Rosedean House 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

People were involved in decisions about their care. The service provided information people could understand. People knew how to give feedback about the service. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. People were involved in planning their care and understood options around choosing to withdraw or not receive care. The service was using locum clinicians and therefore could not always provide continuity of care to people.

This service scored 71 (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.
Care plans reflected physical, mental, emotional, and social needs of patients including those related to protected characteristics under the Equality Act. Our review of clinical records showed patients were supported to understand their condition and were involved in planning for their care needs. They were also involved in decisions about their care.
Staff demonstrated an awareness of people’s different backgrounds and needs. One staff member told us that they had been supported to attend training regarding cervical screening in relation to women from different cultures.
 

The service understood the diverse health and care needs of people and their local communities. However, staff shortages and the use of locums and remote staff made it difficult for the service to provide continuity in care. The service had an active recruitment drive for GP’s and was also working with local organisations to support this process.
A clinician working at the service told us that the service created continuity of care where they were able to and recognised that people should not have to tell their story more than once. Another clinician working within the service told us that they try and provide continuity by booking the follow up appointment with the same clinician however staff shortages means that this is not always possible.
At the time of the inspection, the service was using locum GP’s and additional remote clinicians to ensure the service maintained its required staffing levels. This presented challenges in providing continuity to care for people using the service. A staff member told us they were concerned about people not receiving continuity of care due to the number of locums working in the service as well as remote clinicians who are not familiar with the local demographic of people, or the locality specific processes such as referrals. “There’s no continuity anymore… you could have seven or eight different locums in a week.”
Leaders told us that they were using regular locum GP’s to be able to improve this.
An external service that provided remote appointments with clinicians was used to expand care provision while the service recruited additional clinicians. People could also self-refer into this service. We saw the practice work in partnership with other services to meet the needs of its patient population. This was evidenced through the services multidisciplinary working and its use of other resources during times of staff shortages.
 

The service 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. The practice had access to interpreter services. Information provided by the service met the Accessible Information Standard. People were informed as to how to access their care records.
The service provided information to patients through its website, which included practical details about accessing care, opening hours, services, and how to seek help when the surgery was closed. The website also advised how to use digital tools such as the NHS App and a text based communication channel and how to access help with using these. People who may struggle with digital access were encouraged to contact the practice by phone or in person so staff could support them to submit online requests.
 

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 and were being monitored for trends. People could make complaints about the service in writing or through the website where there was information about how to make complaints and provide feedback about the service.
The service had a PGG and meetings took place regularly. In the minutes of these meetings we saw how the service shared information with the PPG, involving staff working in the service.
Staff told us that they felt able to make suggestions to leaders of the service with one staff member telling us: “We requested a phlebotomist, that’s been taken on board.”
 

The service made sure that people could access the care, support and treatment they needed when they needed it.
People could access the service in a way that met their needs. This included being able to contact the service online, in person and by telephone. Where people needed support to use the NHS app, staff were able to support people with this. Staff could also support people to register with the service and were able to provide people with a private space to fill out forms.
The service was accessible to all people with treatment rooms available on the ground floor.
The service allowed for additional appointments on days where demand has been noted as being higher, such as on Mondays and had started to implement pre-bookable appointments 6 weeks ahead.
However, we did receive some feedback from a person using the service who told us that communication with the service when trying to access an appointment is challenging.
 

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.
Staff treated people equally and without discrimination. Leaders proactively sought ways to address any barriers to improving people’s experience and worked with local organisations, including within the voluntary sector, to address any local health inequalities.
The service was part of the DEEP End Network (a DEEP End Network is a collaboration of GP practices that serve the most socio economically deprived communities) this means that the service may experience more complex needs in its community or workload pressures per patient that may be higher than average.
Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes, such as supporting people to use digital tools to access the service. The service had processes to ensure people could register at the practice.

Our records review showed people were supported to consider their wishes for their end-of-life care, including cardiopulmonary resuscitation. The service had a dedicated priority contact number for people receiving end of life care. Electronic TEP (Treatment escalation plans) were being utilised by the service which meant that information relating to people’s health care wishes could be shared with other organisations such as the NHS 111 service.