Hendford Lodge Medical Centre

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 quality statements in the effective key question.

At our last assessment, we rated this key question as requires improvement. At this assessment, the rating has changed to good. 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 meet their needs.

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.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs.

People felt involved in the assessment of their needs and felt confident staff understood their individual needs. Staff demonstrated an understanding of the additional support some patients may need when attending their appointment such as requiring a translator or a longer appointment. The health coach team provided individual support to patients with a learning disability, mental health conditions, long-term conditions and carers. They referred patients and carers externally to local community groups in Somerset for further support when appropriate.

Patients presenting with symptoms which could indicate serious illness were followed up in a timely way. We reviewed the appointment diary and saw appointments were available to book the same day for urgent appointments and in the following few days for non-urgent appointments.

Patients with long-term conditions were offered an annual review to check their health and medicines needs were being met. Our clinical searches identified 147 patients with diabetes who had a HbA1c at 75mmol/mol or above (a high average blood sugar level indicating increased risk of complications). We reviewed 5 of these patient records and found all the patients received appropriate reviews and monitoring. We also identified 782 patients on the practice’s asthma register and 34 of them had been prescribed 2 or more rescue steroids (treatment for severe asthma episodes) in the last 12 months. We reviewed 5 of these patient records and all had been assessed and reviewed appropriately.

We looked at the potential missed diagnosis of diabetes as part of our clinical searches and 43 patients were identified to be at risk from this. We sampled 5 patient records and found that 3 of them showed missed coding for diabetes and 1 patient required a repeat blood test to fully assess their risk. Following the assessment, the practice reviewed all 43 patients and took action to reduce this risk within a reasonable time frame. The practice implemented a new process to monitor this specific patient group.

Systems and processes ensured staff were up-to-date with evidence-based guidance and legislation.

Evidence-based guidelines were discussed in governance and clinical meetings with minutes shared for all staff. Staff told us they had protected time to complete continuous professional development. The practice supported and encouraged staff to pursue further training in their specific areas of interest.

Our clinical searches showed the practice managed and monitored patients with long-term medical conditions including advanced stages of chronic kidney disease, poorly controlled asthma and hypothyroidism in line with evidence-based national guidance.

The service worked well across teams and services to support people.

Staff appreciated their colleagues and enjoyed the team working environment.Staff were able to request support from GPs and the leadership team who were visible and approachable. Leaders and staff told us they worked closely with colleagues in the locality to meet the needs of the patient population.

Feedback from partners indicated good working relationships with staff from the practice. Representatives from care homes that the service worked with provided positive feedback about the practice and said the service was good and met the needs of their residents. However, one care home expressed a desire for improved communication, mentioning that on occasions, the practice’s responses to their requests were slow. The practice worked collaboratively with their PPG to improve patient’s experience. A representative of PPG commented that the level of medical care provided by the practice was exemplary.

The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff had a holistic, joined-up approach to supporting people and discussed patient care in clinical and complex care meetings.

The practice identified people who may need extra support and directed them to relevant services. This included patients in the last 12 months of their lives and patients at risk of developing a long-term condition and carers.

Staff encouraged and supported patients to be involved in monitoring and managing their own health. The practice had a dedicated health coach team which offered one-to-one sessions to support patients to live heathier lives by promoting lifestyle changes and empowering them to self-manage long-term conditions. The practice organised regular health walks which were open to all patients to promote physical activity. The practice website contained information and links to other sources of information to support patients in making healthier choices.

The service monitored people's care and treatment to ensure continuous improvement.

National data showed that all 5 indicators for childhood immunisations had achieved the 90% minimum uptake rate.Children who were not brought to appointments were followed up with contact made with their parent or carer. Latest national data (dated 30 June 2023) showed that only 63.2% of eligible people had received cervical screening within a set timeframe which was below the national target of 80%. Following the assessment, the practice showed us unverified data showing the number of patients attending for cervical screening had increased. The data evidenced that 68% of patients aged 25-49 years and 70% of patients aged 50-64 years had attended cervical screening as of 1 February 2025. The practice had also increased the number of appointments for cervical screening and would continue to monitor the uptake.

The practice took part in quality improvement work to improve outcomes for patients. The practice carried out regular clinical audits for their leg ulcer service across south Somerset. The wound healing rate was initially low at 42%. The service adopted a holistic approach to managing these patients and being flexible in the time and locations of leg ulcer clinics to cater for the individual needs of patients. As a result, the wound healing rate was improved to 82% and above their target of 72%.

The practice also carried out another quality improvement project on vitamin B12 deficiency management with the aim of switching all suitable patients from vitamin B12 injections to B12 supplements taken by mouth. This resulted in benefits for both the patients and the practice as patients no longer had to attend a clinic for regular injections, freeing up appointments for other patients.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff explained to us how they spoke to people and gained consent. Clinical staff understood the requirements of legislation and guidance when considering consent and decision making. All staff had completed Mental Capacity Act training.

Policies, protocols, and guidance were followed to support people to consent to care and treatment. Clinicians supported people to make decisions. For patients with a lasting power of attorney (a legal document that allow a person to appoint someone, known as ‘attorney’, to make decisions on their behalf), an alert and notes were added to patient’s record so that staff were aware of the status.