Camrose, Gillies and Hackwood Partnership

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination. At our last assessment, we rated this key question as Good. At this assessment, the rating has changed to Requires Improvement. The practice recognised that the recent upgrade for people online access had not been smooth, and the benefits of the new system were yet to be felt by the patients. Some people raised concerns with lack of access to care, support and treatment whilst the online triage system was not accessible. There were long waiting times for routine appointments. Since the inspection the provider has told us that the system issues are now functioning effectively, however we have been unable to assess the impact of this or whether it is embedded into practice.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

As part of the assessment, we asked the practice to invite people to share their experience of the service. From the feedback we received we saw indicators of concern that some people did not always experience being at the centre of their care and treatment choices and they did not always feel the practice worked in partnership with people, to decide how to respond to any relevant changes in people’s needs. Feedback from the Patient Participation Group (PPG) highlighted difficulties accessing services and they had observed staff not always being as responsive as required to people’s needs. The patient record system alerted staff to any access requirements people might have to aid effective communication. Staff told us people who did not have English as a first language and those who used British Sign language benefited from translation and interpretation services.

The service understood the diverse health and care needs of people and their local communities. The practice worked in partnership with other services to meet the needs of its people population. The practice had tailored its services to meet the diverse needs of its community, for example, building relationships with community groups to promote the take up of screening programmes. There were established mechanisms for engaging with the community healthcare provider. We saw the practice enable people to see their own GP or GP of their choice and endeavoured to meet the needs of people’s requests. This was achieved by grouping patients into clinically coded teams with names clinicians to aid continuity of care. The practice’s Frailty team identified and supported people who were cared for at home and who resided in care homes. This team was developed in response to care home feedback noting a lack of urgent and acute care provided in addition to routine weekly ward rounds. The practice provided community health events to support people for example Menopause Evenings; Carers Drop-In Sessions; Veterans Afternoon; Nepalese Community Screening Event.

Some people contacted the Care quality Commission and informed us that access to their GP was challenging when the online triage system was closed without prior warning from 30 September 2024 to the 19 November 2024. During this time some people did not always have access to information to support them to understand how to see their GP in a timely manner and this could have put people at risk. Some people also expressed concern that the online triage system was sometimes closing earlier than stated on the triage system. The practice website contained accessible information, for example opening times, registration, clinics and services, complaints and prescription ordering in the form of posters, large print, braille and easy read. However, during the 2-week website shut down some people who relied on the accessible information on the practice’s website; would have not been able to access the information they required. Reasonable adjustments were made at the practice to support communication, including the use of interpreters. People were also provided with information on how to access their medical records.

Some people told us they knew how to give feedback about their experiences of care and support including how to raise any concerns or issues and can do so in a range of accessible ways. However, during this shut down period the practice did not actively keep people’s experience under review to ensure the remedial arrangements put in place were effective and resulted in an improved patient experience. This was a missed opportunity to learn from people when needing to make improvements. The Patient Participation group told us they did not always feel their input on how improvements could be made was always valued and considered. We identified there were recurring feedback themes such as long routine appointment waiting times and call waiting times required improvement. The practice was taking action to address these concerns such as recruiting additional GP’s, paramedics and pharmacists to assist with service provision however these remain in progress. Complaints were reviewed a timely action was taken in response to complaints in line with practice policy. Management meetings included protected time to reflect on learning from complaints, concerns and general feedback and develop ways to improve the service. Staff demonstrated awareness to learning from incidents and complaints. We saw evidence of actions taken to mitigate re occurrence through team meetings we reviewed.

The service did not always ensure people could always access care and treatment in a timely manner when the online system was switched off. Some patients expressed significant frustration during this time and were not able to have access to their GP when needed. Since the shutdown of the previous online triage system the practice had implemented a new online triage system. However, some patients continued to express their frustration in availability of routine appointments. The National GP patient survey data in relation to access to services was below the local and national England average. The practice had started to address these findings for example a reception team leader had been recruited for better oversight of telephone and appointment accessibility. Rotas were planned with oversight of cover where required, so that should a clinician be absent at short notice, their pre-booked appointments could be put into protected available same day slots with another clinician. However, improvements remain in progress and the online triage system was not always accessible during stated opening times.

Feedback provided by some of the people using the service didn’t work effectively and some patients reported disruption to their service. Some people told us that they experienced continued frustration in routine appointment availability. The practice was in the process of seeking ways to address any barriers to improving people’s experience and were working with local organisations. For example, the practice had implemented a system to ensure people were booked in with their named GP’s or clinical staff associated within respective teams. There were alternative arrangements for people who were unable to access services through the online triage system, this included pre- consultation forms completed with the support of practice staff. However, some people told us that when the online appointment system was switched off due to internal investigations, this impacted service accessibility for people, including, awareness of alternative accessibility arrangements and delays in telephone waiting times to access this support. Some people also informed us that the communication of the system issue was managed ineffectively and not kept under review to ensure all people received ongoing information that met their communication needs. There was a risk during this time that some people requiring additional support to receive the care and treatment required experienced delays.

People were supported to make informed choices about their end of life care and plan their future care while they had the capacity to do so. People who may be approaching the end of their life were identified (including those with protected characteristics under the Equality Act and people whose circumstances may make them vulnerable). This information was shared with other services and staff. People’s decisions and what matters to them at the end of their lives were delivered through personalised care plans that were shared with others who may need to be informed. Reviews of people’s end of life plans were completed on the person’s birth date and people were aware of this and therefore knew when this was going to happen. When people wanted to express their wishes about cardiopulmonary resuscitation, they were supported to do so and were able to change their mind if they wished. People with a learning disability were supported by Social prescriber's through regular health reviews.