Archived: Central 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 inspection, we rated this key question as Requires Improvement. At this assessment, the rating has changed to Good.

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.

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

At our last inspection we found not all patients being prescribed high-risk medicines had received sufficient monitoring. The NHS defines high-risk medicines as medications that carry a heightened risk of causing significant patient harm if used in error.

We also found that some patients with long-term conditions had not received sufficient monitoring. A long-term condition is a health problem that requires ongoing management over months, years, or decades, and cannot be cured but can be controlled through medicine or other therapies.

At this assessment we looked at medical records for several patient groups, including those being prescribed medicines requiring regular monitoring and those being prescribed high-risk medicines. We found that the practice was able to evidence that patients were receiving treatment and/or monitoring in line with national guidelines.

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 effective systems to identify people with previously undiagnosed conditions. Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber.

The practice planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this 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. Clinical records we saw demonstrated care was provided in line with current guidance. The practice held regular meetings to review any new national guidance and safety alerts and to discuss learning from incidents and complaints.

The practice worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. Information was shared with all relevant staff verbally and via emails, a practice account on social media, regular team meetings and a monthly newsletter.

The practice worked with other services including community services, commissioners, and voluntary organisations to ensure continuity of care, including where clinical tasks were delegated to other services.

The practice supported people to manage their health and wellbeing to maximise their independence, choice and control. The practice supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff focussed 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. Staff supported national priorities and initiatives to improve population health, including tackling obesity, dementia checks and cardio-vascular risk assessment and management.

The practice 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. Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation.

All patients, or their legal representatives were encouraged to participate in decisions about their care through shared decision-making. Clinicians discussed treatment options, risks, benefits, and alternatives using language that was clear and accessible. This included the use, where appropriate, of translated materials, easy read documents or interpretation services. If a patient lacked capacity, decisions were made in their best interests, following consultation with appropriate persons, for example, Lasting power of attorney (LPA), family members and next of kin. All consultations were recorded on patients’ medical records.

The practice 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. Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were appropriate and were made in line with relevant legislation.

All patients, or their legal representatives were encouraged to participate in decisions about their care through shared decision-making. Clinicians discussed treatment options, risks, benefits, and alternatives using language that was clear and accessible. This included the use, where appropriate, of translated materials, easy read documents or interpretation services. If a patient lacked capacity, decisions were made in their best interests, following consultation with appropriate persons, for example, Lasting power of attorney (LPA), family members and next of kin. All consultations were recorded on patients’ medical records.