Rushden 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 patients in decisions about their care and treatment and provided them with advice and support. Staff routinely reviewed patients care and worked with other services to achieve this. We rated this key question as 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 National GP Patient Survey found 80% of patients felt their needs were met during their last general practice appointment which was below the national average of 90%.

The practice had systems and processes in place to identify patients’ needs and preferences during the registration process. The practice 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 referred patients with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber.

Staff checked patients’ health, care, and wellbeing needs during health reviews. Clinicians used templates when conducting reviews to support the assessment of patients’ wider health and wellbeing.

We discussed how clinicians identified and monitored patients at risk of developing a long-term condition. Clinicians explained they had systems and pathways established to follow. We undertook clinical record searches to review these systems. Clinical searches identified 5 patients as having a potential missed diagnosis of diabetes. We looked in detail at these 5 patient records and found no issues with the care and treatment for these patients.

There were systems in place to ensure staff were up to date with relevant legislation, evidence-based practice and required standards. Clinical meetings were in place to keep staff up to date. For clinicians who were unable to attend this meeting in person, these meetings were minuted and disseminated to all clinicians.

The remote clinical searches we undertook of the practice’s clinical records system included reviewing the monitoring of people with long-term conditions to assess if National Institute for Health and Care Excellence (NICE) recommendations were followed.

For example, we identified 110 patients with diabetes whose last blood glucose reading was over 75. We reviewed a random sample of 5 patient records and found no issues with the care and treatment of these patients for their diabetes.

As part of our clinical records searches, we reviewed the records of patients prescribed short-acting beta-2 agonist (SABA) inhalers (“reliever" inhalers used for quick relief from asthma symptoms like wheezing and breathlessness): We identified 36 out of 1062 patients on the asthma register had been prescribed 2 or more courses of rescue steroids. We reviewed a sample of 5 patient records and found there were inconsistencies in the follow up of these patients to check their response to treatment in an appropriate timescale following the acute exacerbation of their asthma. National Institute for Health and Care Excellence (NICE) guidance recommends that patients receive a follow up within two working days. We discussed this issue with clinicians who took prompt action to put new policies and procedures in place to ensure patients are being seen/spoken to within a week after oral steroids for asthma; and arranged a learning event to share with staff.

As part of our clinical searches, we looked for patients with chronic kidney disease (Stages 4 or 5) who had not had appropriate urea and electrolyte blood test monitoring in the last 9 months. This search identified one patient who had not received the required monitoring; however, clinicians took immediate action and invited the patient for an appointment to receive a blood test.

As part of our clinical searches, we reviewed the care of patients with hypothyroidism (underactive thyroid). We identified 314 patients who were diagnosed with hypothyroidism of which 4 had potentially not received thyroid function test monitoring for the last 18 months. We looked in detail at the records of these patients and discussed their care with clinicians. We found 2 of the 4 patients had already been booked an appointment for a blood test and a medication review. Clinicians took prompt action to invite the 2 other patients for an appointment also.

The practice worked well across teams and services to support patients. They made sure patients only needed to tell their story once by sharing their assessment of needs when people moved between different services. Staff had access to information they needed to assess, plan, and deliver patients’ care, treatment, and support. Systems were in place to share information about patients electronically with other services.

The practice worked with other services to ensure continuity of care and engaged in regular multi-disciplinary team (MDT) meetings. For example, for patients identified as approaching end of life, the practice referred to and worked closely with, the community palliative care team. Home visits and care packages were implemented to ensure patients’ wishes were followed and carried out in their final stages of life.

The practice worked closely with the Primacy Care Network (PCN) team. The PCN team included Clinical Pharmacists, Pharmacy Technicians, First Contact Practitioners (physiotherapists), and dedicated Mental Health Practitioners.

The practice supported patients to manage their health and wellbeing to maximise their independence, choice and control. Staff supported national priorities and initiatives to improve population health including stopping smoking and tackling obesity.

The practice waiting area and the practice website provided a wide range of health information for patients.

For weight management, the practice referred patients to weight loss clinics and receptionists signposted patients to pharmacy services where appropriate. The practice had also signed up to provide a Local Enhanced Service (LES) to treat patients for chronic weight management. A LES is a tailored NHS primary care service commissioned locally by Integrated Care Boards (ICBs) to meet specific population needs, going beyond core GP contract requirements.

The practice offered Taekwondo and Yoga sessions to patients to assist them in participating in exercise and improving their health.

Staff told us they utilised the social prescriber services to also facilitate supporting patients to live healthier lives.

The practice routinely monitored patients care and treatment to continuously improve it. Staff endeavoured to ensure that outcomes were positive and consistent, and that they met both the clinical expectations and the expectations of patients. 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.

The practice undertook regular clinical audits which demonstrated quality improvement. For example, the practice undertook repeated audits on

Disease-Modifying Anti-Rheumatic Drugs (DMARDS) to ensure these medicines are prescribed correctly and appropriate monitoring occurs. These medicines are used to treat autoimmune conditions like rheumatoid arthritis, and lupus.

As part of our assessment, we reviewed the practice performance data for childhood immunisations. The World Health Organisation (WHO) recommends a rate of 95% for all routine childhood vaccinations.

Published national data showed the percentage of children aged 5 who had received immunisation for measles, mumps and rubella (two doses of MMR) was 90%.

The percentage of children aged 2 who had received immunisation for measles, mumps and rubella (one dose of MMR) was 96%.

The percentage of children aged 2 who had received their booster immunisation Pneumococcal infection was 91%.

The percentage of children aged 2 who have received their immunisation for Haemophilus influenza type b and Meningitis C was 94%.

The percentage of children aged 1 who had completed a primary course of immunisation for Diphtheria, Tetanus, Polio, Pertussis, Haemophilus influenza type b (Hib), and Hepatitis B (Hep B) was 94%.

In addition to childhood immunisation data, we reviewed published national data for the uptake of cervical screening. The practice had achieved 66% for women aged 25 to 49 years, which was below the national target of 70%; and 72% for women aged 50-64 years, which was below the national target of 80%. The practice was working to improve the cervical screening uptake and gave us examples of how they were doing this which included patient education; contacting patients who had failed to attend their screening appointments; and promoting cervical screening awareness.

The practice told patients about their rights around consent and respected these when delivering person-centred care and treatment. A consent policy was in place to ensure appropriate consent was obtained from patients when receiving care and treatment. Staff understood the requirements of legislation and guidance when considering consent and decision making.

Patients were offered a chaperone for care and treatment when this was appropriate. Chaperone posters were on display in the practice to inform patients of this service and staff who provided this service had completed chaperone training.