All Saints Medical Centre PMS

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 found the service was providing effective services because we saw patients with long-term conditions, such as diabetes, were monitored in line with best practice guidance. Patients told us they felt involved with decisions about their care and clinical audits demonstrated evidence of quality improvement.

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 requested evidence of clinical audits completed by the provider over the last 2 years. We saw evidence of 4 audits, however 3 of these were single cycle and therefore did not demonstrate quality improvement. There was a two-cycle audit which looked at patients prescribed a medicine that required monitoring. Recommendations were made following the first cycle, including setting diary reminders for monitoring and sharing details with staff. Improvements were seen in the second cycle of the percentage of patients receiving timely monitoring tests.

We saw that patients with diabetes were monitored in line with best practice guidance. Our review of clinical records identified some patients as having a potential missed diagnosis of Chronic Kidney Disease (CKD) stage 3, 4 or 5. We reviewed 5 patients in detail and found 1 patient had a potential missed diagnosis of CKD stage 3, 4 or 5. We shared our findings with the provider who reviewed each of the patients identified by our search and created action plans where appropriate, including inviting patients to attend for monitoring tests. We found 6 patients had been prescribed 2 or more courses of rescue steroids in the last 12 months. We reviewed these patients and found 4 patients had been managed appropriately, however 2 patients did not have a follow up within a week of their prescription of rescue steroids and were overdue their annual asthma review. We shared our findings with the provider who told us they would update their procedures to ensure an alert was added to follow up within a week any patient receiving rescue steroids for exacerbation of asthma. We reviewed patients with hypothyroidism and found 6 patients were not up to date with monitoring tests. We reviewed 5 of these patients and found 2 were overdue monitoring test, 1 of these patients also needed a medicine review. We shared our findings with the provider who arranged monitoring tests for all identified patients.

During the site visit, we spoke with 2 patients. Both patients reported that they felt listened to by the practice and stated they felt involved in decisions made about their care and treatment. Both patients reported that they were able to request the clinician of their choice and that this was honoured as capacity allowed. The practice had a diverse workforce who spoke a number of languages. The skills of multi-lingual staff were utilised as needed, with patient consent, as well as offering translation facilities if preferred. Patients whose first language was not English was noted on the electronic clinical records system and double appointments were automatically booked.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

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 look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

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.