical performance data was monitored and routinely reviewed at meetings to identify opportunities for improvement. This included monthly review of clinical searches, quality and performance dashboards and the Quality and Outcome Framework (QoF).

As part of our assessment, a CQC GP specialist advisor (SpA) conducted a series of remote clinical searches of patient records to assess the practice’s procedures around the management of patients with long-term conditions. For example, asthma, chronic kidney disease, diabetes and hypothyroidism. Overall, we found good management of these patients. In particular, we saw the practice’s respiratory nursing team had undertaken a considerable amount of work on the systematic review and management of patients issued 12 or more short-acting beta 2-agonist (SABA) inhalers. An audit showed that the team had reduced over a 15-month period the number of patients in this category from 155 to 7 patients.

The practice worked well across teams and services to support patients. Staff had access to the information they needed to appropriately assess, plan, and deliver care, treatment, and support. We saw there were systems and processes in place to ensure care was delivered and reviewed in a coordinated way which included local care homes, people receiving end-of-life care and those with a learning disability. There were regular documented multi-disciplinary team meetings. Information was shared with and received from out-of-hours services through their clinical system, and there were systems in place to follow-up on information received. The practice actively utilised the NHS Pharmacy First scheme as part of their triage model, and we saw they had fostered a close working partnership with local pharmacies. This was highlighted by a visit from NHS England as an example of how appropriate referral to the pharmacy scheme could benefit patients by accessing convenient and timely care for minor health issues and reduce the burden on GP practices.

The practice supported patients to manage their health and wellbeing to maximise their independence, choice and control. Staff told us they were committed to promoting and encouraging patients to live heathier lives. They told us they used consultations to opportunistically discuss health choices and provide supporting information. This included encouraging patients to attend health checks and reviews, signposting to support groups and self-help advice. Staff told us they supported national health priorities, initiatives and screening programmes to improve the population’s health, for example, breast and bowel screening.

Patients had access to care coordinators and the health and wellbeing coaches, which helped them improve their health and social welfare by directly supporting them or connecting them to community services. We saw the practice website had links to health and wellbeing information. The practice included health events and promotion on noticeboards in their waiting areas and organised health and wellbeing events. We saw that the practice had hosted a Dementia Cafe with sessions for patients and caregivers and delivered some outreach sessions for patients with mental health to encourage participation in health checks. In addition, one of the GP partners led on women’s health and had initiated a Menopause Cafe and specialist clinics which had been well attended and received positive feedback. To support this cohort of patients, they had initiated dedicated menopause appointments with extended consultation times and trained PCN pharmacy staff to conduct hormone replacement therapy (HRT) reviews.

The practice routinely monitored patient care and treatment to continuously improve it. We saw that the practice had a programme of quality improvement, including clinical and non-clinical audits, to drive improvements in care and treatment. There were patient registers in place, for example, those with a long-term condition. The practice operated a recall system to ensure patients were offered appropriate health assessments and checks. The practice had systems in place to follow-up those patients who did not attend. Validated data available for this assessment for the period up to April 2024 showed that uptake for childhood immunisations for 1, 2 and 5-year-olds ranged from 80.4% to 90.0%. Practice nurses we spoke with told us they followed-up on non-attendance and promoted uptake in consultations. There had also been engagement in the local community to promote childhood immunisation. Validated data for the uptake of cervical screening for the period up to June 2023 was 60.3%. The practice had systems in place to promote national cancer screening programmes and had a dedicated team who sent out patient recalls and actively followed-up on non-attendance. Appointments were also available in enhanced access clinics for cervical screening.

Clinicians understood the requirements of legislation and guidance around people’s consent to care and treatment, including the assessment of a person’s mental capacity to make a decision. When needed, clinicians supported patients and involved their families, carers and other professionals to make decisions in the person’s best interests, including decisions about Do Not Attempt Cardio- Pulmonary Resuscitation (DNACPR). We reviewed 2 patient records and saw evidence of the patient and their relatives being involved in end-of-life care discussions. We saw Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) care plans were used to record patient wishes regarding care and resuscitation and these were stored in the clinical records. Training records showed that staff had undertaken Mental Capacity Act (MCA), Deprivation of Liberty Safeguards (DoLS) and ReSPECT training relevant to their role. There was a GP partner lead for end-of-life care and regular multi-disciplinary team meetings.

Staff were aware of the need to request consent to share records in line with General Data Protection Regulation (GDPR) principles.

There was a formal consent form in place for invasive procedures, such as minor surgery.