Danbury Medical Centre

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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 2 quality statements from this key question. We have combined the scores for this area with scores based on the rating from the last inspection, which was good. Our rating for this key question remains good. We found staff involved people in decisions about their care and treatment and provided them with advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this. Feedback from people using the service was mainly positive about the care they received once they could access appointments.

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.

78% of respondents to the GPPS stated the healthcare professional they saw was good at listening to them, 77% of respondents stated the healthcare professional was good at treating them with care and concern. In addition, 88% of patients had confidence and trust in the health care professional they saw or spoke to compared to the England average of 92%. However, access to the practice was highlighted as a concern as only 21% of respondents stated it was easy to access the practice by telephone.

Reception staff were aware of the needs of the local community. There were 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. Leaders told us that patients’ immediate and ongoing needs were assessed and patients’ treatment was regularly reviewed and updated. This included their clinical needs and their mental and physical wellbeing. In addition, patients presenting with symptoms which could indicate serious illness were followed up within 48 hours or same day where indicated. Staff told us the dispensary team had a clear system for patients who required chronic disease management, or those who took certain medicines requiring regular blood tests. Leaders told us there was a new system recently established to review patients who had not attended cervical screening tests on a two weekly basis and these patients were called and booked into appointments. Additionally there was a team working to encourage patients to ensure childhood immunisations were carried out.

A sample of the records of patients with long term health conditions were checked. The required monitoring was not always taking place. Not all patients with an undiagnosed long-term condition were identified. The practice complied an action plan during the assessment and told us they had addressed this and it was improving. The practice achieved a 71% uptake for cervical screening. The national target is 80%. The practice had a team who contacted non-attenders on a 2 weekly basis and booked appointments for them. The practice had met the expected minimum of 90% for childhood immunisations in 3 areas. The practice had achieved 89% in 1 area. The practice had a team who focused identifying non-attendance.

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.

Complaints received by CQC expressed concern regarding the outcome of health conditions due to lack of access to the practice. The leadership team shared actions to address improving access including by telephone.

Leaders told us they monitor people’s care and that a programme of audits were in place. The new patient safety meeting had audits as an agenda item, so they could be discussed at future meetings. Leaders and staff told us they conducted audits linked to areas where quality could be improved such as patients whose blood tests showed they had diabetes but had not been appropriately coded on the practice system and could therefore miss out on required monitoring and asthma.

There were systems in place to identify and monitor people’s outcomes. This was achieved through formal quality outcome frameworks used by local commissioners of healthcare and internally agreed monitoring. Where potential shortfalls were highlighted, records needed to demonstrate they had been followed up and improvements made to monitoring outcomes.

Outcomes for people were monitored both individually by clinicians providing their care and treatment and collectively through clinical audits. However, clinical searches found not all patients had the required monitoring and there was some did not demonstrate the prescriber had checked monitoring was up to date prior to issuing a prescription. An action plan was put in place by the practice to address these concerns and they took immediate action.

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.