Bellevue Medical Practice

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 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 their care needs. They were also involved in decisions about their care.

However, patients said that challenges in contacting the surgery at times made it harder for them to get the care they needed when they needed it, which affected their experience of person‑centred care. This was supported by findings from the national patient survey.

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 practice worked in partnership with other services to meet the needs of its patient population. The practice had tailored its services to meet the diverse needs of its community, for example, building relationships with the local community groups to promote the additional services such as flu injections.

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

However, signage for interpreter services were not available in other languages, the provider has assured us that interpreter signage in other languages will be prioritised Information to promote the take up of screening and immunisation programmes was available in a range of languages. The practice had access to interpreter services, including British Sign Language. The staffing group including clinicians were diverse with multiple local languages and dialects spoken, which reduced the need for external interpreters for general conversations. However, trained interpreters were always used as required for example, during consultations. Information provided by the service met with the Accessible Information Standard. Patients were informed as to how to access their care records. We found posters and leaflets were available in a range of subjects such as bereavement, debt advice, and caring for others.

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. Although the Patient Participation Group was newly established, the representative was positive about the service and how they felt their voices were heard. They had a friends and family feedback process which included both the use of electronic feedback and feedback boxes in the practice. They used this data to analyse where improvements could be made and how they could provide a better service to patients. An example of this is when they used feedback to change triage to allow people to come into the surgery to make appointments with help from reception staff.

The service did not always make sure that people could access the care, support and treatment they needed when they needed it.

During our assessment, we looked at the practice’s appointment system and could see that patients were able to book appointments that suited their individual needs. We saw that there was a duty doctor system that could offer emergency appointments on the same day. Patients were able to book appointments over the telephone, in person and online. The provider told us that they were creating an action plan to address some of the results from the National GP Survey to increase patient satisfaction. They had reviewed capacity and demand to identify how many on-the-day appointments were needed in relation to pre-bookable appointments and built the rotas accordingly. Support was offered to patients with learning disability such as telephone and text reminders before appointments should they need them.

However, the National GP Patient Survey data showed, 55% of patients responded positively to their overall experience of contacting the practice, which was below the national average of 75%. Whilst the provider told us they had an action plan and would implement changes until another survey is completed, we cannot be assured the access concerns had been fully addressed.

We saw that the entrance to the building from the car park was not easily accessible for people with physical disabilities, as there was a large bin obstructing the ramp leading from the car park to the building. We brought this to the attention of the management team, and this was immediately removed. They told us of plans to renovate the parking area to improve accessibility.

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.

Feedback provided by people using the service, both to the provider as well as to CQC, was generally positive about care for people who may not speak English as a first language or people with disabilities, with some negative feedback around waiting times for appointments. People told us that staff treated people equally and without discrimination. For example, they appreciated the services understanding of the local community and cultural barriers some in the community may face such as lack of English. Leaders proactively sought ways to address any barriers to improving people’s experience and worked to ensure that equality was a foundation in the care people were provided. Patients appreciated the fact that they could use other languages apart from English to better communicate concerns that they felt they would not be able to articulate in English. 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 and refugees. 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.

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.