The Wall House 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 that staff monitored people’s care and treatment and supported them to live healthier lives. At our last assessment, we rated this key question as good. At this assessment, the rating remains the same.

This service scored 79 (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 always supported people to manage their health and wellbeing to fully 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.

Our assessment also found the service offered NHS health checks to eligible patients and the service had risk assessed their patient list and targeted the groups of people at higher risk of developing illnesses or deteriorating conditions first. In doing so the service had added additional monitoring checks such as blood pressure, blood glucose and cholesterol and had identified people with diabetes or who were pre-diabetic, hypertension (high blood pressure) and obesity. These additional checks were outside of the standard NHS contract the service held. We were shown unverified evidence that the service performed above national averages for all of the recommended care processes by National Institute of Health and Care Excellence (NICE) for diabetes and that 87.9% of people with recorded blood pressures were below the threshold for hypertension compared to national performance of 82.9%. This helped to prevent future risks of stroke, heart attack and heart failure and, kidney disease.

The NHS health checks had also identified people that showed signs of alcohol dependency or high alcohol usage.

Staff told us about an app they signposted patients to which gave details about local initiatives aimed at supporting people to manage their conditions and live healthily. Information was available in the service to support people living with Parkinsons disease and with mental health needs such as anxiety or depression, as well as promoting the benefits of sport and activity with local options such as badminton. Sharing this information helped people to remain healthy and possibly reduce their future needs for care and support.

We also found the service volunteered to support local events such as ‘Parkrun’ (a weekly organised run in the local area) and another running event as well as the Christmas Fair in the town. These events were used to demonstrate the importance of exercise for maintaining people’s health but also to provide opportunistic health checks such as blood pressure, where again, people with previously undiagnosed hypertension had been identified and were then able to access care and treatment.

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 national targets for the uptake of childhood immunisations with all 5 indicators exceeding the national target (90%) and 3 of the 5 achieving the World Health Organisation (WHO) target of 95%. The service performed better than the England average in relation to several cancer screening programmes, including screening for breast and bowel cancer.

As of June 2024, the service performed below the national target (80%) for the uptake of cervical cancer screening. However, the service provided unverified data showing they had met the target and had increased uptake overall from 80.3% in 2023/24 to 82.3% in 2024/25 and with the year-to-date figure showing continued improvement. The service also explained how they had achieved this improvement by offering more availability of appointments and at different times of the day, such as early mornings to meet the needs of working age people and carers. Also, the care coordinators monitored the lists of eligible patients and making personalised contact with them. Where people had not responded to invitations, different communication methods were used as well as offers to discuss any concerns with staff and where time allowed, opportunistic screening was offered. The impact this had was more women were screened, reduction in overdue patients and earlier detection of cancer.

We also saw a list of the clinical audits and quality improvement projects the service had completed in the previous 12 months which showed the service monitored the quality of care and aimed to improve outcomes for people using the service. We reviewed an audit of prescribing of testosterone for women which was against guidance issued by the British Menopause Society. The audit was to assess and improve safety, monitoring, and prescribing practice and included 2 cycles of audit in 2023 and 2025. The outcome was that every area improved after the second cycle with significant improvement in monitoring and dose adjustments which aligned with guidance for safe prescribing.

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.