Linden Hall 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. 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.

Feedback from people using the service was mainly positive. The results of the GP patient survey 2025 showed that 95% of practice respondents felt their needs were met during their last appointment compared to the local and national average of 90%. The percentage of respondents whodescribed their overall experience of this GP practice as good was 94%, which was significantly higher than the local and national averages of 75%.

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. Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber.

The practice held a register of carers, which included young carers. The practice aimed to identify patients as carers during new patient registration and posters were displayed requesting patients to identify themselves to reception staff.

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 good practice and standards.

Systems were in place to ensure staff were up to date with evidence-based guidance and legislation. The practice was a training practice and offered a strong culture of training and development. Meetings were held to support the sharing of information and the practice participated in quarterly protected learning time sessions. Clinical leads had been identified for key areas and had responsibility for disseminating any new guidance. Staff had access to online training resources as well as access to the Shropshire training hub.

The practice offered a robust program of clinical supervision to non-GP clinicians, such as advanced nurse practitioners, first contact physiotherapists, primary care paramedics, and clinical pharmacists. Protected time was allocated daily for debriefing and discussion with an allocated GP supervisor. This allowed for an open-door and real time approach to supervision and clinical guidance.

The remote clinical searches we undertook of the practice’s clinical records system included reviewing the monitoring of people with long-term conditions. The results of the searches showed that National Institute for Health and Care Excellence (NICE) recommendations were being followed.

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 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. A register was maintained of patients with palliative care needs and monthly meetings were held with members of the multidisciplinary team to review their needs. Patients had access to the Primary Care Network staff (PCN) which included clinical pharmacists, pharmacist technicians, first contact physiotherapists, paramedics, social prescribers and a mental health practitioner.
 

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. Patients had access to a social prescriber service as well as a community care co-ordinator, which offered support with bereavement, exercise, weight, lifestyle, housing, employment, carers support and loneliness and signposted patents to other agencies and local support groups as appropriate.

The practice monitored people’s care and treatment to improve it. During our assessment of the service, we noted that the practice had undertaken audits with a view of improving outcomes for patients. One of these audits sought patients’ views on the new triage system and satisfaction with the time seen by a clinician and identified further areas for study.

A review of the most recently published data for cervical cancer screening showed the practice had achieved an uptake of 70.8% within the last 3.5 years for their eligible population aged 25 to 49 years old and 79.4% uptake within the last 5.5 years for their eligible population aged 50 to 64 years old. These were below the national target of 80%. The practice had attempted to improve on the cervical screening uptake through a variety of ways, including offering appointments on a Saturday, once per month at their Muxton branch. The practice had identified patients who had concerns about the screening process and had contacted these patients by telephone with the aim of alleviating their concerns and encourage uptake.

The practice had met the World Health Organisation based target in 4 of the 5 childhood immunisation indicators. The percentage of children aged 5 who had received immunisation for measles, mumps and rubella was 86.1% which was slightly below the 90% minimum target.

The practice had a lead for child immunisation, who was proactive in undertaking searches for children who had not received their scheduled immunisations. Staff offered as much flexibility as possible to facilitate appointments at a time which best suited parents and children.

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. We checked the records of 5 patients who had a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision on their file. For the files checked, we found that decisions were appropriate. We found that for 2 patients, the form was unavailable on their files. For one of these patients, there was a clear reason why the document was not on file and detailed records had been kept regarding the patient’s wishes. For the second patient, the decision had been made prior to joining the practice.

Following the inspection, the practice confirmed that key staff had reviewed DNACPR processes to ensure a copy of the respect form appeared on patient records where possible. The practice had since also implemented a process for undertaking yearly reviews of the decisions.