The Ivy Medical Group Also known as Lambley Lane Surgery

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

People’s immediate and ongoing needs were fully assessed. Where appropriate this included their clinical needs and their mental and physical wellbeing. People were advised what to do if their condition got worse and where to seek further help and support. People were involved in the assessment of their needs, and support was provided where needed to maximise their involvement. The needs of carers of people using services were assessed and met. Care planning with the involvement of multi-disciplinary teams enabled a person-centred approach to delivering 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.

Results from the last GP patient survey showed that 85% felt their needs were met during their last general practice appointment, compared to a local average of 92% and national average of 91%. Additionally, 87% of respondents felt they were involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment, compared to a local average of 91% and national average of 90%. The practice had a Patient Participation Group (PPG) in place. This is a group of registered patients who aim to help the practice work as best as it can for patients, staff and leaders. The PPG reviewed and wrote a report on the delivery of end-of-life care services whose findings were shared with the wider primary care network practices in Nottingham.

Feedback on end-of-life care from the care and nursing homes was mostly positive about the practice’s intervention. They told us anticipatory medicines were put into place and residents were supported to die in the place of the persons preferred choice.

We reviewed concerns received regarding the management of clinical correspondence at the practice. We found there was a good process for managing pathology results and correspondence which was audited regularly to ensure effectiveness. There was a process for prioritising urgent letters. Our review of outstanding correspondence did not find any which indicated clinical concerns. We also completed clinical searches on the practice’s patient records system as part of our assessment. The search results did not indicate any concerns regarding the management of medicines, monitoring of people taking medicines liable to abuse, and medication reviews. People were supported to live healthier lives by regular multi-disciplinary team meetings with community nurse specialists and care co-ordinators. The practice offered health checks to patients over 40 years of age with no pre-diagnosed medical conditions and there were good processes to follow up patients who were at risk of developing a long-term-condition. In addition, the practice nurse referred patients to various external clinics, including, diabetes prevention program, weight loss management, stop smoking clinic, and specialist services such as vascular clinics, pulmonary rehabilitation clinics and wound care clinics. Results from our clinical searches on the monitoring of people with long term conditions such as asthma, chronic kidney disease, hypothyroidism and diabetic retinopathy did not find concerns which required immediate follow-up by the practice.

Overall, the most recent GP patient survey results demonstrated that patients felt they received effective care. This was supported by the fact that patients felt listened to and involved in decision about their care. For example, 92% had confidence and trust in the healthcare professional they saw or spoke to during their last general practice appointment compared with a local and national average of 93%. Feedback submitted by patients on NHS UK website was positive about how patient needs were fully assessed with referral pathways used to address their needs.

Staff told us long-term conditions management was carried out by practice nurses and GPs with support from the healthcare support worker. There was a lead GP for patients with diabetes and a lead practice nurse for patients with diabetes who carried out joint review clinics with a diabetic nurse specialist. Test results were sent to the GPs apart from the diabetic bloods which went to the diabetic GP lead. Feedback from residential homes was mostly positive about end of life care. They told us decisions were reviewed in a timely manner with residents, their family and staff. Anticipatory medicines were in place and residents were usually supported by the practice and district nurses to die in the place of their preferred choice. The Advanced Clinical Practitioner also attended regular virtual meetings with hospital consultants who provide information on new treatments and management of conditions, to ensure that practitioners keep up to date with evidence-based guidelines. Information provided by the practice showed they performed highly against the Integrated Care Board (ICB) quality dashboard within their Primary Care Network (PCN) of practices; this included vaccination, immunisation, cancer screening rates and medicines management. The practice had the highest rates for bowel and breast cancer screening uptake in the Nottingham North and East area. They also provided a higher percentage of face to face appointments compared to their PCN practices, in recognition of older people who may have more complex needs to foster better engagement with clinicians, and achieve better outcomes.

We reviewed concerns received relating to end of life care at the practice. We found end of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable. The practice’s PPG worked with Nottinghamshire Hospice to undertake a quality improvement project on end of life care in December 2023. The aim was to seek the experiences and opinions of families, carers and friends of those who had died at home under the care of their GP to identify gaps in the service. The provider implemented recommendations from the survey which was shared with the local Integrated Care Board (ICB) for wider learning in primary care. A review of 6 patient records with a Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) code showed decisions were made in line with relevant legislation and were appropriate. The practice held regular Multi Disciplinary Team Meetings (MDT) with care coordinators and community nurse specialists when they are available, including palliative care nurses. All GPs and GP Registrars attended the MDTs when available. The PCN social prescriber also attended the meetings to assist patients with social and non-health related problems. We saw evidence of quality improvement projects undertaken to improve patient outcomes, in line with NICE guidelines. For example, an audit was undertaken to review the benefits of dapagliflozin (a medicine used to treat type 2 diabetes) on renal function and mortality among patients with chronic kidney disease, including those with type 2 diabetes. The results showed improved adherence to the medicine, with plans to re-audit to observe if further improvements are made.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

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.