Brierley Park Medical Group

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

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment the rating remained as good as the provider had action plans in place to address concerns regarding the care of people from the branch practice they took over in July 2023. This meant people’s outcomes were good, and people’s feedback confirmed this.

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.

The service did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. The practice had a branch practice which they took over in July 2023. Leaders told us that since taking over the practice they had found areas where care was not in line with national guidance and they had started to address this, protocols were being developed. However, systems to identify people with undiagnosed conditions, who were previously registered with the branch practice, were not fully embedded into practice. For example, we identified 327 people with a potentially missed diagnosis of chronic kidney disease (CKD). Following our assessment the leaders sent us details of the actions they were taking to follow up these people. They informed us that when they reviewed the records, many of the people did not have CKD. We found a small number of people with long-term conditions that were overdue monitoring. Staff used digital flags within the care records system to highlight any specific individual needs, such as the requirement for longer appointments or for a translator to be present. Staff checked people’s health, care, and wellbeing needs during health reviews. Clinical staff used templates when conducting care reviews to support the review of people’s wider health and wellbeing. Staff could refer people with social needs, such as those experiencing social isolation, to a social prescriber.

People’s care and treatment was planned and delivered with them, including what was important and mattered to them for example, end of life care. This was mostly done in line with legislation and current evidence-based good practice and standards. Systems were in place to ensure staff were up to date with evidence-based guidance and legislation. Clinical records we saw mostly demonstrated care was provided in line with current guidance.

The service worked well across teams and services to support people. Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support. Staff feedback was very positive about how they worked together within the practice. For example, weekly meetings were held to rectify any issues; there was team working across different staff groups to address issues such as follow up of people who failed to attend important appointments; positive feedback regarding the effectiveness of staff working following the merger of the 2 practices. The practice worked with other services to ensure continuity of care. For example, the wider multidisciplinary team to support vulnerable people. Representatives from 3 care homes were overwhelming positive about how the practice worked with them to deliver and support the care of people living there. The practice had worked collaboratively with their Patient Participation Group (PPG) to provide an event to raise awareness around the issues experienced during the menopause. Following the event, the practice established a monthly menopause clinic for their patients.

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 routinely monitored people’s care and treatment to continuously improve it. The practice met national targets for screening and childhood immunisations. National data showed that all 5 indicators for childhood immunisations had achieved the 90% minimum uptake rate and this was consistent over time. The practice ran frequent audits and searches to monitor and improve the uptake of these immunisations. National data showed that the uptake of cervical screening was 79.1% which was very slightly below the national target of 80%. We found that uptake had increased over time. The practice was part of a pilot to improve cervical screening uptake within the transgender population. There was a programme of audits and quality improvement. The provider had reviewed the effectiveness of suggested changes in some of the audits they shared with us.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment. A consent policy was in place to ensure appropriate consent was obtained from people when receiving care and treatment. The policy was underpinned by national guidance such as the Mental Capacity Act 2005. Processes were in place to ensure Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions completed by clinical staff working in the practice were in line with relevant legislation. However, copies of DNACPR reports were not available within people’s records when they had been put in place by secondary care. Following our assessment the provider informed us they were exploring ways of how these could be obtained and scanned into people’s records. There was a formal system in place for obtaining written consent for minor surgery procedures.