Dr C D Lenton & Partners Also known as Ashfield 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

We carried out an announced assessment of 2 quality statements (Delivering evidence-based care and treatment and Monitoring and improving outcomes) under the effective key question and found: People and communities have the best possible outcomes because their needs are assessed. Services work in harmony, with people at the centre of their care. Leaders understand current outcomes, however, did not always support staff appropriately to improve quality.

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 did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

We reviewed information relating to a complaint we had received and found the patient had received appropriate care that included multiple appointments with the same clinician. Patient experience was poor because of poor communication between teams; however, care was delivered safely, in line with guidelines.

Leaders told us patients receive care, treatment and support that is evidence-based and in line with good practice standards. Patients are told about current good practice that is relevant to their care and are involved in how this is reflected in their care plan. Our review of patient records indicated that patients received appropriate care and treatment in line with guidelines for COPD, minor surgery and mental health. Where appropriate patients were involved in decision making. However, not all staff we spoke with felt they were kept updated about how the practice was performing, what the priorities were and how the practice would achieve their targets in delivering effective care.

The practice carried out monthly searches on their clinical system to help identify those patients that required a review and if any additional information was required to help support their care and treatment. Leaders reviewed the performance of the practice in meetings and decided on priorities. We saw evidence of performance being shared with clinical staff and following the assessment, leaders sent us evidence to show that meeting minutes were shared with all practice staff. However, during the assessment not all staff we spoke with could recall being sent meeting minutes and not all staff were aware of the practice's priorities. The practice was not routinely having meetings that all staff could attend. This meant not all staff were kept updated about performance and priorities. Leaders were aware that communication needed to improve and were in the process of setting up regular meetings where all staff or staff representatives from each team could attend.

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 collect the evidence to score this evidence category

Leaders told us they had monthly business meetings where they discussed performance targets to see which patients needed to be prioritised and recalled for appointments. However, some clinical staff told us they were not aware of where the backlogs were, what their priorities were and how they were going to achieve them. Staff told us, following minor surgery audits in 2022, they identified a trend in post- operative complications. An action following the audit was to increase the length of the appointment time. At re-audit in 2023 the number of post-operative complications remained similar; however, the number of patients requiring follow-up appointments had reduced.

We saw evidence of meeting minutes where performance and outcomes were discussed with clinicians and leaders and this information was used to make further improvements. However, this information was not shared with all relevant staff and this process needed improvement. The provider had implemented processes to monitor that correspondence from external organisations was being triaged, coded and actioned appropriately. The provider had reviewed and improved their processes for travel vaccinations following complaints from patients and concerns from staff. The provider carried out minor surgery audits to monitor complication rates and make further improvements. The practice referred patients to the social prescriber for additional support and advice and had processes in place to receive feedback from the social prescriber on any actions they had taken. At the time of the assessment, the social prescribing service was being changed and new processes were yet to be arranged.

Our review of patient records indicated that patients received appropriate monitoring in line with guidelines for COPD, minor surgery and mental health. Minor surgery audits we viewed showed low complication rates that were comparable to national averages. The previous social prescriber provided the practice with a monthly report to update staff on the number of patients seen and a summary of interventions.

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.