GP Hub Parkway

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

Staff comprehensively assessed people, so the care and treatment provided met their needs. This included both their mental and physical health and any personal circumstances that needed to be considered. Staff worked in a culture of consistent, evidence-based practice. They worked together and with others when assessing people’s needs and shared information to maintain continuity of care.

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

Staff discussed patients’ needs with them, and they were involved in how care and treatment was planned. Patients told us they felt listened to and survey feedback reflected high levels of satisfaction.

Staff used effective tools to support good clinical practice with people who experienced challenges communicating. These included resources for people with cognitive impairment and interactive tools for understanding pain experienced by children. Staff assessed and acted on risks to patients of avoidable harm. Staff worked with other specialist services to support people with additional needs.

Records were up to date and showed staff carried out comprehensive assessments of each patient appropriate to the minor illness or injury setting. Staff took a medical history from each patient and asked about their recent clinical reviews with other providers to help establish a good picture of need. Many patients sought care from the hub as a result of challenges in securing appointments with their registered GP for ongoing or long-term care. Staff recognised this and worked with patients to assess immediate needs while supporting them to find a more appropriate long-term solution.

The provider 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.

Staff gave people clear information about their care and treatment to support both their physical and mental health and wellbeing.

The provider managed policies and standard operating procedures and ensured they were reviewed and updated in line with national guidance. Clinical staff had access to a shared electronic patient record system that enabled them to review referrals from other providers, which ensured coordinated care.

The provider maintained digital access to a comprehensive range of up-to-date policies and standard operating procedures, which reflected current practice. It had guidance for staff around collaboration with multi-agency teams and for delegation of clinical tasks to ensure the right people delivered evidence-based care and treatment.

The clinical lead was a GP with a special interest in mental health and was part of the European Forum for Primary Care. Actively involved with a research project on the resilience of the workforce in elderly care, they used this work to make sure care for elderly patients reflected the latest understanding of good practice.

The service was agile and responded quickly to alerts from the UK Health Security Agency. For example, the senior team coordinated a standard operating procedure to treat patients with suspected Mpox infection (an illness caused by a viral infection). They liaised with other services to make sure the system had capacity, competency, and treatment available in such cases. This worked well in practice and staff demonstrated how they identified a missed case of infection when a patient presented are treatment in another service. The suspected infection occurred at the provider’s other Croydon hub service. As staff worked between sites and policies, audits, and procedures were the same, such learning was shared and contributed to consistent standards.

The provider 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.

The service had access to patient’s clinical records from other secondary care providers who used the same system. This helped staff to deliver more effective care because it meant they had access to detailed medical history.

The senior team worked with NHS 111 to improve the consistency of referrals and ensure only patients with needs that could be met by the hub were booked. The clinical team reviewed each appointment made by the 111 service and contacted them to arrange another service where this would better meet the patient’s needs. For example, the clinical lead worked with the 111 team to ensure patients with suspected sepsis, chest pain, or abdominal pain that could be related to a miscarriage, were always sent to an urgent service.

Clinical staff were proactive in liaising with other services to make sure patients accessed the right care. For example, staff liaised with community nursing teams and health visitors. Staff had access to NHS microbiologists to coordinate care, such as for a change in prescription for patients with an infection that had not responded to treatment.

Staff completed monitoring information on each patient’s clinical record to help their registered GP maintain an up to date understanding of need. This included blood pressure measurements and details of smoking habits. Clinical staff also provided a discharge summary for the patient’s GP if they consented.

The GP hubs were part of IRIS (identification and referral to improve safety), a referral system for patients experiencing domestic abuse. GPs were trained to provide comprehensive support to people and refer them to specialist services to protect their safety.

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

Staff recognised the health challenges in the local community and helped people understand how to adopt healthier habits and lifestyles. This included an approach to encourage self-care and reduce the need for clinical input. Staff provided printed and electronic health advice information and signposting to relevant organisations.

Clinical staff educated people on the benefits of the childhood and adult vaccination programme as a strategy to support long-term good health and protection.

While the service did not treat long-term conditions medically, staff supported patients to manage these through health promotion strategies.

Staff based health promotion activities and advice on their understanding of the health inequalities in the local community. For example, staff focused on the health and care needs of children and young people and particularly those with experience of social services. They also promoted access to mental health care through links with specialist services.

The service worked with community services to promote access to care and support for elderly people as part of a strategy to reduce hospital admission.

We saw staff give health education to a patient regarding diet and fluid intake to reduce frequent infections they’d experienced. In another instance, staff gave a person advice on improving their nutritional intake when they noted skipping meals as a result of work pressures.

The provider 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 themselves.

GPs referred patients for cancer tests using the national 2-week wait programme. The service was commissioned to manage this process independently from the patient’s registered GP during the 2-week period. This reduced delays to care and treatment. Once results were confirmed, the hub referred the patient to their registered GP, or to the local acute hospital under a service level agreement if they did not have a registered GP.

The hub was a commissioned service and monitored key performance indicators (KPI) in line with contractual requirements. Staff reported audit results into the parent company as part of oversight arrangements.

Commissioners required the monitoring of 2 KPIs; the time spent in the hub per patient and the number of patients referred to the urgent treatment centre. The target was for 97% of patients to be assessed, treated, and discharged or referred on within 90 minutes of arrival. In the previous 12 months the service consistently exceeded this target. Monitoring took place at provider level and so KPI results reflected both this location and the Purley GP Hub. The second KPI did not have a benchmark or target and the ICB used data for monitoring.

Patients spoke positively about the efforts of staff to make sure they had good outcomes from their visit.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The service did not offer minor surgery or procedures that required a cooling off period. This meant written, signed consent was not needed for care and treatment as patients provided this verbally when discussing their needs. Clinicians asked patients for consent to make written referrals and to send their registered GP information about care and treatment.

Clinical staff were trained in Gillick competence, which enabled them to make an informed decision as to whether a person under the age of 18 was competent to make decisions about their own care and treatment. The service did not offer sexual health or contraception and so the Fraser guidelines were not applicable. However, clinical staff knew where to secure support for young people seeking sexual health services.