Park Medical Centre

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 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.

We found that staff involved people in decisions about their care and treatment and provided them with advice and support. Staff worked together and collaboratively with external health and social care providers to make sure people could access other services easily. Patients received care and treatment that supported them to live healthier lives including being supported to undertake national screening programmes and vaccinations. Patients who required monitoring underwent regular checks on their health. Clinical and non-clinical audits were carried out to improve outcomes for patients. Our review of the clinical patient record system for the sample of patients whose records we looked at showed that overall, care and treatment had been delivered in line with evidence-based guidance. Multi-disciplinary meetings were held on a regular basis where the needs of patients with complex needs or those approaching the end of life could be discussed, reviewed and planned for.

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.

Patient experience of the service as indicated in the National GP Patient survey showed that 96% of patients who responded felt they knew what the next steps would be within 2 days of contacting the service, and 94% of patients who responded had confidence and trust in the healthcare professional they saw or spoke to. Both indicators are above local and national averages.

Support was available and accessible for people with additional needs or communication needs. For example, people who required the services of an interpreter or patients who had a learning disability. Leaflets were available in reception in easy read format and patients with a learning disability who were at risk of diabetes were supported with easy read and pictorial information sheets to support healthy eating.

People who reported symptoms that could be considered a clinical emergency could be seen on the day or be signposted to a more appropriate service. Relevant information was shared with other professionals when planning care and treatment and treatment records were updated to reflect any changes made.

Following appointments patients were advised when to seek further help and what to do if their condition deteriorated. Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber. A social prescriber isa healthcare professional who helps patients identify and connect with non-medical resources and activities in their community to address social, emotional, and practical needs that impact their health and well-being.

Systems were in place to ensure staff were up to date with national guidance, evidence-based good practice and required standards. Staff attended meetings, training, educational sessions and underwent regular appraisal.

Our review of the clinical record system for the sample of people whose care and treatment we looked at, indicated that people received care, treatment and support that was evidence-based and in line with good practice standards. Overall, appropriate monitoring and reviews were in place for people with long term conditions. We have referred to a range of issues in the Medicines optimisations section under the key question of safe, which the provider promptly actioned during the assessment.

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. Referrals to other services were made promptly and information about their needs was shared effectively.

Staff told us there was an open culture and the practice manager had an open-door approach. They told us the whole leadership team were approachable and supportive. Staff told us teamwork was good and without exception, they enjoyed working at the practice. Staff told us they were confident and comfortable approaching the management team for any reason.

The practice worked with other services to ensure continuity of care. Leaders and staff collaborated closely with colleagues in the local primary care network (PCN) to meet the needs of the patient population.

The practice recently implemented a total triage appointment system and learning from this experience was shared throughout the (PCN).

The service supported people to live healthier lives and manage their health and wellbeing. Staff focussed on identifying risks to patient’s 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. People were called in for regular checks on their health when they were living with a long-term condition.

Staff supported local and national priorities and initiatives to improve population health, including smoking cessation and encouraging patients to start national screening programmes.

People living with long term health conditions underwent regular monitoring. Staff referred or signposted them to local support services for information, education, advice, and support linked to their needs. The practice contacted patients who did not attend cervical screening and child immunisation programmes to encourage uptake. The percentage of persons eligible for cervical screening were below expected targets for patients aged 25 to 49 years old (expected 80% observed 72.5%) and aged 50 to 64 years old (expected 80%, observed 75.5%). Childhood immunisation uptake was above the 90% World Health Organisation targets in all except one category. Children aged 5 who have received immunisation for measles, mumps, and rubella (two doses of MMR) was 89% slightly below target.

We discussed this with the provider who demonstrated that people who had not attended for cancer screening or child immunisation were followed up and encouraged to attend.

The service routinely monitored people’s care and treatment to continuously improve it. People who required monitoring underwent regular checks on their health. From the clinical records we reviewed, we found that people who used the service experienced positive outcomes in line with best practice guidance. Leaders demonstrated that monitoring and improving outcomes for patients was important to them and they used information and data to drive improvement. Regular searches of patient’s medicines were undertaken to monitor patients. Depending on the results this included providing extra help to manage long-term conditions, advice for those on multiple medicines and better access to health checks.

People who used the service felt they could make an informed decision about their care and treatment because they had been provided with information they needed to support them to do so. The National GP patient survey results showed that 96% of respondents felt their healthcare professional had all the information they needed, above local and national average, however 90% of respondents felt involved as much as they wanted to be in decisions about their care and treatment, slightly lower than the local and national average.

Staff we spoke with demonstrated the importance of ensuring that people understood what they were consenting to and the importance of obtaining consent before they delivered care or treatment. Clinical staff had undergone training in the Mental Capacity Act. Staff understood the requirements of legislation and guidance when considering consent and decision making.

We sampled 5 patient records with a Do not attempt cardiopulmonary resuscitation (DNACPR) decision. Of these, the majority contained the information expected, however 2 appeared to need further consideration. We discussed this with the provider during our assessment and in both cases the records were initiated by another service. The letters where the decision had been made were available and a copy of the DNACPR had been given to the patient.