Pearl Medical Practice

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 assessed all the quality statements from this key question. We looked for evidence that staff involved people in decisions about their care and treatment and provided them advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this. At our last assessment, we rated this key question as requires improvement. At this assessment, the rating has changed to good.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People providing feedback for the assessment described examples of how the practice had fully met their needs, for example prioritising care when there was an urgent problem or promptly referring people to appropriate specialists for further investigation and treatment. The most recent national GP patient survey results (2024) showed that 94% of respondents felt their needs were met during their last general practice appointment. (The national result for this indicator was 90%).

The clinicians and staff described how they assessed and recorded people’s needs, including people’s communication needs. The practice team used the electronic patient records system to code specific needs to ensure staff (including temporary locum staff) were made aware of these.

Clinical staff used validated templates, for example when carrying out care planning or long-term condition reviews, to ensure that all relevant issues were covered including patients’ wider health and wellbeing. There were systems in place for sharing clinical updates and reviewing clinical cases for learning. The lead GP had clinical oversight of the team, for example, carrying out a monthly audit of the quality of clinical record keeping across the clinical team, including staff in associated roles. The provider had improved its processes for clinical oversight since our previous inspection.

People told us that they and their family members had always received good care with several people describing their experience as ‘excellent’ or ‘fantastic’.

The lead GP provided examples showing how evidence-based clinical guidelines were incorporated into normal practice and examples of good practice or unusual cases shared within the team. Clinical staff confirmed they had opportunities to maintain their professional development and access to good clinical support and advice when required. The provider sought advice from external and specialist sources of expertise when appropriate.

The provider used resources and tools such as clinical audit to ensure the team were delivering evidence-based care. We saw examples showing how the practice had audited various aspects of care in line with the latest guidelines.

Some people participating in this assessment commented positively specifically about the way in which their GP liaised with other teams and services to provide excellent care. For example, one person described how their GP had gone ‘over and above’ to organise their care.

The lead GP described the way in which the practice liaised with other professionals, for example, local community teams to reduce the risk of people with complex conditions experiencing sudden deterioration and avoid admission to hospital.

Partners we spoke with described a positive working relationship with the practice. The practice had also surveyed 7 local pharmacies to understand their experience of working with the practice. Responses were positive with 6 describing their working relationship with the practice as ‘excellent’ and 1 stating it was ‘good’.

Clinicians worked with other health and care professionals to deliver a coordinated package of care for patients with the most complex needs, for example, care planning reviews and end of life care.

People did not provide specific feedback about the support they received to live healthier lives for this assessment.

The practice team were able to describe how they supported people to live healthier lives, for example, taking opportunities during consultations and reviews to address relevant lifestyle issues. We spoke with members of the team with a particular focus on this aspect of care including the healthcare assistant and the health and wellbeing coach. For example, the health and wellbeing coach (funded by the primary care network) offered a 4-5 session course for people identified as having ‘pre-diabetes’. They told us they booked interpreters and used double length appointments when patients attended with particular communication needs or a learning disability.

Patients identified as at raised risk of developing certain long-term conditions were provided with structured support on how to reduce the risk through lifestyle changes. Eligible patients could be referred for additional support for example, a structured weight loss programme. The practice offered screening and health checks such as the NHS health checks programme for people aged 40 to 74. The healthcare assistant used structured templates which were integrated into the electronic records system to ensure they covered all components of various checks and reviews.

People did not provide specific feedback about improved outcomes but more generally described the quality of the care they received very positively.

Leaders told us that monitoring and improving outcomes was a priority within the practice. They used a range of sources of data including comparative benchmarking to assess performance. The team described how they had put resources and effort into improving aspects of performance noted to be below average at the previous inspection such as cervical screening and childhood immunisation uptake. Staff were able to describe the strategy to encourage people to attend for screening and immunisation, for example, individually contacting people who had not attended cervical screening by telephone to explain the benefits of the test.

The practice had systems in place to monitor performance and outcomes, for example, regularly carrying out clinical audit on aspects of prescribing and patient management. We carried out a series of structured searches of the practice electronic records system which showed that the practice had effective systems in place to call and recall patients with long-term conditions to monitor and promote positive outcomes in line with guidelines.

The provider was achieving just above 90% coverage for childhood immunisations in line with the recommended UK schedule for children by the age of 1 and 2 years old (2022/23 figures) and just under 90% for the completion of MMR immunisations for children by the age of 5. Performance on cervical screening was markedly below the 80% national target but had improved over the previous year. The practice team was actively working to increase uptake of childhood immunisations and cervical screening in the younger age cohort where uptake was significantly lower. Data published by the UK Health Security Agency showed that the practice had steadily increased coverage of this younger 25-49 cohort from 57% (Jan to March 2023) to 65% (April to June 2024) that is by the time of this assessment.

People participating in the assessment did not provide specific feedback about consent to care and treatment. The most recent national GP patient survey results (2024) for Pearl Medical Practice showed that 97% of people were involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment. The average result on this indicator for all practices in Brent was 89%.

Staff were able to explain how they involved people to obtain consent to specific decisions. For example, the nurse obtained (and recorded) verbal consent from the parent or guardian in relation to childhood immunisations. People with communication needs were given longer appointments to ensure there was enough time to discuss decisions.

Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) decisions were made in line with relevant legislation and showed that, where possible, the patient’s views had been sought and respected. The practice team discussed DNACPR decisions during team meetings.