What is the Quality of Care at The Practice St Albans

Positive

"• Patients at risk of dementia were identified and offered an assessment to detect possible signs of dementia."

Positive

"The practice was designated as being dementia friendly and the improvements made to the branch site had been done in a ‘dementia friendly’ manner for example brighter colours used to paint the walls and consistent flooring throughout."

Positive

"When dementia was suspected there was an appropriate referral for diagnosis."

Neutral

"People experiencing poor mental health including people with dementia The practice is rated as requires improvement for the care of people experiencing poor mental health including people with dementia."

Neutral

"However the number of face to face reviews of patients with dementia had declined from the previous year."

Positive

"Requires improvement ––– People experiencing poor mental health including people with dementia The practice is rated as requires improvement for the care of people experiencing poor mental health including people with dementia."

Positive

"For example the mental health lead had developed a ‘Health Thinking Café’ at which patients were invited to attend and engage with local support groups and the mental health lead to speak openly and in private about their condition and break down barriers with staff of the organisations."

Positive

"People experiencing poor mental health including people with dementia: • Staff had a good understanding of how to support patients with mental health needs and those patients living with dementia."

Positive

"People experiencing poor mental health including people with dementia: • There were a higher proportion of registered patients with mental health needs at the practice."

Positive

"• The practice worked with the community mental health service to support patients."

Positive

"For example the mental health lead had developed a ‘Health Thinking Café’ • We spoke with two members of staff about the Accessible Information Standard but neither were aware of it."

Positive

"• The management of patients with long term conditions and those suffering from poor mental health as indicated in QOF results was below local and national averages."

Positive

"The population groups are: • Older people • People with longterm conditions • Families children and young people • Working age people including those recently retired and students • People whose circumstances may make them vulnerable • People experiencing poor mental health including people with dementia."

Positive

"• The practice regularly worked with multidisciplinary teams in the case management of patients experiencing poor mental health including those with dementia."

Neutral

"• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations."

Positive

"• The management of patients with long term conditions and those suffering from poor mental health as indicated in QOF was below local and national averages and had declined in some areas from the previous year."

Positive

"The population groups are: • Older people • People with longterm conditions • Families children and young people • Working age people including those recently retired and students • People whose circumstances may make them vulnerable • People experiencing poor mental health including people with dementia."

Positive

"• The practice regularly worked with multidisciplinary teams in the case management of patients experiencing poor mental health including those with dementia."

Positive

"• Due to extensive waiting lists for psychiatry appointments the practice chose to mitigate the risks associated with long waiting times and ensured that patients were seen by a GP prior to any repeat prescriptions and contacted patients who did not attend mental health reviews."

Positive

"• Continue to monitor QOF data in relation to long term conditions and mental health to ensure that the improvements made are being sustained."

Neutral

"People experiencing poor mental health including people with dementia The practice is rated as requires improvement for the care of people experiencing poor mental health including people with dementia."

Neutral

"• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary."

Positive

"The population groups are: • Older people • People with longterm conditions • Families children and young people • Working age people including those recently retired and students • People whose circumstances may make them vulnerable • People experiencing poor mental health including people with dementia."

Positive

"Requires improvement ––– People experiencing poor mental health including people with dementia The practice is rated as requires improvement for the care of people experiencing poor mental health including people with dementia."

Positive

"• The practice worked with multidisciplinary teams in the case management of patients experiencing poor mental health including those with dementia."

Positive

"This included services for people experiencing poor mental health and bereavement."

Positive

"• The practice offered longer appointments for patients with a learning disability and for others who required this."

Positive

"• The practice offered longer appointments for patients with a learning disability and for others who required this."

Positive

"The practice had taken a long term approach to improving the relationship with patients with a learning disability most of who resided in a supported living home nearby."

Positive

"The practice acknowledged improvements could be made and staff had taken proactive steps to liaise with the learning disability primary care liaison nurse and care home provider to improve these patients’ access to annual health checks and reviews."

Positive

"The practice was in liaison with the learning disability primary care liaison nurse and care home provider to ensure most of these patients received their health checks."

Positive

"For example the low number of health checks completed for patients with a learning disability and the high number of correspondence waiting to be scanned into patient records."

Positive

"• Take more proactive steps to ensure patients with a learning disability receive an annual health check."

Positive

"Uptake for bowel cancer was slightly below averages."

Positive

"The practice also encouraged its patients to attend national screening programmes for bowel and breast cancer screening."

Positive

"The practice also encouraged its patients to attend national screening programmes for bowel and breast cancer screening and screening rates were comparable to local and national averages."

Positive

"This included NHS health checks and cancer screening programmes."

