Aelfgar Surgery

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

People were involved in decisions about their care. The practice provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The practice was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. The practice worked to reduce health and care inequalities through training and feedback. People were involved in planning their care and understood options around choosing to withdraw or not receive care.

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 practice made sure 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.

The practice had found their continuity of care approach had increased patient satisfaction and their experience of their GP service. They ensured the same group of clinicians reviewed patients who lived in care home settings. Patients were invited to book back appointment/consultation with the same GP for their follow up and the reception team supported patients to book in with a doctor they had previously seen. The practice supported people considering gender transitioning including referrals. Should gender transitioning patients be privately prescribed medicines the practice, to reduce potential gaps in monitoring, supported blood test monitoring and sharing of information as required.

Care plans reflected physical, mental, emotional, and social needs of patients including those related to protected characteristics under the Equality Act. Our review of clinical records showed patients were supported to understand their condition and were involved in planning for their care needs. They were also involved in decisions about their care.

The practice understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

We saw the practice worked in partnership with other services to meet the needs of its patient 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. The practice staff referred patients to the local services such as the ‘Staying well’ service, Everyone health and the weight loss service to further support patient wellbeing.

The practice supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

A digital display screen was in use in the reception waiting area, highlighting useful information for patients. The screen noted the patients name and consulting room to attend both in writing and audibly to assist patients.

Information to promote the take up of screening and immunisation programmes was available in a range of languages. The practice had access to interpreter services, including British Sign Language. Information provided by the service met the Accessible Information Standard (AIS). Patients were informed as to how to access their care records.

The practice made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

We saw complaints were managed in line with the practice’s policy. Learning from complaints was evident and staff were able to identify changes made as a result of patient feedback, including complaints.

The practice made sure that people could access the care, support and treatment they needed when they needed it.

At the time of the inspection the practice did not have a Patient Participation Group (PPG). They had evidenced actively trying to recruit members by advertising on their website, in the waiting room and on the waiting room TV screen but had no success. The practice ensured patients were kept informed of any changes at the practice using their Facebook page, waiting room reception notices and their website, as well as text messaging. The provider obtained patient feedback by conducting an annual survey, encouraging completion of friends and family questionnaires, text messaging and with patient feedback in the forms of compliments and complaints. These were reviewed at staff meetings and resultant actions completed.

In response to the National GP Patient Survey data and from feedback from members of the community the provider identified changes to improve access to the service. The practice had carried out an analysis of appointment and patient access. They adjusted appointments to increase availability and took the opportunity to educate patients on accessing healthcare, to book appointments in advance rather than same day for ongoing chronic conditions. They had analysed telephone figures and NHS App usage on a monthly basis and shared good practice with members of their Primary Care Network (PCN). For example, they had recruited additional salaried GPs and additional roles (ARRs) staff and had increased the number of hours within the reception team. There were extended appointment availability for people with a learning disability and veterans. People could access the service to suit their needs for example online, in person and by telephone. Treatment rooms were on the ground floor and the entrance to the practice was via automatic doors.

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 positive. Staff treated people equally and without discrimination. Leaders proactively sought ways to address any barriers to improving people’s experience and worked with local organisations, including within the voluntary sector, to address any local health inequalities. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers. 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.

Staff we spoke with understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes.

The practice had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People felt supported to raise concerns and felt staff treated them with compassion and understanding. Leaders encouraged staff to raise concerns when things went wrong. During staff meetings, the team discussed and learnt from clinical issues. Staff felt there was an open culture, and that safety was a top priority. The provider had processes for staff to report incidents, near misses and safety events. The documentation reviewed showed a lack of a detailed route cause analysis and risk mitigation, although staff spoken with assured us these were fully discussed in their meetings. There was a system to record and investigate complaints, and when things went wrong, staff apologised and gave people support. Learning from incidents and complaints resulted in changes that improved care for others.