Crabbs Cross 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

Staff worked together to deliver evidenced based care and treatment. Staff worked collaboratively with other healthcare providers to make sure patients could access wider services easily. Leaders at the service monitored patient outcomes and took action to improve these if required. Staff supported patients to consent to care and treatment and understand the risks and benefits of any onward referrals.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff told us they received training and knew how to prioritise patients who reported symptoms which could be clinical emergencies. Patients were told when they needed to seek further help and what to do if their condition deteriorated.

People we spoke with said they were confident their individual needs had been appropriately assessed and were understood. People’s communication needs were recorded in their notes so staff could see who would need additional support during an appointment.

The practice had systems and processes in place to ensure patients’ immediate and ongoing needs were fully assessed. People’s care needs were routinely reviewed. For example, the lead GP had completed annual reviews for people with a diagnosed learning disability. We saw no evidence of discrimination when staff made care and treatment decisions.

People we spoke with told us they can get information and advice about their health, care, and support. For example, referrals to the hospital were made in a timely way so patients received the medical care they needed.

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 and supervisions to share guidelines and discuss cases.

Our remote clinical searches reviewed the care and treatment of patients who required routine monitoring including those on heart medication. We identified 19 patients who required monitoring for this type of medication. We found 2 patients who despite having a medication review, were overdue for blood tests. This was rectified by the practice straight away. 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 and ensure these were followed up with patients including those who had not attended the arranged appointment.

We received feedback from staff who told us they received appraisals and felt supported in their role. They gave examples of how they were encouraged to develop, such as attending additional training in areas such as spirometry (a test which shows ow well the lungs are working). Leaders and staff at the practice worked closely with colleagues in the local Primary Care Network to share examples of good practice.

Practice management had made changes to monitoring and supporting continued professional development. As a result, staff had regular appraisals and supervisions, and were supported to complete ongoing training and development opportunities.

People told us they felt their care and support was co-ordinated and services worked well together. For example, one person told us when they had previously been referred to another service it was done in a coordinated manner.

The local integrated care board (the statutory NHS organisation responsible for managing the NHS budget and arranging for the provision of health services in a geographical area) informed us they had no concerns regarding how staff, teams and services work together at the practice.

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.

The service took part in national audits as required and shared the results with staff to improve outcomes. We reviewed audits provided by the practice for the issuing of medicines to children under 3. This audit demonstrated compliance to national guidance however the practice had identified some areas of improvement to the way they recorded the outcomes and were in the process of altering this for the next cycle of audits.

We completed remote clinical searches to check the quality of how leaders were monitoring outcomes for patients. For example, one search looked at the potential missed diagnosis of diabetes. We had no concerns about the way staff at the practice interpreted the data and used this for follow ups with patients where required.

Leaders and staff showed us the improvements they had made to monitoring outcomes for patients. This included a streamlined process for booking into clinics, so patients saw the right person at the right time. Staff had received additional training to ensure they had the necessary qualifications for their roles which meant better outcomes for patients.

People said the team at the practice worked well together to ensure they received good outcomes.

The practice had a consent policy in place and staff were aware of how to access it. Staff supported patients to make decisions. Where appropriate, they assessed and recorded a patient’s mental capacity to make a decision. Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions were made in line with relevant legislation where appropriate

We had no concerns about people’s experience regarding consent to care and treatment at this practice.

Leaders and staff told us they understood the requirements of legislation and guidance when considering consent and decision making. Staff told us they understood Gillick competence (deciding whether a child under16 is able to consent to their own medical treatment) and knew who to go to in the practice if they needed support with this.