Yew Tree Medical Centre

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 assessed all quality statements from this key question. The rating given is Good.The service provided person centred care and treatment whereby people’s individual needs and wishes were respected and acted upon. Information was offered in a way that could be understood and people were able to discuss things in their preferred language. 95% of patients who responded to the GP patient survey stated that were involved as much as they wanted to be in decisions about their care and treatment. Staff were trained to direct people to the most appropriate clinician or service to meet their needs and clinicians were available to see people on-the-day for all types of appointment requests. There was a GP on call each day to deal with urgent requests and provide support to care navigation staff. According to results from the GP patient survey, the service was not always easy to access. Of those patients who responded only 20% found it easy to get through to the practice by phone, 22% found it easy to contact using their website and 23% found it easy to contact using the NHS app. The practice made changes to the telephone and appointment system because of this feedback. Staff worked to reduce health and care inequalities and people were offered options around choosing to withdraw or not receive care. Information about how to raise a complaint was provided and the sample of complaints we looked at had been investigated, although not always thoroughly documented. Learning from complaints was shared effectively across the staff team. The practice worked within the primary care network (PCN) and supported local service developments as part of this. Continuity of care was offered to patients where required or when requested and longer appointments were available if necessary. The premises were purpose built and reasonable adjustments had been made to ensure the premises were accessible to patients who required disabled access.

This service scored 71 (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 was good at ensuring people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs. Feedback from people we spoke to who used the service was that they were well supported to understand their condition and felt involved in decisions about their care and treatment and in planning for their future needs. Feedback from the Friends and Family Test was positive. The response rate to the GP patient survey was 23%. However, of those who did respond, only 58% felt they had enough support from local services or organisations in the last 12 months to help them manage their long term conditions against the local and national averages of 69% and 68% respectively.Regular multi-disciplinary meetings were held with relevant professionals and services to discuss and plan patient care and treatment so that people’s needs could be met holistically. Staff demonstrated a person centred approach to their work and we observed staff who were supportive of patients during our assessment. 63% of people who responded to the GP patient survey said they found the reception and administration team helpful, which was below local and national averages of 84% and national average of 83%. We spoke to 4 people who used the service and they were complementary about the way staff had taken the time to make sure their needs were met holistically.

The practice worked in partnership with other services to meet the needs of its patient population. The clinical staff team was constant following a period of instability and were able to provide continuity of care. Staff told us where necessary, people were able to request and see the same healthcare professional. Staff worked with multi-disciplinary professionals to meet the needs of patients. All staff we spoke with were familiar with the patients who attended the practice. Referrals to other services were made promptly and information shared by other services was managed effectively and timely to support good outcomes for people. The practice had tailored its services to meet the needs of its community, and were able to demonstrate how they encouraged patients to attend for follow up appointments, screening programmes and child immunisation uptake. The provider worked closely with the Primary Care Network (PCN) to plan, develop and deliver services across the locality.

Staff communicated and provided information in a way that helped people to understand their care. People were provided with information about their health and treatment options to enable them to make an informed decision. The provider used systems to share information about patients effectively across services. Safety netting advice was provided when patients were at risk of deteriorating. Feedback from people who responded to the National GP Patient survey showed that 94% knew what the next step would be within two days of contacting their GP practice, which was in line with National average. The practice had access to interpreter services to support people who did not use English as their first language and staff who could speak the language of many of their patients. The practice website contained NHS information about health conditions and support services that people could use.

Information was available at the service and online so that people knew how to give feedback about their experiences of care and support, including how to raise any concerns, complaints or issues. We saw feedback from the Friends and Family Test and via complaints. People were encouraged to write in to the practice if they wished to complain about their care, treatment and support, and complaints were responded to appropriately with a full response and an apology. Reception staff told us how they dealt with people’s concerns on a daily basis and reacted to concerns before they escalated. However, this verbal feedback was not documented to enable the practice to manage trends. We discussed these missed opportunities during the assessment with staff and leaders who were receptive to our feedback. People responded positively in person and by responding to the GP patient survey that the healthcare professionals who saw them were good at listening to them and involving them in decisions about their care and treatment. However, their responses were still below local and national averages.

People we spoke to who used the service did not have any concerns about access. The practice made sure all information including accessing appointments was easily accessible and in several languages. Staff said that most patients who requested it could see a GP on the day of request or were signposted to a more appropriate person or service to meet their needs that day. An on-call GP was available to see people for urgent appointment requests. Staff were trained to direct people to the most appropriate clinician or service to meet their needs. The provider monitored patient access effectively and made changes in response so as to ensure patient satisfaction. The percentage of respondents in the National GP Patient Survey who responded positively to their overall experience of contacting the practice was low at 46% and only 32% said they were offered a choice of time or day when they last tried to make an appointment. Only 20% said they found it easy to get through to the practice by phone and 22% found it easy to contact the practice using the website or the NHS App. The local and national averages for these were between 45% and 50% for all. However, Primary Care Network (PCN) and Integrated Care Board (ICB) data supplied by the practice showed that 98% of patients were being seen within 2 weeks of request.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Feedback provided by people using the service, both to the provider as well as to CQC, was mostly positive. Staff treated people equally and without discrimination and understood the importance of providing an inclusive approach to care which was adjusted to support people’s individualities. There were processes to ensure people could register at the practice, and people in vulnerable circumstances such as homeless people and Travellers were treated equally. Staff used appropriate systems to capture and review feedback from people using the service, including those who did not speak English or have access to the internet. The provider monitored data about the care and treatment provided to patients. Available data showed that people experienced similar to or better outcomes for care and treatment when compared to services locally and nationally. The results of the National GP patient survey showed that 86% of respondents felt their needs were met during their last general practice appointment. 61% described their overall experience of the practice as good, which was lower than the local and national averages of 76% and 74% respectively.

People who used the service were provided with information to make informed decisions about their current and future care and treatment and supported to plan for these. Our records review showed people were supported to consider their wishes for their end-of-life care, including cardiopulmonary resuscitation. This information was shared with other services as necessary. Multi-disciplinary meetings were held on a regular basis to discuss the needs of people receiving end of life care.