Cookham 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

During the assessment we reviewed policies, spoke with staff, and undertook observations while on site. Our findings were: Patient feedback showed that most patients felt confident their needs had been met by the practice. External data regarding patients’ feedback of their experience, how the practice supported and involved them, and their confidence in the care and treatment they received showed the practice performed above the national average. 1 indicator showed positive variation compared to the national average. Staff clearly looked for opportunities to support patients to be as involved as possible in their own care and treatment. Where patients had specific needs, the practice had systems to identify these and found ways to support the individual to ensure these were met. The practice supported carers to maintain their own health so they could continue to care for people. Staff used up to date and accurate information to understand people’s needs. There were opportunities to improve the recall systems and review of patients care to ensure the effectiveness of care and that treatment was maximised and patients’ health was optimised.

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.

We asked the provider to share details of our Give Feedback on Care process with patients. We received 3 pieces of feedback during the assessment and reviewed submissions dating back to June 2023 which included 12 further pieces of feedback. There were 2 patients that provided feedback they felt confident in the care of all the staff at the practice. However, we also reviewed 2 pieces of feedback which suggested patients were not confident their individual needs had been appropriately assessed or fully understood by the practice. We also reviewed the results of the GP Patient survey and found the practice was above the national average for 4 indicators which related to this quality statement. Of these, 3 had no variation, however, 1 indicator showed positive variation. This related to the percentage of patients who stated that during their last appointment they had confidence and trust in the healthcare professional they saw or spoke to. Overall, feedback indicated that most patients felt confident their needs had been met and that they had been involved in decisions about their care and treatment. However, this was not the case for all the patients that had shared feedback.

Our discussions with staff helped us understand how the practice and staff supported patients to maximise their own involvement in their care and treatment. For example, staff we spoke with gave clear examples of how they would gain consent to treatment from a patient and where staff had concerns about a patients’ capacity to decide, we heard how they would support the patient. Staff used up to date information to understand patients’ current needs. For example, we heard an example about how a staff member had supported a patient that was a non-verbal communicator by reading the patients’ care plan and speaking with their carer. The staff member had explored how the patient communicated and used this to assure themselves the patient had consented to treatment. We found patients were involved in their assessments and the practice looked for opportunities to review their health and wellbeing with them. For example, referrals could be made to the Primary Care Network (PCN) social prescribers. We also heard an example of how the practice had identified a group of patients that wanted more support and information about the menopause and, in response the practice had developed an education programme which they reported had been very well received by patients. We also heard how the practice had supported patients from Ukraine to register and, where those patients were already undergoing treatment, the practice had worked with partners, including the Integrated Care Board, to place the patient at the correct point in their care journey. Overall we found the practice spoke of involving patients in their care, assessing the whole person and their needs, and had a clear focus on supporting the individual to maximise their health.

There was a culture of considering risks that could impact the practice. A risk register was maintained and there was a rolling programme of review to remove old and add new risks. All risks had control measures assigned to mitigate or manage the identified issue. Meeting minutes showed evidence of open and transparent communication. We found the practice used audit to identify performance concerns and acted where improvements were needed. For example, in addition to staff explaining how they maintained security of data and confidential information we saw evidence of a compliance audit where many areas were found to be 100% compliant. Where action was needed to improve, this had been completed. The practice maintained oversight of financial sustainability, workforce planning and staffing levels. We also found the practice undertook succession planning which was evidenced by a restructure due to a retirement and staff resignations. However, the practice’s own governance had failed to identify the concerns we found in relation to: The findings of the remote clinical searches which indicated guidance was not always followed regarding prescribing of medicines requiring monitoring and monitoring of patients with long-term conditions. The PSD process did not follow guidance. The system to manage blank prescription stationery was not effective. The newly introduced protocol to manage medicines safety alerts from the MHRA was not operating effectively. The decision not to stock 3 recommended emergency medicines had not been reviewed for many years. In summary, we found the practice had systems and processes which provided oversight of performance to leaders and managers and there were ambitions to improve these processes further. However, improvement was required to ensure ineffective governance processes were identified and improved and, that best practice and guidance was embedded in practice.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

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.