Millrise 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

There were systems and processes for assessing needs, delivering evidence based care and treatment. The practice had strengthened their systems to ensure that those patients requiring medicine reviews and ongoing monitoring were actively being reviewed and recalled. Our clinical searches were mostly positive and showed good care and appropriate monitoring of patients with long term conditions and those on high-risk medicines. Identified shortfalls were responded to and had been completed at the time of the on-site inspection to mitigate risk. The practice undertook a range of clinical audits to ensure the quality and safety of people’s care and treatment was effectively monitored to improve outcomes. Staff worked with other services to provide effective care to patients.

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.

Feedback from the patient participation group was positive and we were told patients felt involved in decisions about their care, that they were able to ask questions during their consultation and that they received an explanation in a way that they could understand.

Clinicians told us they worked to current NICE guidance and local clinical protocols. The lead nurse told us that the practice ensured that care and treatment was delivered following evidence-based guidelines, and these were discussed at their regular meetings. They told us they attended external training events and practice learning event days. Staff told us the templates used on the electronic systems were updated in line with best practice guidance, which were a regular item for discussion at monthly clinical governance meetings.

The practice had implemented a number of clinical audits. This ensured the quality and safety of people’s care and treatment was effectively monitored, to improve their outcomes. The attainment for the management of cervical cancer screening was slightly below local and national averages at 78.7% with the target of 80% and this was discussed at their clinical governance meeting to consider improvements to their uptake. The practice utilised quality improvement initiatives such as the local integrated care board quality improvement framework (QIF) and the national quality outcomes framework (QOF) for quality improvement and benchmarking. Our clinical searches were mostly positive and appropriate monitoring of patients with long term conditions and those on high-risk medicines. Areas identified by our clinical searches for action were responded to in a timely manner and had been completed at the time of the on-site inspection. There was a structured system in place for inviting patients in for their long-term condition annual reviews and there were designated administration staff who had oversight of this. The practice had a system for reviewing patients test results. We had received information of concern which suggested there had been a backlog. of workflow documents. We found that the practice had identified this as a risk, it was noted on their risk register and at the time of our clinical searches the test results were being dealt with in a timely manner. We observed referral letters to be actioned in a timely manner. The provider monitored and improved outcomes for patients by carrying out clinical audits, although we did not see any 2 cycled clinical audits.

Staff attended regular multi-disciplinary team meetings to discuss patients whose circumstances may make them vulnerable. For example, patients receiving end of life care. External partners such as district nurses and palliative care staff were invited to attend.

The provider had a General Data Protection Regulation (GDPR) policy in place and safe processes for information sharing. They were registered with the information governance commission and had effective shared care agreements (ESCA) in place with stakeholders involved in patient’s safe care and treatment. Coordination and collaboration took place from the first contact with the patient through the practices workflow system to any relevant referrals to other health and social care stakeholder services. We found that following clinical searches referral letters were being completed in a timely manner. Following a recent workflow backlog in coding and letters, the practice had put in place an additional procedure for referral safety netting purposes. This was also reported on the practice governance risk spreadsheet. Transitions of care (including from children to adult services) were monitored and discussed with the local safeguarding teams and a clinical audit had taken place to ensure the practice systems and processes regarding safeguarding electronic codes and alerts were effective. The practice had put measures in place to ensure that when a clinical colleague took leave that the tasks were appropriately delegated and shared to appropriate staff.

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.

Staff carrying out long-term condition reviews told us they had received appropriate training for the role. Staff reported they had used electronic templates for long term conditions which were in line with best practice recommendations. Clinical staff advised us that arrangements were in place to support non-medical prescribers. The practice told us the nurse practitioner (NP) was provided with opportunity for regular debriefs and support from a GP. The practice completed a more structured audit of their consultations in weekly supervision reviews and with the clinical pharmacist. The non-medical prescribers reported positively on the support they received.

The practice had implemented a variety of clinical audits to ensure the quality and safety of people’s care and treatment is effectively monitored, and that the practice continuously improve their outcomes. The practice utilised quality improvement frameworks such as the local integrated care board QIF and the national quality outcomes framework for quality improvement and benchmarking. Our clinical searches were mostly positive and appropriate monitoring of patients with long term conditions and those on high-risk medicines. Areas identified by our clinical searches for action were responded to in a timely manner and had been completed at the time of the on-site inspection and were reviewed by our clinical specialist advisor as having mitigated the risk. There was a structured system in place for inviting patients in for their long-term condition annual reviews and there were designated administration staff who had oversight of this. We saw the practice had a system for reviewing patients test results. We had received information of concern which suggested there had been a backlog in test results, coding, and document workflow. We found that the practice had already identified this as a risk, and had noted this on their risk register. At the time of our assessment, we saw that these were being dealt with We observed referral letters to be actioned in a timely manner. The provider monitored and improved outcomes for patients by carrying out clinical audits, although we did not see any 2 cycle clinical audits, other than medicine audits.

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.