Harris Memorial 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 involved people in the assessment of their needs, and support was provided where needed, to maximise their involvement. Staff worked with all agencies involved in people’s care for the best outcomes and smooth transitions when moving services. Staff made sure people understood their care and treatment to enable them to give informed consent. Staff involved those individuals important to them in making decisions in people’s best interests where they did not have capacity. At our last assessment, we rated this key question as Requires Improvement. At this assessment, the rating has changed to Good.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People felt involved in the assessment of their needs and felt confident that staff understood their individual and cultural needs. Staff were aware of the needs of the local community. Digital flags on patients records highlighted additional support, such as the requirement for longer appointments or for a translator to be present. Staff identified opportunities to refer people to social prescribers (a service that connects people to activities, groups, and services in their community) to help improve health and wellbeing, for example, to support individuals experiencing mental health related conditions such has anxiety, stress and depression. Our clinical searches identified 449 people on the asthma register, 32 of those people had been prescribed 2 or more rescue steroids (treatment for severe asthma episodes) in the last 12 months. We reviewed 5 patient records and found 5 people had not been reviewed appropriately in line with national guidance, including an assessment at the time of prescribing and a timely follow up to check the response to treatment. Following our on-site visit, the service acted swiftly and implemented a new process to ensure people received the appropriate assessment and follow up. We reviewed the appointment diary and saw appointments were available to book the same day for urgent appointments and in the following few days for routine appointments.

Systems were in place to ensure staff were up to date with evidence-based guidance and legislation. Clinical records we reviewed demonstrated care was provided in line with current guidance.

Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. The practice worked with other services to ensure continuity of care, including where clinical tasks were delegated to other services. People received consistent person-centred care when they moved between services. On the day of our site visit, there were 144 incoming clinic documents that required processing. The oldest document being actioned was from the 20 January 2025.

Staff focussed on identifying risks to patients’ health, including those in the last 12 months of their lives, patients at risk of developing a long-term condition and those with caring responsibilities. For example, the practice arranged a ‘Super Sunday’ diabetes day to support those individuals with a diagnosis of diabetes, who find it difficult to attend planned reviews during normal practice opening times. Over 80 appointments were attended, supported by service nurses, Diabetes UK, Retinal Screening and Primary and Community Care (PCN) nurses.

There was a system in place to review health conditions such as diabetes and chronic kidney disease (CKD). However, our remote clinical searches identified some people had not been monitored appropriately. Following this being identified, the practice told us they had reviewed the people who required further monitoring and invited them in for review. For example, our clinical searches identified 122 people with a potential missed diagnosis of chronic kidney disease stage 3-5. We looked at a sample of 5 patient records, and all 5 had a missed diagnosis of CKD 3-5. Following our feedback, the practice told us they had reviewed 122 people’s notes and coded them appropriately. The practice was observed to be achieving 70.7% below the expected minimum target of 80% for cervical screening, however, an action plan was in place to increase the uptake of cervical screening, which included extra clinics at evenings and weekends.

Staff understood and applied legislation relating to consent. Capacity and consent were clearly recorded. Staff had completed Mental Capacity Act Training. Policies, protocols and guidance were in place to support people to consent to care and treatment. Clinicians supported people to make decisions.