The Wellington Practice

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• 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 assessed all 6 quality statements from this key question. We found improvements had been made since the previous inspection in January 2023. For example, staff were up to date with mandatory training, patients with long-term conditions received care in line with national guidance and clinical supervision was in place to ensure staff in advanced roles were competent to carry out their roles.

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.

Patient feedback via the 2024 National GP Patient Survey (GPPS) indicated 95% patients felt their needs were met during their last general practice appointment. This was above local averages of 87% and the national average of 90%.

Leaders and staff told us they used codes, alerts and flags which they added to patient records to ensure patients’ communication, disabilities and any impairment needs were highlighted for staff to tailor patient care. Leaders told us they were aware the practices’ performance in cervical screening uptake was below the national target. However, they informed us staff review eligible patients throughout the year, follow up non-attenders, and send multiple invites to try to encourage patients to attend.

Our clinical searches identified patients were receiving the assessments, including tests, they required to ensure effective care planning. Diagnostics and consultations for long term condition care were undertaken to ensure effective care planning. We found there were no patients identified with potential undiagnosed diabetes or chronic kidney disease.

We noted 94% of patients who responded to the GP patient survey in 2023 stated they had confidence and trust in the healthcare professional they saw or spoke to during their last GP appointment. In addition, 88% respondents said they felt involved in decisions about their care and treatment. These were both in line with local and national averages.

Staff told us they were provided opportunities to keep up to date with current guidelines and changes to evidence-based care and treatment and we saw some evidence this had been discussed in clinical meetings.

From our clinical searches we identified most patients were delivered care in line with evidence-based guidance. However, we found the practice did not consistently follow up patients who had received 2 or more courses of rescue steroids in the last 12 months in line with national guidance. This was raised with the practice who reviewed their process to ensure this would be implemented immediately.

Patient feedback did not indicate significant concerns with the coordination of care within the practice or between the service and external providers.

Staff told us they worked as a cohesive team to ensure patients received high quality healthcare. Staff informed us there were processes for managing correspondence and referrals to external services.

Both local care homes provided feedback that the GPs were supportive of all care home staff and patients. They told us all GP practice staff were dedicated to ensure patient care was coordinated effectively to allow patients to access the care and support they needed.

Staff had access to the information they needed to appropriately assess, plan and deliver people’s care, treatment and support. There was an effective process in place to action and manage correspondence and referrals to external services. The provider had processes to work with agencies to manage care, for example, there were systems to share information about patients with other services such as safeguarding meetings where external health visitors and school nurses attended.

Patient feedback via the 2024 National GP Patient Survey (GPPS) showed 91% respondents felt the healthcare professional they saw had all the information they needed about them during their last general practice appointment. This was in line with local and national averages.

Staff informed us they supported and advised patients on how to lead healthier lives and how to manage their long-term conditions independently.

The practice website was accessible to patients and included useful health promotional material and resources as well as up to date information on opening times, appointments information, prescriptions information and new patient registrations. The practice had also recently employed an outreach worker to support patients with health and well-being.

Patient feedback did not include reference specific to the monitoring and improving outcomes of care.

Feedback from staff and leaders was positive about monitoring and improving outcomes. Staff encouraged patients to attend for screening and childhood immunisations and patients who did not attend were followed up. Leaders told us they undertook quality improvement audits and used the information to make improvements.

Patient outcomes regarding the care of long-term conditions and prescribing of high-risk medicines were overall positive. The practice was monitoring the recall systems used to ensure patients received timely interventions. The practice used information collected for the QOF and performance against national screening programmes to monitor outcomes for patients.

The practice had a programme of quality improvement activities which included carrying out regular audits to review the effectiveness of systems as well as care and treatment provided. For example, the practice had carried out an audit to review patients with higher levels of Hba1c (blood glucose levels) which was a risk factor to the patient developing diabetic retinopathy (a medical condition in which damage occurs to the retina due to diabetes). As part of this review, the practice took action to help reduce this risk to patients, for example, referring the patients to diabetic specialist nurses for further follow up. This audit was carried out twice and the second audit demonstrated improvement to the patients HbA1c (blood glucose levels) and therefore reduced this risk factor.

The national GP patient survey results demonstrated 88% respondents felt listened to at their last GP appointment. This was in line with local and national averages.

Clinicians understood the requirements of legislation and guidance when considering consent and decision making.

There was guidance and training for staff in consent and related legislation such as the Mental Capacity Act (2005) and legal guidance such as the Gillick Competency (regarding consent for young people under 16 years of age).