Scott Arms 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

At the last inspection we rated the practice as requires improvement for providing responsive services as patient feedback was negative on accessing care. At this assessment we have continued to rate the practice as requires improvement as patient feedback was negative on appointment availability and accessing services. We found there had been improvements in patient feedback through the national patient survey, however the results continued to be below local and national averages.

Improvements had been made so people could access services when they needed to, without physical or digital barriers, including out of normal hours and in an emergency. The practice website had online access to appointments. Leaders understood the challenges to patient access and services were being designed to make them accessible and timely for people who were most likely to have difficulty accessing care. The provider was currently taking part in an access project with the primary care network to prioritise opportunities as needed to tackle inequalities and achieve equity of access.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The practice told us that they regularly involved patients in planning and making shared decisions about their care and treatment that meets their needs. However, we found no evidence to demonstrate that staff had been trained in equality and diversity, consent, deprivation of liberty safeguards and mental capacity. We received mixed reviews about the overall experience of using the service. Comments on NHS UK, information received by the CQC, patient feedback during the onsite assessment. The results of the GP national patient survey demonstrated a significant negative variation in comparison to local and national averages in people's overall experience of contacting their GP practice.

The practice understood the needs of its local population and were taking action to develop services in response to those needs. There were regular meetings held with community services for continuity of care, support and treatment. Through the Primary Care Network (PCN), the practice staff were able to offer people access to other services such as social prescribing, physio and mental health to support their overall health and wellbeing.

The practice website provided useful information on health awareness and promotion. Information and resources were available for people to support them to understand how to access services. For example, there were arrangements in place for people who need translation services or who may be digitally excluded. There were systems in place to support people who face communication barriers to access treatment and clinical records were held in line with guidance and requirements. We found the practice complied with the Accessible Information Standard (AIS) and that information about people that collected and shared was in line with data protection legislation requirements.

Feedback from the GP patient survey results demonstrated that 69% of people said the healthcare professional they saw or spoke to was good at listening to them during their last general practice appointment and 69% stated that during their last appointment, the healthcare professional was very good or fairly good at treating them with care and concern. The survey results were lower than the local and national averages. The practice told us they collated feedback via the Friends and Family test to make improvements to the service. However, the evidence provided showed that no data had been reviewed since October 2024 from people who responded to the Friends and Family test.

Leaders told us that complaints were regularly reviewed and discussed in practice meetings to share learning. The practice had received 17 complaints between January 2024 and December 2024 and there was evidence that appropriate action was taken. We reviewed a random sample of complaints and found they had been handled appropriately. The practice had a complaints policy in place and complaints were reviewed further and were responded to improve the quality of care. There were regular practice meetings where complaints and significant events were discussed to share learning to make improvements. Information about how to complain was readily available and patients could make a complaint in person, or via the practice website.

Patients could book appointments by telephone, online, and in person by visiting the practice. Appointments were available face to face, by telephone, or as a home visit. A duty doctor was available each day to support the clinical team and review urgent requests. Appointments with a GP were available throughout the week. Extended access was available every Wednesday and Friday from 6.30pm and 8.30pm. When the practice was closed patients were able to contact 111. The practice offered appointments from a variety of additional clinical staff for example specialist practitioner, nurse, health care assistant and pharmacist. The 2024 National GP Patient Survey data demonstrated a significant negative variation in results relating to access in comparison with local and national averages. This also aligned with the feedback we received on the day of the onsite assessment from people we spoke with. We reviewed the statistics of the call centre whilst onsite at the practice and found that in the morning from 8am to 9.20am 92% of calls had been answered with a maximum wait time of 12 minutes. We spoke with members of staff in leadership and management roles. It was clear that improving access and patient experience was a priority for the practice. The practice implemented an action plan in response to the annual National GP Patient Survey results. One of the actions was a power hour between 8am and 9am when as many staff as possible answered the phones to cut down on waiting times. The practice was also working with the primary care network on a modern general access project to review current access systems and implement improved ways of working.

The provider complied with legal equality and human rights requirements, including avoiding discrimination, having regard to the needs of people with different protected characteristics and making reasonable adjustments to support equity in experience and outcomes, including meeting the Accessible Information Standard. We saw examples where the practice had met the needs of vulnerable patient groups and removed barriers for improved patient experience. For example, the practice premises had a hearing loop in place and access to interpreters was available. People with learning disabilities and poor mental health experienced additional care through annual reviews and people with dementia were referred to appropriate services where required.

Further evidence provided showed same day urgent appointments were available for people with an exacerbation of asthma, with 98% of patients being seen within 4 hours. The practice had achieved 18% below the local area indicator for AE attendances and also evidence from the Integrated Care Board (ICB) showed the practice as 12% lower than the local average for emergency admissions.

Leaders understood the requirements of legislation when considering consent and decision making and had access to policies to support them. We were told that the practice held multidisciplinary meetings with other agencies to share and discuss information relating to patient care and treatment, for example, those on the practice palliative care register. Systems to ensure staff kept up to date in training relating to the Mental Capacity Act and Deprivation of Liberty Safeguards was ineffective and we were unable to gain assurances that staff had completed this training. We identified gaps in training for both clinical and non-clinical staff, however we received assurances that staff training would be reviewed and updated.

The practice had a higher than average population of people aged 65 years and over, including 12% of their practice list aged 75 years and over. The practice monitored these age groups to ensure the received the appropriate monitoring and care.

Evidence provided showed the practice was below local averages for cancer diagnosis through emergency services with the practice having achieved 3% in comparison to the local average of 8%. The practice attributed this success to their programme of early detection. There were registers held for those patients who were vulnerable who were on the palliative care register or at the end of their life. We found that clinicians understood the requirements of legislation and guidance when considering consent and decision making and saw that consent was documented. Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions were made in line with relevant legislation and were appropriate.