Park Lane 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 outstanding. At this assessment, the rating has changed to good.

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 mostly made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs.

Feedback from people using the service was overwhelmingly positive. People felt involved in any assessment of their needs and felt confident that staff understood their individual and cultural needs. Reception staff were aware of the needs of the local community. 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.

The provider had systems to identify people with previously undiagnosed conditions. Our remote clinical searches identified 8 people with a potentially missed diagnosis of diabetes. We looked at four records.The provider told us these people were already included on the pre-diabetes register, which meant they received annual blood tests and were monitored accordingly. This was confirmed by our search, as we saw people had been given lifestyle advice and had been in receipt of at least annual blood monitoring tests. Repeat blood tests were being organised to establish if there was a definitive diabetes diagnosis. The records we looked at for people with diabetes whose blood glucose levels were high demonstrated the majority had received all of the appropriate checks and reviews.

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

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. This was mostly done 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 records reviewed for people who received treatment following an exacerbation of their asthma did not always demonstrate follow up within 48 hours or evidence of safety netting advice. However, our searches identified detailed asthma reviews had taken place during the previous 12 months.

The service worked well across teams and services to support people. 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.

Staff were positive about how the service worked well across teams and services to support people. There was evidence of working with the wider health care teams though multi-disciplinary teams (MDT) meetings. People had access to services provided by the Primary Care Network (PCN), including physiotherapy, social prescribers and on the day services. The service had worked with their patient participation group to make improvements.

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 focused 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. Eligible people were invited for the NHS health check, to identify any potential health issues. Staff supported national priorities and initiatives to improve population health, including stopping smoking and tackling obesity. People could be referred to Live Life Better Derbyshire or Live Well Derby for a range of support and guidance.

Since 2023 the service, in collaboration with the patient participation group, had hosted and supported a series of talks related to health topics and living well. These included a perimenopause and menopause talk; talking about end- of- life care; skin cancer and sun safety; aging positively and living well; living well with healthy feet and living well with pain.Twenty people were reviewed during the skin cancer and sun safety event, resulting in 6 referrals to dermatology specialists for further investigation and treatment, which identified 2 cases of skin cancer. The practice organised a menopause clinic following the talk, enabling people to discuss their individual concerns with a GP. Staff from the service had also attended a local playgroup to speak with parents about the importance of childhood vaccinations. An information leaflet was also provided outlining the importance of vaccines, the vaccination schedule and issues relating to misinformation, so parents had sufficient information to make an informed choice.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people. There were systems in place to ensure that people with long-term conditions were reviewed regularly.

The service met the minimum national targets for childhood immunisations, with 1 of the 5 having achieved the 90% minimum uptake and 4 of the 5 having achieved the 95% World Health Organisation based target for uptake.

National data showed the uptake of cervical screening was 78.5% (June 2023) which was below the national target of 80% and had been decreasing over time.

The service proactively promoted the uptake of breast cancer screening and bowel cancer screening through patient engagement and targeted outreach strategies. The practice breast and bowel cancer screening rates were above the national average. The service planned to integrate the same communication strategy into the cervical screening protocols, and to use messaging services to contact people who have missed or were overdue their appointments to promote uptake.

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. The do not attempt cardiopulmonary resuscitation (DNACPR) decisions looked at were appropriate and were made in line with relevant legislation.

The provider told us they were notified about DNACPR decisions through discharge letters from secondary care. This was recorded in the electronic record, however, they did not receive a copy of the Recommended Summary Plan for Emergency Care and Treatment form (ReSPECT) or details of the discussion. A ReSPECT form is a personalised plan created through conversations between the individual, their family, and healthcare professionals, detailing what treatments the person would or would not want in an emergency when they may not be able to communicate their wishes. There was no system in place to obtain a copy of the form which is ordinarily held by the patient. This should be reviewed whenever there is a significant change in a person's health condition, circumstances, or wishes. The provider told us the introduction of the digital ReSPECT form should resolve this issue.

Following the assessment, the provider told us the digital respect form system had been implemented within the service, which enabled secondary care and external providers to upload the respect form containing DNACPR decisions directly into the patient notes. This meant the information was accessible to all providers and had improved communication issues between providers regarding new care plans and end of life decisions.