Nettleham Medical Practice Also known as Dr Waller and partners

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.

People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on latest evidence and good practice. Staff worked with all agencies involved in people’s care for the best outcomes and smooth transitions when moving services. Staff made sure people understood their care and treatment to enable them to give informed consent. Staff involved those important to people took decisions in people’s best interests where they did not have capacity.

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 provider ensured that the care and treatment offered were effective. Clinicians completed thorough assessments and reviewed each person’s health, care and wellbeing needs in partnership with them. At the initial consultation, the clinician carried out a comprehensive assessment which included a full medical history, and details relating to the person’s presenting concerns. Following this assessment, clinicians discussed appropriate treatment options with the person.

Our review of clinical records showed that clinicians consistently explained the benefits, risks and possible side effects of proposed treatments so that people could make informed decisions about their care. When the service identified that a person’s needs could not be met safely or effectively within the service, clinicians considered alternative pathways and directed individuals to other appropriate services.

Staff we spoke with were aware of and signposted patients to support available in the local area. We saw several noticeboards with information on community projects and help available to patients and their families.

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.

People were involved in decisions about their care, including what was important and mattered to them, including, end of life care.

Clinical records we saw demonstrated care was provided in line with current guidance. For example, we reviewed medical records for five people with diabetes. All patients were being managed appropriately.

Staff we spoke with told us they held clinics to support people with long term conditions such as asthma, diabetes and chronic heart disease. They told us they used local and national guidelines and kept up to date through training and updates were circulated within the practice.

Clinical audits were conducted to ensure care was delivered in line with legislation and recommended guidelines. For example, clinicians carried out audits to identify asthma patients who were potentially overusing their inhalers, ensured a review was undertaken and the patient was then supported with timely clinical intervention.

The service worked well across teams and other healthcare services to support people. We received feedback from care homes supported by clinical staff, we were told staff were very responsive and knowledgeable, however they did not have a direct line to clinicians which sometimes led to delays due to lengthy phone queues.

Staff shared assessments of patients’ needs when they moved between services, helping to ensure people only needed to repeat their information once.

Staff had access to the information they needed to appropriately assess, plan, and deliver care.

Staff told us that recently the regular meetings with the integrated care board (ICB) around infection control had ended due to the ICB being reorganised. This meant they no longer had connections to support, knowledge and guidance.

The service supported people to manage their health and wellbeing to maximise their independence, choice, and control. Staff worked with patients to help them make informed decisions about their care and encouraged actions that could improve their overall health.

We saw digital information boards in waiting rooms which displayed a comprehensive range of support available to patients to lead healthier lives. These included stopping smoking and tackling obesity.

The service identified patients at risk of developing long-term conditions or other health complications and provided advice or interventions to help reduce these risks.

Staff routinely monitored people’s care and treatment to support continuous improvement. Clinicians reviewed assessment findings, treatment plans and follow-up outcomes across all areas of the service, including asthma, new cancer diagnosis, diabetes and palliative care.

This regular monitoring ensured that care remained appropriate, safe and effective for the range of conditions managed by the service. The approach supported the delivery of positive and consistent outcomes that met recognised clinical expectations, as well as the personal goals and expectations of the people who used the service.

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. The provider met national targets for screening and immunisations.

Staff we spoke with demonstrated how they assessed, recorded and respected patients’ rights around capacity and consent. They explained the purpose of assessments and treatments to patients and had access to interpreting and translation services when required. They understood and applied legislation and guidance relating to consent. Staff assessed a person’s ability to make decisions when required and ensured that decisions were made in the best interests of individuals who lacked capacity.

We saw Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) forms were completed appropriately and involved the patient voice.