Dartmouth Health & Wellbeing 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 looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination.

At our last assessment in April 2016, we rated this key question as Good. At this assessment, the rating remains unchanged.

People were involved in decisions about their care. The service worked to reduce health and care inequalities through training and feedback. People received fair and equal care and treatment. Requests for appointments were allocated based on clinical needs. The service understood their patient population. Changes were identified to improve the service where required.

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 service 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.

People were supported to understand their conditions and were actively involved in planning and decision-making regarding their care. Regular multi-disciplinary meetings were held with relevant professionals and services to discuss and plan person centred care and treatment so that people’s needs could be met holistically. People were able to see the same staff at their appointments, which provided continuity of care. Adjustments were made to support those with additional needs, including offering longer appointments for people with a learning disability or other protected characteristics under the Equality Act 2010.

The service liaised with and involved mental health teams, learning disability nurses and external agencies to co-produce care plans (where relevant).

The service had access to social prescribing services, who provided people with a non-medical approach to improve health and wellbeing by connecting them to local community groups and activities.

The practice worked in partnership with other services to meet the needs of its patient population.

The service 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 service worked in partnership with other services to meet the needs of people.

The service had tailored its services to meet the diverse needs of its community. For example, building relationships with community groups to help facilitating of screening programmes.

The appointment system enabled people to request and see the same healthcare professional to provide continuity of care. Staff worked collaboratively to meet the needs of patients across all areas of the service.

The service was an accredited Armed Forces veteran friendly practice which meant they had staff who understood military-related health conditions and who could provide appropriate healthcare information and could refer to specialist services

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

Information to promote the take up of screening and immunisation programmes was available in a range of languages.

The practice made reasonable adjustments to meet individual needs in line with the Accessible Information Standard.

Adjustments included: easy-read materials, interpreter services including Language Line and British Sign Language, Interpreter services, longer appointments if needed, carer involvement and translated materials.

The practice website contained health promotion information, including details on NHS Health Checks, screening programmes, maternity care, and contraception. This supported people in understanding their health needs and accessing preventative services.

People were informed as to how to access their care records.

The service 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.

Learning from complaints was evident and staff were able to identify changes made because of feedback from people who use the service. The practice monitored complaints and identified themes and trends.

Information on how to provide feedback or make a complaint was clearly displayed on the service website. People could raise concerns in person, in writing, or by email, and those who did were listened to and received a timely response. We reviewed a sample of complaints received by the service and found they were handled in line with the provider’s policy and responded to appropriately. Records also showed there were clear records maintained of all complaints received, the actions taken, outcomes, learning and duty of candour in responses to complaints.

The Patient Participation Group (PPG) had undertaken a survey following the move of the service to new premises. Feedback was reviewed and analysed with reports developed outlining feedback and considerations for changes. For example, disabled car parking spaces allocated to the service, and accessing minor injury treatment.

Changes were made in response to patient feedback. For example, supporting people with the online consultation system.

Patient feedback mechanisms included forms available in the service and surveys sent via text links following appointments.

Feedback from the PPG was mixed but constructive. The service was responsive to requests for data and communication, often replying promptly to messages. However, the PPG expressed a desire for more structured communication.

The service made sure that people could access the care, support and treatment they needed when they needed it. The service had systems to monitor access. Including audit, patient feedback and identifying trends in complaints relating to access and patient outcomes.

Feedback provided to CQC, in relation to access, was positive. People told us they had a good experience accessing appointments. One person stated “I have just had a series of appointments recently at my GP practice. My appointments are timely, appropriately responsive and very helpful in addressing my needs.”

The National GP patient survey 2024, identified that 82.7% of patients responded positively to the overall experience of contacting the GP practice, and the percentage of people who responded positively to the overall experience of contacting their GP practice by telephone was 73.4%. This data was above the national averages of 69% and 52% respectively.

Feedback from members of the community about the provider were positive. People could access the service to suit their needs. For example, online, in person and by telephone.

To ensure people with learning disabilities had regular annual health checks and reviews, the practice team made personal phone calls to book appointments. This promoted maximum flexibility when planning their appointment, as well as the practice team being able to follow up those who did not attend. Appointments for these people were longer, adjusted, and people could be supported by carers where appropriate.

The service anticipated that some people would find difficulties accessing the on-line booking system. Evidence collected from people’s feedback, demographic data and telephony data, indicated that a system where appointments were made in person or over the phone ensured that people were not digitally excluded.

The service provided extended access on Tuesdays between 6.30pm - 8pm. pre-bookable appointments were available with a range of clinicians, including GPs, nurses, and healthcare assistants, depending on service demand and were either face to face or telephone appointments.

As part of the local Primary Care Network arrangements, people also had access to extended hours appointments provided at nearby sites. The service appointment types included face-to-face, telephone, and online consultations to support people’s choice and convenience. Information regarding extended and enhanced access was publicised via the service’s website. People were informed that they may be offered an appointment at an alternative site if this provided earlier or more suitable availability to them. All appointment/clinical records were fully integrated with the person’s usual GP record, ensuring continuity and safe, effective care.

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 and practice staff proactively sought ways to address any barriers to improving people’s experience and worked with local organisations 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, refugees 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 assisted people in registering for online access, including offering digital inclusion support and tailored guidance for those less confident with technology.

The service could accommodate people with sensory needs to wait in quieter areas rather than the waiting room (if appropriate and safe). The service considered and always tried to accommodate requests for preferred times of the day for appointments to assist people who preferred to attend when the practice was quieter.

We saw that digital flags were added to people’s records to ensure consistent care for people with specific needs, and who may need reasonable adjustments. For example, people with, learning disabilities, autism, mental health conditions, deafness and visual impairment.

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.

Staff attended multi-disciplinary meetings to discuss patients receiving end-of-life or complex care. Clinical records were updated to reflect any actions or changes made to their care plans. Clinical records contained information to show people were supported to consider their wishes for their end-of-life care. Care plans documented a do not attempt cardiopulmonary resuscitation (DNACPR) decision when it had been made. Families and/or carers had been involved in these decisions when the person lacked the capacity to make them independently. This information was shared with other services, such as the out-of-hours services, when necessary.