i-HEART 365 Service - Extended Hours

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 service provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback.

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.

The provider assured us that care plans reflected patients’ physical, mental, emotional and social needs, including needs related to protected characteristics under the Equality Act. They told us that patients were supported to understand their conditions and were involved in decisions about their care. The provider reported no complaints or incidents relating to this and had carried out their own audits to confirm that their approach was working effectively.

The service maintained timely communication with patients registered GPs. Friends and Family Test feedback indicated that patients felt their consultations were thorough and that they were involved in decisions about their care.

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 provider worked in partnership with local practices and also hosted the primary care network (PCN) to meet the needs of the town’s patient population. For example, through the PCN they had recruited mental health workers through the Additional Roles Reimbursement Scheme (ARRS) to provide short‑term specialist assessment and support for practices across Barnsley. The provider supported local practices by offering weekend and evening cervical cytology appointments when sufficient demand for patients from all practices in Barnsley providing additional capacity and improved access, particularly for patients who struggle to attend during the day.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The service had access to interpreter services, including British Sign Language. Information provided by the service met the Accessible Information Standard.

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.

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. For example, following a delayed referral staff received refresher training on the local physiotherapy referral pathway.

The service ensured that people could access the care, support, and treatment they required at the time they needed it. The provider delivered additional primary care appointments that could be pre-booked or arranged on the same day, outside normal GP practice hours, through the extended access clinic. This service operated Monday to Friday from 6:30pm to 10:30pm and on Saturdays and Sundays from 9am to 5pm. Patients accessed these appointments by calling a dedicated phone line, which was open from 4pm to 6pm on weekdays and from 8am to 9am at weekends. Patients would be seen by GPs, advanced nurse practitioners (ANPs) or physician associates. The service provided a minimum of 153 hours of extended access per week.

The service also offered extra daytime appointments between 2pm and 10pm Monday to Friday to increase primary care capacity and ease pressure on local GP practices during busy periods. These appointments, for patients aged over two years and meeting specific criteria, were booked directly by GP practices and were mainly provided by ANPs.

In addition, the extended access clinic offered extra cervical cytology appointments during evening and weekend hours when demand from GP practices required them. These were delivered by a nurse and a nurse associate.

The provider also operated a home visiting service, offering same-day clinical visits between 10am and 6pm for housebound patients aged over 19 years who were registered with a GP in Barnsley. GPs could refer eligible patients directly into this service. Visits were undertaken by ANPs or physician associates with supervision, debrief and support from the locum GP on shift. Provider data shows that the service supports an average of 240 patients per month through this service, with around 1% or fewer being referred back to their own GP for further care and approximately 3% being referred to accident and emergency.

Treatment rooms were available on the ground floor at both sites with disabled access and facilities available.

Clear staffing rotas were in place, and the provider reported using the same staff across both the out-of-hours and extended hours services to increase workforce availability. The provider also had plans to undertake a project to analyse demand and capacity further, allowing them to identify peaks and troughs and continuously improve the service.

Friends and Family Test feedback indicated that patients were able to obtain appointments when needed and were seen promptly when attending the service.

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. For example, the service provided additional cervical cytology screening appointments during out‑of‑hours periods to support patients who were unable to attend their practice during standard daytime hours.

Feedback provided by people using the service, to the provider was largely positive. Staff treated people equally and without discrimination. Staff had received training in equality and diversity. Leaders 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 access to a patient’s medical record and could access records relating to any health plan or important life changes, including end of life decisions.