The Medical Centre Crabbs Cross

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

Patients’ needs were assessed, and care and treatment were delivered in line with current legislation, standards and evidence-based guidance supported by clear pathways and tools. Patients gave positive feedback about the way staff treated people. Where appropriate patients gave consent for any treatment required. Staff supported people to live healthy lives and provided them with support and information on their care and treatment.

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.

Feedback from patients using the service was positive. Patients felt involved in any assessment and felt confident staff understood their individual and cultural needs.

Reception staff were aware of the needs of the local community. Staff placed 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.

Patients told us the treatments they received had a positive effect on their overall health and wellbeing. Patients were informed about the evidence their treatment was based on and the potential side effects of the treatment.

Staff and leaders told us they had systems and processes in place to keep them up to date as guidance changed. We saw evidence of regular clinical meetings where they shared guidelines and discussed cases.

Our remote clinical searches reviewed the care and treatment of patients who required routine monitoring including those with long term conditions. Staff ensured all patients received regular monitoring, medication reviews and follow up appointments. The practice had systems and processes to keep clinicians up to date with current evidence-based practice for example, the practice shared NICE guidelines and local prescribing guidelines with relevant staff. The practice had a system for checking on the two week wait referrals to ensure these were followed up with patients including those who had not attended the arranged appointment.

Patients felt staff worked well together to ensure they received the care and treatment they needed. Patients received treatment from both GPs and nurses and found this was done easily and felt seamless for them.

Staff worked well with other services to ensure people received safe and effective care. They met weekly with the frailty team who support local nursing homes and with professionals who were providing palliative care to patients. Staff recorded patients communication preferences and whther they had caring responibilities.

Staff from the frailty team were positive about the support and interaction they had with staff at the practice. They could make contact with the lead GP when they needed to for advice and guidance.

We reviewed the minutes from multidisciplinary team meetings which demonstrated that staff worked well with other professionals to benefit their patients.

Leaders at the practice worked closely with colleagues in the local Primary Care Network to share examples of good practice.

Patients told us how this service had encouraged them to live healthier lives. Patients told us they were given guidance about nutrition and lifestyle which complemented medical treatment.

Staff gave patients advice and guidance about leading healthier lives. For example, they discussed healthy diets and exercise with patients who had type two diabetes to support them to lead healthier lifestyles and improve their health.

Leaders had policies and procedures in place to ensure staff had the skills needed to discuss healthier lives with patients. They ensured information was available for patients in the waiting area which they could read while waiting for their appointment.

Patients received their test results promptly. They were able to discuss these with the GP and received advice on ongoing treatment if required. To ensure they achieved the best possible outcomes.

Staff received training to ensure they had the skills required to improve outcomes for patients. Staff recognised people from diverse backgrounds might need different approaches to achieve a good outcome. For example, treatment for skin disorders could differ depending on the skin type and colour.

We completed remote clinical searches to check the quality of how leaders were monitoring outcomes for patients. We found no concerns with the way these were monitored and followed up. Leaders used audits to monitor and improve outcomes however these did not always contain enough detail to see how the information was used for improving outcomes for patients. Leaders did discuss outcomes at team meetings to ensure ongoing improvements were made about call and appointment monitoring.

Patients had no concerns about how their consent was gained during consultations. Staff spoke with patients and gained consent for treatment.

Staff understood the requirements of legislation and guidance when considering consent and decision making. They told us they supported patients to make decisions. They had received training in the Mental Capacity Act and understood how to use Gillick Competence and Fraser Guidelines for supporting children.

We found Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders were fully documented, made in line with relevant legislation and were appropriate however of the 4 we checked one was of date. Further investigation showed this was a scanned copy for a patient who had transferred to the practice when they went into a nursing home. Leaders took immediate action to rectify this. Leaders met weekly with other teams involved with frail and end of life patients and meeting notes showed DNACPR was discussed for each patient during the meeting.