Brune 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

Effective - This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on the best available evidence.

At our last assessment, we rated this key question Good. At this assessment, the rating has remained unchanged.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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

Information was shared with staff and other agencies to enable them to deliver effective care and treatment. Delays in referrals were monitored and audits were carried out to ensure urgent cancer referrals were actioned.

The latest verifiable data from NHS England showed cervical cancer screening uptake for eligible patients was 68.7%, below national target. The practice had proactively worked to increase uptake and education in this area. For example, Saturday appointments were available with a GP and a nurse practitioner. Dedicated female health clinics had been implemented where patients could book appointments accessibly online and via the NHS app.

Leaders demonstrated how patients who required recall monitoring were supported and managed. This included inviting patients for annual health reviews and long-term conditions reviews in line with national guidelines.

During our clinical searches, patients with long-term conditions were assessed and treated in line with national guidelines, such as patients with asthma, chronic kidney disease (CKD) and hypothyroidism. However, we found examples of patients who were not always coded as diabetic despite blood results at correct intervals confirming diagnosis. A sample of records showed patients with diabetes did not always receive annual reviews to ensure care was delivered effectively in line with national guidelines.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, this was not always carried out in line with legislation and current evidence-based good practice and standards.

During our clinical searches, patients with long-term conditions were assessed and treated in line with national guidelines, such as patients with asthma, chronic kidney disease (CKD) and hypothyroidism. However, we found examples of patients who were not always coded as diabetic despite blood results at correct intervals confirming diagnosis. People are at higher risk of developing long-term health problems such as heart attack, kidney disease and blindness, if they are not monitoring blood sugar levels appropriately and without a management plan in place. A sample of records showed patients with diabetes did not always receive annual reviews to ensure care was delivered effectively in line with national guidelines.

At the time of the inspection, the diabetic nurse was in the process of reviewing the list of potential patients who had not been coded as diabetic. The service had an action plan in place to review diabetic patients further to ensure safe care and treatment. To further support this work, the service was supporting practice nurses to complete the diploma in diabetes care, with all health-care assistants now trained and assessed as competent to complete the first part of the reviews. The service was also recruiting for additional long-term condition nurses, with a locum recruited as an interim measure. The service also received support from the Trust’s community diabetes specialist nursing team and dietician team. The service has also dual appointed a diabetic nurse with the Trust’s research team.

Staff told us they received regular clinical supervision to ensure their clinical decisions were reflective of evidence-based good practice and required standards. We saw evidence of clinical supervision audits for non-medical prescribers which reviewed a randomised sample of cases on a routine basis as part of checks to ensure prescribing was appropriate. Staff told us they were supported with their professional development, such as clinical education sessions.

The service worked well across teams to support people, particularly when people moved between different services.

The practice worked with stakeholder organisations such as secondary healthcare providers to establish and maintain safe systems of care for patients. For example, staff used a clinical decision support tool to log and monitor urgent referrals and this included input from external professionals involved in the patient's care.

The practice worked alongside external stakeholder services such as the community mental health team to support vulnerable patients through treatment planning as part of a multi-disciplinary team. Feedback from the community mental health team highlighted the outcomes for people were positively managed and care and treatment protected them from harm where possible. Learning was shared across staff based on regular evaluation of care.

The practice had a system in place for processing new patient information and summarising of notes. The practice had kept up to date with patient summarising to ensure accurate information was available for clinicians. There were processes to monitor and manage care when patients were moved between services such as after referral to secondary care, or admission to hospital. A review of the practice’s clinical system, indicated patient test results were being managed in a timely manner to inform future care and treatment planning.

During our review of the practice’s clinical records systems, we found examples of effective plans for the transition of patients across multiple services. Referrals and discharge summaries were managed appropriately and considered people’s individual needs, circumstances, ongoing care arrangements and expected outcomes.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

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.