The Oval Practice

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 reviewed 6 quality statements in the Effective key question – 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 and consent to care and treatment. Patients were assessed using a range of assessment tools. We saw evidence of audits carried out to ensure patients care was appropriate. Communication needs of patients were considered and we saw that the practice could support patients with translation requirements, or hearing or visual disabilities. The needs of carers of patients were also considered. Staff were able to use social prescribing and could sign post patients and their carers to additional support. Our review of the remote searches of patient records showed that care and treatment was evidence-based and in line with good practice standards. Staff were up to date with national legislation, evidence-based good practice and required standards. Referrals to specialist services were documented, contained the required information and there was a system to monitor delays in referrals. Our review of the remote searches of patient records showed that patients with long terms conditions were being routinely monitored and re-called when required. The practice shared clear and accurate information with relevant professionals when deciding care delivery for patients with long-term conditions. Medicine alerts were discussed at meetings and audits created to ensure patients were receiving the most up to date care. The practice routinely monitored patient’s care and treatment and their outcomes. These meet agreed expectations as set out in legislation, standards and evidence-based clinical guidance.

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.

Referrals to specialist services were documented, contained the required information and there was a system to monitor delays in referrals. We also reviewed the results of the National GP Patient Survey and found the percentage of patients who stated that during their last GP appointment they had been involved in decisions about their care and treatment as much as they wanted to be, was 87.7%,with the national average being 90.3%. The national patient survey showed 85% of patients said last time they had a general practice appointment; the healthcare professional was good or very good at treating them with care and concern the national average was 83.3%. The national patient survey showed that 77% of patients said the healthcare professional was good or very good at listening to them. The national average was 85%. The national patient survey showed that 94.2% of patients said they had confidence and trust in the healthcare professional they saw or spoke to. The national average was 93%.

The practice explained it offered double appointments to patients with a learning disability to ensure they were able to support the patient to maximise their health and well-being. Staff informed us they could support patients with translation requirements, or hearing or visual disabilities. We were informed the pharmacist and lead GP were trained in British Sign Language (BSL). The practice had multilingual staff who could assist patients speaking (Bangladeshi, Urdu, Punjabi and Hindi).

Patients had been appropriately assessed and their needs understood. Audits were carried out to ensure patients care was appropriately managed in line with current guidance. Patients had access to appropriate health assessments. Our remote clinical searches reviewed the care and treatment of patients with the following long-term conditions: asthma, chronic kidney disease stages 3 – 5, hypothyroidism and diabetes. We found 4 patients had been prescribed 2 or more courses of rescue steroids in response to exacerbations of their asthma. Our GP specialist advisor sampled the records of 4 of these patients and found 3 of these patients were issued steroid medication with no appropriate documentation/clinical review. When we raised this with the practice they took immediate action reviewed these patients, produced a laminated list of clinical examinations required for an acute exacerbation and placed it in all clinical rooms. They also changed their process from free typing to read coding accurately. Our review of patients with chronic kidney disease stages 4 to 5 found no concerns with monitoring or care provided.

During this assessment we were only able to speak with one patient, they were happy with the care and treatment they received from the practice.

Leaders told us patients’ treatment was regularly reviewed and updated. There were appropriate referral pathways to make sure that patients’ needs were addressed.

We reviewed a range of consultation notes, medication reviews and saw appropriate care and treatment was given. The practice had systems and processes to keep clinicians up to date with current evidence-based practice.

During this assessment we were only able to speak with one patient, they feedback that clinicians take time to explain things and helped them to understand any issues they have.

Staff feedback they have monthly meetings, leaders feedback they have weekly clinical meetings where they discuss patients and any concerns, leaders also said because it's a small practice they know their patients very well and they often have informal as well as formal discussions.

We had no feedback from any external partners.

We reviewed a range of consultation notes, medication reviews and saw appropriate care and treatment was given.

During this assessment we were only able to speak with one patient, they feedback that they had been provided with information on healthy life styles and also managing a long term condition.

Staff said they were given a list to chase up patients who needed to be contacted, and they also had a vulnerable patient list in the reception at all times. They also said if a vulnerable patient failed to attend the practice they contact the patient to see if everything is okay then offer to rebook them.

We reviewed a range of consultation notes, medication reviews and saw appropriate care and treatment was given. Patients’ immediate and ongoing needs were fully assessed. This included their clinical needs and their mental and physical wellbeing.

During this assessment we were only able to speak with one patient, they feedback they had no concerns about the care and treatment they had received from the practice.

Leaders feedback they follow national guidance to routinely monitor people’s care and treatment to continuously improve it.

The practice had process in place to invite patients in for high-risk drug monitoring.

From the clinical searches we found: DMARD: Methotrexate -Patients were adequately monitored. • Patients prescribed- ACE inhibitor or Angiotensin II receptor blocker- no concerns • Teratogenic drugs in childbearing age- We saw patients had the necessary education. • Potential Missed diagnosis of Chronic Kidney Disease stage 3, 4 or 5- Patient was having regular follow ups- no concerns, although there was a coding issue. • Medication reviews- Reviews were just coded, mostly no patient contact.

During this assessment we were only able to speak with one patient we did not get their view about their rights around consent.

Leaders feedback consent was always obtained, this could be verbal as well as written and would be documented in patients notes.

We reviewed DNACPR records and saw appropriate consent was obtained.