Hagley 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. At our last assessment, we rated this key question as Good. At this assessment, the rating remains the same.

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. 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. For example, some reception staff had received care navigation training to ensure that each patient received the appropriate care from the appropriate clinician or service.

Data from the National GP Patient Survey showed that 97% 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 above the national average of 91%. In addition, 77% of respondents said the healthcare professional they saw or spoke to was good at considering their mental wellbeing during their last appointment which was in line with the national average of 74%.

Friends and Family Test data was reviewed monthly and the latest Friends and Family Test data found 97% of patients surveyed found their care at the practice to be either ‘Very Good’ or ‘Good.’

Feedback CQC received from patients indicated they felt listened to, involved in their care, and treated as individuals.

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 however highlighted 59% 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 lower than 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.

96% 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, 88% 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. Staff told us they had reviewed the telephone system and between 8:00am-9:00am they had arranged for additional reception staff to be on duty to answer the practice telephones to accommodate this busy period.

The practice listened to patient preferences when making decisions about their care. The National GP Patient Survey data reported 92%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 above the national average of 87%.

The practice had a complaints policy, and the Site Manager was the lead for handling complaints. 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 37 complaints in the last 12 months, and we found they had been addressed appropriately. Staff took an empathetic approach to patient complaints and told us it was important to say “Sorry” at the first point of contact.

Complaints were discussed during practice meetings and the lessons learnt were shared with staff. Staff shared an example of learning from a complaint relating to a patient who had undertaken a blood test for their cholesterol level. The test identified the patient’s cholesterol level was high, and in communication with the practice pharmacist, the patient was asked straight away if they wanted to be prescribed a statin medication to treat this. The patient felt the pharmacist did not explore any background with them about why their cholesterol might have been raised or give information on why a statin medication would be beneficial. The learning from this incident was shared with the pharmacists and staff were instructed to ensure they discussed and provided adequate information to patients before prescribing a statin medication.

The practice was open from 8.00am to 18:30pm Monday to Friday. Patients could receive extended access appointments from the Wyre Forest Health Partnership Monday to Friday from 18:30pm to 20:00pm; and Saturday 9:00am to 15:00pm.

Various appointment types were available such as in person, online or telephone consultations. A duty GP was responsible for the patient triage process.

The practice provided us with telephone statistics to demonstrate performance with access for patients such as the percentage of telephone calls answered in less than 10 minutes; the percentage of telephone calls answered in 5 minutes or less; and the percentage of telephone calls answered from the telephone queue. Latest data showed the practice was meeting all telephone targets for the Wyre Forest Health Partnership. In addition to telephone statistics, the practice monitored the medical triage requests per month to ensure the triage process was working effectively. Staff told us improvements had also been made to the telephone system with shorter recorded messages and easy to cancel appointments.

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

81% of respondents described their experience of contacting the practice as good, which was above the national average of 70%.

68% of respondents found it easy to contact the practice by telephone which was above the national average of 53%.

55% of respondents found it easy to contact the practice by their website, which was in line with the national average of 51%.

50% of respondents found it easy to contact the practice by the NHS app, which was in line with the national average of 49%.

75%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%.

33%of respondents said they usually got to see or speak to their preferred healthcare professional when they would like to, however which was below the national average of 40%.

As part of our assessment, CQC received feedback from 6 patients about their experience of the practice. Feedback we received regarding access to the service was mixed. The majority of patients were positive about their experience accessing appointments however some patients expressed difficulty in getting appointments and dissatisfaction with having telephone rather than face to face consultations.

We discussed with leaders the challenges related to patient access. Leaders told the number of patients registered with the practice had increased over time and they felt that the service had outgrown the size of the building as a result. At our last assessment, the practice was providing services to approximately 7,986 patients and was currently providing the service for approximately 9,875 patients. However, staff gave us examples of how they had worked to improve access for patients. This included receptionist staff completing the online proforma on behalf of patients if they experienced difficulty or did not have internet access; and undertaking long term conditions reviews for patients who were housebound. 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 on the ground floor. Disabled toilets were available as well as baby feeding and changing facilities. There was a car park with designated disabled parking spaces.

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.

We found staff treated people equally, without discrimination. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Leaders proactively sought ways to address any barriers to improve people’s experiences. For example, as an accredited Veteran Friendly Practice, they demonstrated a proactive approach to supporting former members of the armed forces.

For patients with learning disabilities, the practice had a GP Learning Disability Champion who worked to get to know patients and their carers and act as a point of contact for them within the practice and assist with accessing external resources for them. Staff told us extended appointments were available for patients with learning disabilities and staff endeavoured to try to meet as many needs of these patients in one visit. Staff explained they had been working on improving both the quality and the proportion of learning disability patient reviews; and sharing ‘Reasonable Adjustment Flags.’ The NHS Reasonable Adjustment Flag was developed to enable health and care workers to record, share and view detailsof reasonable adjustments across the NHS, wherever a person is treated. We saw there were sensory packs available for patients who needed them and patients could access quieter areas in the practice if required.

For patients with visual impairments, guide dogs were welcome within the practice; and staff would assist patients in the waiting area for their appointments by escorting them to and from the consultation rooms as required.

For patients with hearing impairments, we saw the practice was equipped with a hearing loop system. For patients whose first language was not English, the practice was able to access interpreting services for them.

Whilst the practice was not located in an area of deprivation, arrangements were in place to ensure vulnerable people such as homeless people could register at Hagley Surgery or at neighbouring practices within the Wyre Forest Health Partnership. In addition, practice staff worked with outreach service “vans” to provide health checks and support to homeless people; and linked with council housing teams.

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 met regularly with District Nurses and the palliative care team to update patient care plans.

Staff told us a number of patients registered with the practice had Lasting Powers of Attorney (LPA) arrangements in place and staff ensured these contact details were appropriately flagged on the clinical patient record system.