The Bassingham Surgery

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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 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. At this assessment, the rating remains the same.

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.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

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 people’s health, including those in the last 12 months of their lives and those with caring responsibilities. Staff supported national priorities and initiatives to improve population health, including stopping smoking and tackling obesity.

The service had effective arrangements in place to provide a range of health checks, including NHS Health Checks for eligible patients and annual health checks for patients with a learning disability.All eligible people with a learning disability were offered an annual health check, and 88% of those invited had received one.

To further support patients to live healthier lives, there was a Health and wellbeing coach based at the practice one day a week who also carried out home visits where necessary. They supported patients to increase motivation and commitment to change to enable them to make lifestyle changes that were important to them.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive, consistent and met the expectations of people themselves.

The service met some national targets for the uptake of childhood immunisations. They had achieved the 90% minimum coverage rate for all childhood immunisations with the exception of children aged 5 who had received immunisation for measles, mumps and rubella (two doses of MMR) as they had achieved a coverage rate of 85% for this indicator which was lower than the 90% minimum target and the World Health Organisation recommended rate of 95% coverage. To encourage uptake, practice nurses had carried out structured follow-ups of non-responders for childhood immunisations. The practice provided unverified data which showed that this was currently 90% coverage.

The service performed better than the England average in relation to most cancer screening programmes, including screening for breast, bowel cancer, and cervical cancer. One indicator for cervical screening was slightly below the national target. The practice had introduced evening cervical screening appointments to improve uptake.

The practice had implemented the Daffodil Standards framework, a UK-wide, evidence-based framework created by the Royal College of General Practitioners (RCGP) and Marie Curie end of life charity to improve the quality of palliative and end-of-life care in primary care settings.

Staff had received relevant training to support this and to ensure patient care was led by what mattered most to patients and that end-of-life patients’ needs were prioritised.

During our visit we observed discussions between members of the multi-disciplinary team which demonstrated a holistic, person centred, joined up approach to end-of-life care which took in to account not only the needs of the patient but also their family or carers.

The practice had also created a help sheet to improve completion of ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) forms. This had been useful in helping patients and clinicians complete the forms with the appropriate, accurate and relevant information to ensure patients’ wishes were followed.

Leaders told us how they had developed and introduced several systems and protocols to prevent, monitor and improve outcomes for patients. For example, processes to identify cardiovascular risk at an early stage and prescribe statins where appropriate. GPs would contact identified patients directly with information about the benefits of statins and healthy lifestyle guidance to allow them to make an informed choice.

We saw that the multi-disciplinary practice team, including staff not employed directly by the practice, worked effectively and cohesively to provide an integrated, holistic and person-centred approach to patient care.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.