Church Street 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

We looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination.

We rated this key question as Good.

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. Patients had access to appointments provided by a range of clinicians. The practice used patient feedback to identify areas for improvement and made necessary adjustments to ensure patient care was optimum.

Data from the National GP Patient Survey showed that 95% of respondents felt theywere involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment, which was in line with the national average of 91%.

67% of respondents said the healthcare professional they saw or spoke to was good at considering their mental wellbeing during their last appointment which was below the national average of 74%. Clinicians held regular mental health MDT meetings to discuss patients’ care.

Friends and Family Test data was reviewed monthly and the latest Friends and Family Test data found 95% of patients surveyed found their care at the practice to be either ‘Very Good’ or ‘Good.’

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

For example, the practice held regular multi-disciplinary team meetings with other healthcare professionals; and information about patients care and treatment needs was available to share between services as required.

National GP Patient Survey results highlighted 61% of patients felt they have had enough support from local services or organisations in the last 12 months to help manage their long-term conditions or illnesses which was below the national average of 69%.

The practice supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Information provided by the service met the Accessible Information Standard. The practice had access to interpreter services, including British Sign Language and the practice website was available in 10 different languages. Patients were informed about how to access their care records.

93% of respondents from the National GP Patient Survey felt the healthcare professional they saw had all the information they needed about them during their last general practice appointment. In addition, 90% of patients reported they knew what the next step would be after contacting the practice.

A range of health and wellbeing leaflets and posters were on display in the waiting area for patient information. In addition, the practice provided information for patients on social media, the practice website, and on the screens within the patient waiting area.

The practice made it easy for people to share feedback and ideas about their care and treatment. Feedback could be given verbally or in writing.

We discussed with leaders, changes that had been made as a result of feedback from patients. For example, the PPG had fed back to staff regarding Accurx text messages with links to letters that they found these were not user-friendly. In response the practice had escalated this to the Wyre Forest Health Partnership central team for review and change.

The practice listened to patient preferences when making decisions about their care. The National GP Patient Survey data reported 83%of respondents said the healthcare professional they saw or spoke to was good at listening to them during their last general practice appointment, which was below the national average of 87%.

The practice had a complaints policy, and the Site Manager was the lead for handling complaints. Leaders told us complaints were “Feedback and an opportunity to improve.” Patients could make a complaint verbally, via the practice website, or by writing to the practice. The complaints process was advertised by leaflets and posters within the practice, and on the practice website. Patients were signposted to the Parliamentary and Health Service Ombudsman (PHSO) if they were not satisfied with the outcome of the complaint.

We saw evidence that complaints were audited annually across the Wyre Forest Health Partnership. The numbers of complaints per practice were analysed and trends and themes were identified. The practice had received 32 complaints in the last 12 months of which 12 were upheld.

Complaints were discussed during practice meetings and the lessons learnt were shared with staff. Clinicians shared an example of learning from a complaint relating to a delay in the processing of information following the death of a patient which resulted in distress for a family member. Learning from this complaint included the development of a new death notification process for the reception team to follow to ensure all tasked are completed effectively.

The practice was open from 8.00am to 18:30pm Monday to Friday. Patients could receive extended access appointments from18:30pm to 20:00pm on Tuesday and Thursday; and 9:00am to 15:00pm on Saturday.

Various appointment types were available such as in person, online or telephone consultations. There was a designated GP each day to undertake the patient triage process. The triaging GP was based in the reception call centre to support the reception team with patient enquiries. The triaging GP used a traffic light system to prioritise patient appointments based on urgency. Staff described to us the benefits of their total triage appointment system which included directing patients to the right service such as GPs, the nursing team, or pharmacists; urgent patient medical needs being seen faster; and the triage form allows patients to provide more information on how the practice can support them.

The practice monitored the medical triage requests per month to ensure the triage process was working effectively and patient demand was being met. Leaders explained whilst the practice operated an online triage process, they did not digitally exclude any patients. Patients were able to telephone the reception team if they were unable to complete the online triage form and the Care Navigators could complete this on their behalf.

The practice provided us with telephone statistics to demonstrate performance with access for patients such as the percentage of telephone calls answered from the telephone queue which was 95%. Latest data showed 92% of telephone calls were answered in 5 minutes or less; and 99% were answered within 10 minutes. The Wyre Forest Health Partnership set telephone targets for all of their practices to achieve and performance against these targets was monitored on a monthly basis.

We also reviewed data from the National GP Patient Survey relating to patient access to the service. Practice data was mostly above the national averages. For example:

75% of respondents described their experience of contacting the practice as good, which was above the national average of 70%.

62% of respondents found it easy to contact the practice by telephone which was above the national average of 53%.

64% of respondents found it easy to contact the practice by their website, which was above the national average of 51%.

57% of respondents found it easy to contact the practice by the NHS app, which was above the national average of 49%.

76%of respondents felt they waited about the right amount of time for their last general practice appointment, which was above the national average of 67%.

24%of respondents said they usually got to see or speak to their preferred healthcare professional when they would like to, which was significantly below the national average of 40%.

To hear from patients about their experiences we asked the service to share details of CQCs ‘Give Feedback on Care’ process. CQC received feedback from 9 patients of which 7 were positive about their experience of the service; and 2 were negative. Positive patient feedback included satisfaction with access to the service and the appointment triage process.

