Westminster Medical Centre

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• 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 good. The rating remains good following this assessment.

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.

There were systems in place to ensure people’s immediate and ongoing needs were assessed and people who required monitoring were recalled for checks on their health. Our review of the clinical record system for the sample of people whose care and treatment we looked at, indicated that people’s long-term conditions were being appropriately managed overall. We identified that improvements were needed to the process for following up people who had been treated for asthma with rescue steroids to check their response to treatment. Following the assessment the provider told us how this was being addressed.Following the assessment the provider told us how this was being addressed by improving the system for identifying patients who need a follow-up.

The provider had systems to identify people with previously undiagnosed conditions. Staff and leaders were aware of the needs of the local community. The provider used registers to identify people with specific needs, for example, people with learning disabilities, mental health conditions, long-term conditions, palliative care needs and carers to ensure that needs were assessed and managed appropriately.

The practice had systems and processes to keep clinicians up to date with current evidence-based guidelines and the use of clinical tools. They regularly audited prescribed medications to assess the care and treatment provided and improve outcomes for patients.They carried out audits around long term condition management and audits to ensure people had timely and appropriate referrals to secondary care.

The provider monitored the timeliness for managing clinical correspondence and tasks. We looked at the workflow for managing clinical tasks and found these were up to date.

Leaders and staff told us they 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. For example, information was shared with external health and social care professionals. The provider worked with colleagues in the local primary care network (PCN) to meet the needs of the patient population.

The service supported people to live healthier lives and manage their health and wellbeing. Staff supported national priorities and initiatives to improve people’s health, for example, weight management campaigns. Patient health checks were provided and the provider was also working with a local university to offer further patient health checks. The provider reported that this has led to identifying a significant number of treatable conditions early. People living with long term health conditions were referred or signposted to local support services for information, education, and advice linked to their needs. The staff team were aware of local services and support networks that they could refer patients to, in order to support them with their needs and to prevent ill health. For example, a local charity provided a range of services to support peoples physical and mental well-being. The provider was one of the highest referrers in the region to a local pharmacy for blood pressure checks. People could be referred to services provided by the PCN. These included a social prescribing service for support with social issues impacting on their health such as isolation and housing.The PCN had also been working with patients who have ADHD to offer services to meet their needs.

Staff and leaders told us how people were supported to manage their health and wellbeing and where possible reduce their need for future care and treatment. They advised people when they needed to seek further help and what to do if their condition deteriorated. They identified people who may need extra support and directed them to relevant services. We saw that people were able to get test results and were referred to other services without delay.

People had access to appropriate health assessments and checks. People were encouraged to attend cancer screening and take up vaccinations offered as part of national programmes. The most up to date published data for cervical cancer screening (NHS England 30/06/2024) showed the practice attainment was below the expected target rate of 80% (56% - 59% practice attainment). More recent, unverified data provided to us by the practice indicated an improvement in this attainment.

The most up to date published data for childhood immunisations (UK Health Security Agency 01/04/2024 – 31/03/2025) showed immunisations for children were below the World Health Authority recommended target rate of 95% and the minimum target rate of 80% (practice attainment for children aged 1 and 2 ranging from 75% - 77.6% and for under children 5 being 58.4%). The practice had a low number of children registered as patients which had an impact on attainment.

The provider informed us that it was difficult to encourage the practice population to attend for routine health screening and immunisations. The provider told us how uptake of childhood immunisations and cervical screening was being monitored and the steps they had taken to improve uptake. This included contacting people directly to provide information about their importance, flexible appointments and patient education. Although action had been taken to increase the uptake of childhood immunisations and cervical screening this had only recently been recorded as an action plan that could be periodically reviewed to assess if the action taken was effective.

Staff told us how people were provided with information about their care and treatment to enable them to make an informed decision. They understood the importance of obtaining consent before they delivered care or treatment. Staff had undertaken training in the Mental Capacity Act to enable them to understand the requirements of legislation and guidance when considering consent and decision making. We looked at a sample of ‘Do not attempt cardiopulmonary resuscitation’ (DNACPR) decisions in patient records. Appropriately completed documents were available and had been shared with other relevant services and alerts had been added to the patient record system.