Halcyon 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 7 quality statements under the responsive key question. We looked for evidence that the practice met people’s needs, and that staff treated people equally and without discrimination. This is the first inspection for this practice since its registration with CQC. This key question has been rated as good.

We found that staff treated people equally and without discrimination. The practice complied with legal equality and human rights requirements. People were encouraged to give feedback which leaders used along with other evidence to improve services. The practice prioritised and allocated resources and opportunities as needed to tackle inequalities and achieve equity of access. People and communities were always at the centre of how care was planned and delivered. Care, support and treatment were mostly easily accessible, including physical access. People could access care in ways that met their personal circumstances and protected equality characteristics. People, carers, and staff could easily access information and advice. There was partnership working to make sure that care and treatment met the diverse needs of communities.

This service scored 79 (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. Care plans reflected physical, mental, emotional, and social needs of people including those related to protected characteristics under the Equality Act. Our review of clinical records showed people were supported to understand their condition and were involved in planning for their care needs. They were also involved in decisions about their care. People with caring responsibilities were identified and supported.

Staff listened to people and gave examples of when they had gone the extra mile to support people, for example, working with hotel managers to help asylum seekers living at the hotel manage long-term conditions. All staff who booked appointments could access an updated register of vulnerable people such as those on end-of-life care or with safeguarding concerns which allowed them to offer priority access, extended appointments and continuity of care to those patients who needed it most. People had access to a range of healthcare professionals so they could access the most appropriate care straight away. In the national GP patient survey 2024 96% of people said they were involved in decisions about their care as much as they wanted to be (which was above the national average of 91%).

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 such as the shared care agreements for transgender patients and use of the “Right to Choose” pathway. The practice had tailored its services to meet the diverse needs of its community, for example, building relationships with community groups such as a local community centre catering to the Chinese population and local LGBT+ groups. Staff maintained positive working relationships with 3 local universities to support students who were patients at the practice, particularly international students who may not be familiar with the NHS. The practice also had a stall at university open days to promote access to primary healthcare for new students.

The practice employed some students who were doing healthcare related degrees within its administrative team. This group of staff had personal experience and understanding of issues that other student patients may be experiencing. The practice used this insight not only to support people who were students but also to inform decisions about future services. There were established regular mechanisms for engaging with the community healthcare providers. Feedback from partner organisations received by the CQC was universally positive.

The practice supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Information to promote the uptake of screening and immunisation programmes was available in a range of languages on request. The practice had access to interpreter services, including British Sign Language or use of the BSL app. Information provided by the practice met the Accessible Information Standard.

People were informed as to how to access their care records. Information was provided on the practice’s website about how to register, how to book an appointment, out of hours services, signposting to 111 and other self-care information. There was printed information in the waiting room although this was all in English however, the practice website translated into 33 languages and staff told us they had access to leaflets in a variety of languages and in large print. Television screens in the waiting area displayed health promotion messages. Staff also spoke of using pictures / pictograms to explain information if needed. A hearing loop was available. Longer appointments were available to be booked if staff used a translator, for neurodiverse people or people with a Learning Disability or if they needed to provide education and discuss a procedure like a cervical smear before it was done. Patient participation group (PPG) members we spoke to found the 2 monthly education sessions very informative. People we spoke with reported being given the information they needed.

There was a suitable Information Governance policy and all staff were aware of and took action to maintain confidentiality / data security. All IT systems met national and local data security standards. The practice is registered with the Information Commissioners Office. The practice has a Caldicott Guardian.

The practice was good at enabling people to share feedback, 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 people’s feedback, including complaints. For example, we saw a written complaint outcome letter which involved more than 1 GP in the person’s care. Each GP had contributed a personally written response within the letter, in which they reflected on their behaviour and actions and described to the person what changes they would make to avoid a recurrence.