Staff gave us examples of how they had worked to improve access for patients. This included the recruitment of 3 new receptionists to meet patient demand; and a patient drop-in session which had been arranged to help patients use the NHS app. In addition, the Wyre Forest Health Partnership had commissioned a voluntary organisation to provide low level mental health support to patients to help to reduce waiting times and improve patient access to care.

As part of our assessment, we assessed access to the practice premises. We found the practice was accessible for wheelchair users, and all consultation rooms were accessible with lifts providing access to the upper floor. Disabled toilets were available as well as baby feeding and changing facilities. There was a car park with designated disabled parking spaces.

We found staff treated people equally, without discrimination. Staff understood the importance of providing an inclusive approach to care. Leaders proactively sought ways to address any barriers to improve people’s experiences.

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes and provided exceptionally tailored care, support and treatment in response to this.

Leaders told us there was a focus on the ‘Core20PLUS5’ across the. Wyre Forest Health Partnership. Core20PLUS5 is a national NHS England approach to inform action to reduce healthcare inequalities.

Leaders had undertaken an extensive analysis of the patient population assessing health needs and deprivation. Staff told us there was a high rate of drug users amongst the patient population. For example, the patient population was located in an area with the highest heroin use in the county. Staff provided us with statistics for drug-related crime which showed that drug-related crime figures for the practice population area were almost three times higher than the national rate.

Leaders told us Church Street Surgery employed a comprehensive, integrated approach to managing substance misuse, aligning with national best practices. The practice demonstrated a longstanding commitment to opioid substitution therapy (OST) and had developed good relationships with local drug team workers. We saw evidence of positive engagement with these stakeholders.

Church Street Surgery was the first practice in the North of the county to deliver Buvidal medicine. Buvidal is a long-acting injectable medicine used to treat opioid dependence such as heroin or morphine addiction. It treats addiction by reducing cravings and withdrawal symptoms and is administered weekly or monthly by a healthcare professional, providing an alternative to daily medication.

Four GPs at Church Street Surgery were OST prescribers. Wyre Forest Health Partnership has a total of 6 OST prescribers. Leaders explained the positive outcomes of OST which included a 30% reduction in drug-related hospital admissions and a 40% reduction in needle-sharing. A recent audit by the practice had demonstrated a 16% reduction of Out of Hours, AE, and NHS 111 contacts by patients receiving OST.

In addition, among the local population, OST contributed to a marked decrease in Hepatitis C transmission. Clinicians told us the practice had a good uptake of Hepatitis C and HIV screening among patients with a history of intravenous drug use.

Clinicians informed us that through the close working with local drug treatment services and mental health teams, the practice has improved patient engagement. The practice was working with Cranstoun Worcestershire, which is a social justice and harm reduction charity which inspires people to achieve positive changes and live healthier and safer lives.

The practice was in the process of trialling self-booking links for patients who enquire about Cranstoun referrals and staff reported this had been working well. Staff explained this new process being online and discrete helps to break down barriers and enable patients to take that first step to engage with services which can help them.

In addition to the Cranstoun Worcestershire, staff had worked with and developed good relationships with, a local women’s refuge where they arranged temporary patient registrations for women.

As an accredited Veteran Friendly Practice, the practice demonstrated a proactive approach to supporting former members of the armed forces. The practice was also a Gypsy, Roma, and Traveller (GRT) Friendly practice. These communities face inequalities in access to healthcare and can experience serious mental health outcomes. Being a GRT friendly practice, people from this community were supported to register with the practice and access care and treatment to meet their needs. Clinicians told us they were working to engage more with this community and had put up a plaque at reception to advertise Church Street Surgery was a GRT friendly practice as a visible symbol to welcome patients.

For patients with learning disabilities, the practice had a GP Learning Disability lead. Extended appointments were available for patients with learning disabilities and staff endeavoured to try to meet as many needs of these patients in one appointment. Staff told us one GP comes in early to the practice when it is quieter for appointments with a patient with learning disabilities. The practice also provided home visits for housebound patients with learning disabilities with a designated Advanced Nurse Practitioner. To ensure patients with learning disabilities understood their care and treatment, staff explained they regularly utilised picture care plans.

The practice had undertaken a sensory friendly assessment to identify any potential triggers for neurodivergent people and also environmental adaptations which could be made. For example, staff told us they had changed their weekly fire alarm from 11am to 8am before the practice opens to prevent sensory overload with loud noises for patients; photographs of staff were posted on a noticeboard in reception and on the practice website to aid patients with staff recognition; and the practice premises were decorated throughout with neutral colours. In addition, sensory packs were available for patients who needed them and patients could access quieter areas in the practice if required.

For patients with visual impairments, clinicians put flags on these patients’ records to alert staff to provide assistance for them at reception. For patients with hearing impairments, clinicians put flags on these patients’ clinical records to alert staff of their needs and if they preferred text message communication. The practice was also equipped with a hearing loop system. For patients whose first language was not English, the practice was able to access interpreting services for them.

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 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. Staff told us they reviewed patient ‘ReSPECT’ forms regularly to ensure these reflected patient’s current wishes and could be changed accordingly. ReSPECT stands for Recommended Summary Plan for Emergency Care and Treatment. These forms create personalised recommendations for clinical care in emergency situations where people are not able to make decisions or express their wishes.

Palliative patients were able to have home visits and care packages to ensure their wishes were followed and carried out in their final stages of life. Clinicians worked collaboratively with District Nurses and the palliative care team to update patient care plans.