Positive

"• For patients with the most complex needs the practice team worked with other health and care professionals for example community diabetes specialists to deliver a coordinated package of care."

Positive

"• Newly diagnosed patients with diabetes were mostly referred into a structured education course to help them manage their condition."

Neutral

"The specialist diabetes nurse attended the practice to assist with the management of more complex patients."

Positive

"Clinical and nonclinical staff had lead roles in a range of areas such as diabetes prescribing human resources and recalls; however staff told us there were times when there did not seem enough clinicians available to meet demand."

Neutral

"• There were practice hosted clinics available for patients such as a diabetes baby and lung health clinics."

Neutral

"• There were practice hosted clinics available for patients such as a diabetes baby and lung health clinics."

Neutral

"Clinical and nonclinical staff had lead roles in a range of areas such as diabetes prescribing human resources and recalls."

Neutral

"• Indicators to measure the management of diabetes were lower than local and national averages."

Neutral

"• The practice hosted an acupuncture service and the local diabetes specialist nurse facilitated a clinic each week to see patients with complex needs."

Neutral

"This included management of long term conditions such as diabetes and hypertension."

Positive

"• The practice should consider disability access at the branch site."

Positive

"However this was not possible if the person was on the telephone and raised concerns about treating patients with a disability in a dignified manner."

Positive

"• The practice offered longer appointments for patients with a learning disability and for others who required this."

Positive

"• There were facilities for patients with a disability including dedicated parking and accessible toilets."

Positive

"• The practice offered longer appointments for patients with a learning disability and for others who required this."

Positive

"The practice had taken a long term approach to improving the relationship with patients with a learning disability most of who resided in a supported living home nearby."

Positive

"• There were facilities for patients with a disability including dedicated parking and accessible toilets."

Positive

"The practice acknowledged improvements could be made and staff had taken proactive steps to liaise with the learning disability primary care liaison nurse and care home provider to improve these patients’ access to annual health checks and reviews."

Positive

"The practice was in liaison with the learning disability primary care liaison nurse and care home provider to ensure most of these patients received their health checks."

Positive

"For example the low number of health checks completed for patients with a learning disability and the high number of correspondence waiting to be scanned into patient records."

Positive

"• Take more proactive steps to ensure patients with a learning disability receive an annual health check."

Positive

"• The premises at both The Practice St Albans and The Practice Nirmala branch site were accessible for patients with a disability and there was a hearing loop available."

Positive

"• The practice had collaborated with the local Fire and Rescue Service to link the flu clinic appointments with engagement about fire safety and smoke alarms."

Neutral

"• The practice nurse and advanced nurse practitioner managed chronic disease visits to housebound patients including flu vaccinations when appropriate who were not part of the community matron caseload."

Neutral

"• A project to improve the identification of atrial fibrillation had been organised to run later in the year by taking instant ECGs of patients in the waiting room during the flu clinics."

Positive

"This included: • Increasing the awareness of online access to though text messaging display information on the patient call screen and distribution of promotional leaflets at key events such as flu clinics."

Positive

"• The practice was not always responsive to the needs of older people and although they offered home visits and urgent appointments for those with enhanced needs which included nurse appointments and flu vaccinations."

Neutral

"Carers were offered flu vaccines and health checks in addition to extended appointments and the flexibility of a home visit or telephone consultation if appropriate to meet their needs."

Positive

"• The practice was responsive to the needs of older people and offered home visits and urgent appointments for those with enhanced needs which included nurse appointments and flu vaccinations."

Neutral

"Carers were offered flu vaccines and health checks in addition to extended appointments and the flexibility of a home visit or telephone consultation if appropriate to meet their needs."

Positive

"Lower values were achieved for long term conditions such as chronic obstructive pulmonary disease chronic kidney disease hypertension and depression."

Positive

"For example the practice audited the care patients on methotrexate a medicine which can be used to prevent joint damage in patients with arthritis to ensure they were not automatically prescribed the medicine in the long term without relevant monitoring."

Positive

"This included osteoporosis rheumatoid arthritis and heart failure."

Positive

"Other services offered included: • Chronic disease management use of Florence telehealth service for monitoring blood pressure readings and phlebotomy."

Positive

"• Patients had access to “Florence” a telehealth system which allows for the monitoring of blood pressure readings at home at work or at the practice."

Positive

"This covered areas such as chronic kidney disease register and patients at risk of selfharm."

Positive

"Lower values were achieved for long term conditions such as chronic obstructive pulmonary disease chronic kidney disease hypertension and depression."

Positive

"This included osteoporosis rheumatoid arthritis and heart failure."