Askern Medical 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

At our previous inspection, the practice was rated good for providing an effective service. At this assessment we have rated the practice as good for providing an effective service. Through our clinical searches completed we saw that the service delivered evidence-based care. They monitored and improved outcomes for patients by carrying out clinical audits. We saw that the most available data showed that childhood immunisations were in line with national targets, however cervical screening was below these.

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.

Our assessment raised no concerns in this area, and we received no specific feedback from patients on this.

The provider was the clinical lead at the practice, they discussed with us at interview how patients’ needs were assessed and delivered in line with current legislation. We saw several examples of the minutes of monthly clinical meetings. They told us, for example, that 2 week wait appointments (a patient who may have symptoms of cancer should be seen by a consultant within 2 weeks) were dictated while the patient was with the GP and they would receive a text to confirm their appointment. The provider told us that the practice had achieved 100% compliance for dementia reviews and learning disability checks.

In relation to outcomes we saw from data from NHS Digital - Cervical Screening Programme Coverage Statistics that for the percentage of persons eligible for cervical cancer screening who were screened adequately within 3.5 years for persons aged 25 to 49, and within 5.5 years for persons aged 50 to 64, at 30/6/2023 the practice had achieved 71.3% - the expected percentage was 80%. The practice told us this indicator had improved and provided us with unvalidated data from their own clinical system giving the achieved percentage at the time of assessment as women aged 25-49 – 82.1% and 50-64 – 86.9%. Child immunisations were above the 90% minimum vaccination rate recommended by the World Health Organisation (WHO). From our remote searches of clinical records we sampled 5 medication reviews of 421 identified in the last 3 months and there were no issues with the reviews. We sampled from the records how the practice managed long term medical conditions. For example; We looked at a sample of 5 patients with asthma from 33 who had been prescribed 2 or more courses of rescue steroids, from these we identified there was no follow up. National Institute for Health Care Excellence (NICE) guidance states that this should be within 2 days. We looked at 4 patients in detail with hyperthyroidism to check their thyroid function test monitoring in the last 18 months, we identified no issues. We looked at 5 patients who were diabetic to check their blood glucose monitoring, there were issues with 2 of the patients monitoring, however the lead GP could explain to us why reviews were outstanding, for example the patient refused diabetic care.

Our assessment raised no concerns in this area and we received no specific feedback from patients on this.

The lead GP explained to us that the practice had carried out audits to improve care and followed National Institute for Clinical Excellence (NICE) guidance. We saw on a board in the practice conference room a list of audits, from 2022 the practice had carried out 42 audits which included, audits of urinary tract infections (UTI), friends and family test, minor surgery audit and an audit of the reduction of controlled medication.

We looked at two audits in detail. One was an end-of-life audit, the practice had carried out this type of audit every year since 2009. The 2023 audit showed that all patients expected to die except 1 had died in their preferred place, DNACPRs were in place, medications managed, and information issued for the family. The practice had carried out an audit of thyroid function test monitoring in the community. This was a 2-cycle audit in January 2024, which identified 14 patients who had not undergone the required monitoring. The audit was re-run a month later and all patients were 100% compliant.

We received no specific feedback from patients on this.

Information received from whistle blowers prior to this assessment and staff indicated that clinical correspondence received by the practice was not always responded to. However, on review of clinical records we did not identify any issues. We discussed with the lead GP and managers the processes for how they worked together with other teams and services, for example, the clinical lead explained to us the process for processing 2 week wait appointments for patients.

We asked for feedback from the care home where the practice had patients registered who were resident there. They said they had asked the practice to bring the medication cycle, for repat prescriptions for residents, in line with theirs as it was causing them difficulties. The GP practice were reluctant to do so, they were unsure why and the care home said they found them difficult to engage with.

We saw examples of recent multi-disciplinary team meetings (MDT) where for example, safeguarding and palliative care were discussed. Recent deaths were discussed to assess if there was any learning from the practice for the future. There was a procedure for staff to follow to action incoming letters and discharge summaries.

Our assessment raised no concerns in this area and we received no specific feedback from patients on this.

The lead GP explained that the staff had been trained to signpost patients to other services which could help them. The practice had ‘champions’ amongst staff for example, a veterans, mental health and carers champion. The practice offered services for the elderly, for example dementia diagnosis. Bereavement care for families, advanced musculoskeletal health, healthcare specifically for Travellers and training for hairdressers to refer patients with suspicious skin conditions.

The practice identified patients who may need extra support and directed them to relevant services. This included patients in the last 12 months of their lives, patients at risk of developing a long-term condition and carers. Staff encouraged and supported patients to be involved in monitoring and managing their own health. Patients had access to appropriate health assessments and checks. Staff discussed changes to care or treatment with patients and their carers as necessary. The practice supported national priorities and initiatives to improve the population’s health, for example, stop smoking campaigns and tackling obesity. Palliative patients were discussed at multi-disciplinary meetings. The practice carried out an end of life audit every year.

Our assessment raised no concerns in this area and we received no specific feedback from patients on this.

The lead GP explained the process for monitoring clinical outcomes at the practice. We discussed our clinical searches with the lead GP and pharmacist.

We saw the processes for clinical audit and safety incidents at the practice. The clinical searches of the practice patient records system showed patient medication reviews and long-term condition management were positive.

We had no concerns with any of the patient outcome data regarding care which we looked at.

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.