There was a “you said, we did” display in the waiting room which reflected changes made in response to complaints we had viewed. Both staff and patient surveys had been carried out in the previous 12 months and action plans developed as a result. For example: in response to people reporting it was not easy to contact the practice through their website the practice redesigned it to make it more user friendly. The new website provided more self-help resources, information about how to book an appointment, links to the NHS app and links to complaints forms. It also had accessibility features and was translatable into 33 languages.

We saw an example of a comprehensive response to a Freedom of Information request to a local LGBT+ group. Friends and Family Test (FTT) data for the practice showed out of 224 responses received in 2024, 215 rated their experience as good or very good, whilst only 2 people rated it poor or very poor. All the people we spoke with said they felt listened to during consultations and this was reflected in the national GP patient survey where 87% of people felt their healthcare professional was good at listening to them (the same as the national average).

The practice made sure that people could access the care and treatment they needed when they needed it. Access was not an issue that was raised with CQC prior to our assessment. Some people told us they sometimes had difficulty getting an appointment or waited a long time on the phone. Data from the GP national patient survey showed the practice was performing at or just below the national average for ease of contact through their website or by phone and above the national average for ease of contact through the NHS App. People could book an appointment by phone or access a direct booking link through the website or NHS App.

Since the current provider took over, leaders had increased the number of appointments available by 30% by recruiting extra staff. Leaders used data about appointment usage and allocation to inform decisions about how to improve access, for example data showed that on average 84% of appointments were used, an increase of 7% from 2022. The practice is open from 8am to 8pm weekdays and 9am-1pm on Saturdays. When we visited the practice the next available routine GP appointment was the following day. The longest wait was 4 working days for a child immunisation appointment. The practice had increased the number of administrative staff and they had access to live telephone data. Access by phone had improved as people switched to booking electronically, the practice survey done in January 2024 showed 89% of people found telephone access easy.. The practice had a policy to call back all abandoned calls (those where the caller ends the call before it is answered) to see if the person still needed an appointment. The practice was trialling a triage system one day a week with a view to introducing this imminently.

The practice was on the first floor of the building and was accessed by stairs and one lift. If the lift was not working staff contacted people with mobility issues to cancel and rebook them, provided a telephone appointment or arranged a home visit depending on the person’s needs.

Staff and leaders actively listened to feedback from people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Several people told us they were unhappy at being de-registered from the practice and some people had experienced difficulties registering. The practice was aware of this and the factors affecting it. The challenges were related to people who had moved outside the practice catchment area and did not understand the impact this would have on the service such as a home visit or referral to local healthcare services that the practice would be unable to provide. The practice had undertaken risk assessments and followed their policy for removing these people from the practice list. A dedicated staff member monitored the patient list and de-registered people according to their policy. The transient nature of the practice’s student and international population meant people often moved away or abroad without informing the practice.

The practice acknowledged that because of their high turnover of patients there had been backlogs in processing registrations. This had been outsourced to an external company which had eliminated the delays. The practice had a young, multi-ethnic, international and transient population along with asylum seekers and homeless people. They understood their population well and tailored services to meet their needs. They undertook outreach services to local LGBT+, homelessness and asylum facilities to support people who were likely to have a poorer experience of healthcare or have difficulties accessing it. Leaders and staff were alert to discrimination and inequality, whether from wider society, organisational processes and culture or from individuals that could disadvantage certain people or groups using their services. Staff at the practice complied with Human rights Act and Equality Act by avoiding discrimination and met the needs of those with protected characteristics.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Our observations raised no concerns. 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 when necessary. A Gold Standard Framework (GSF) register of all people receiving end of life care was maintained and all staff booking appointments had access to this information to facilitate priority access to advice and treatment. There were regular meetings to discuss these people within the multidisciplinary community team, including staff from the local hospice. Young people could access services for sexual health and contraception, this service was provided under an ANP lead with a specialism in gynaecology. The practice also supported a fairly large transgender community by entering into shared care agreements with certain providers of transgender care and providing bridging prescriptions.