The Eston 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 requires improvement. At this assessment, the rating is now good.

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 National GP Patient Survey showed that 94% of respondents felt the healthcare professional they saw had all the information they needed about them during their last appointment, which was higher than the national average response. In addition, 80% of respondents would describe their overall experience of this service as good, which was higher than the national average of 74%. We saw evidence of person-centred care within patient records, including involving the patient and their family members in decisions about their care. The practice leadership demonstrated knowledge of the demographics of their practice population and had taken steps in collaboration with other organisations to engage with hard-to-reach groups. For example, the practice leadership had engaged with Deep End North East North Cumbria to improve vaccine uptake in children under 5. In addition, the practice had contacted teenage patients who had not had all their childhood vaccinations during non-term time, inviting them to make an appointment. We also saw that the practice had worked with Deep End North East North Cumbria and the Waiting Well Team on opioid reduction plans for post-surgical patients. The practice also engaged in social prescribing initiatives and gathered feedback from patients on their experience of this support, which was positive.

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 local networks to promote the uptake of immunisations. Feedback from people collected by CQC was positive in this area, which described joined up care with quick referrals and arrangements of blood tests.

The leadership told us that people were supported to see the clinician of their choice where clinically appropriate. The National GP Patient Survey showed that 49% of respondents usually get to see or speak to their preferred healthcare professional, which was higher than the national average of 40%. The practice leadership had considered people who were not able to access online services and had arrangements in place to ensure this was not a barrier to receiving care. People were able to contact the practice via telephone or by speaking to the reception desk to access any services available online. As part of the new patient registration process, patients completed a questionnaire in which they were able to opt-in to online service or join the Online Patient Reference Group. The practice leadership had held sessions for the public to provide support and awareness. This included patients who needed support during menopause, and another session aimed at supporting patients and relatives with a learning disability.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The practice communicated through its website, social media, and noticeboards.

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. Information provided by the service met the Accessible Information Standard. Patients were informed as to how to access their care records.

The practice had information clearly available on their website to support national priorities and initiatives to improve the populations health, for example, stop smoking campaigns, weight management, and sign posting to mental health services. The practice leadership had analysed data to review the usage of online services by patients.

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. At the time of the assessment, the surgery were in the process of considering merging with another practice. We saw evidence that the practice leadership had considered the patient experience in these plans and was actively engaging with the community by holding drop-in sessions and promoting an online survey for feedback.

We saw complaints were managed in line with the practice’s policy. Information on how to make a complaint was available to patients within the practice waiting room. We saw evidence that complaints were regularly discussed within meetings. Learning from complaints was evident and staff were able to identify changes made as a result of patient feedback, including complaints. For example, the online booking system had been updated with staff roles and remits to ensure appointments were booked with the appropriate clinician. In addition, the practice leadership had created messages and added information onto their website regarding a patients right to choose. We saw evidence of staff feedback being collected by the practice leadership, and changes being made in response to staff feedback. For example, changes made to desk layout and the break room to improve the staff experience.

The practice leadership had reviewed data from The National GP Patient Survey and had also conducted their own patient survey to gather peoples views. According to The National GP Patient Survey, 79% of respondents said the healthcare professional was good at listening to them during their last appointment.

The service made sure that people could access the care, support and treatment they needed when they needed it.

In response to the National GP Patient Survey data and from feedback from members of the community the practice leadership had taken steps to improve access to the service. For example, the practice leadership had aimed to understand the concerns patients had related to access, and had conducted their own patient experience survey, in which patients were asked in depth about access. The survey was available from reception, in the waiting room, and online, and was therefore available to all patients. The results of this survey were that 16% of respondents thought it was not easy to contact the practice via telephone, and 20% of respondents did not think it was easy to book an appointment in advance. In response to this feedback, leadership told us they had advertised their pre-bookable appointments via their website, social media, and displays within the practice. In addition, a new telephone system was being introduced at the time of the inspection. The practice leadership had conducted reviews of appointment availability and analysed demand for GP appointments, as well as appointments with other healthcare professionals. People could access the service to suit their needs; for example online, in person and by telephone.

The practice leadership had analysed data to review the usage of online services by patients. The results of this analysis showed that 50% of patients had used the NHS App, and 43% of patients had access to their medical records via SystmOne Online. This was reflected in the National GP Patient survey, in which 76% of respondents reported finding it easy to contact this GP practice using the NHS App, compared with the 45% national average.

Treatment rooms were available on the first floor of the health centre, accessible by escalator or passenger lift. On site parking was available, with designated disabled access bays clearly signposted.

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 positive. Feedback from people collected by CQC described joined up care with quick referrals and arrangements of blood tests. 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 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 processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers. 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.

The practice leadership demonstrated a good understanding of the local patient population, and the difficulties people may encounter. The practice leadership had sought out local groups, networks, and sessions that were held in the community to promote these within the practice using posters. We saw examples of social prescribing in which these groups and networks were utilised. For example, the local women’s centre, housing support, and Exercise on Prescription. Staff had completed training in equality, diversity, and inclusion.

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.

We saw evidence that people were supported to consider their wishes for their end-of-life care, including cardiopulmonary resuscitation. Our review of records also showed the practice worked closely with other services to ensure specific patient needs were met. This information was shared with other services when necessary. We saw evidence of regular monthly meetings to discuss patients who were receiving palliative and end of life care. A Cancer Care Coordinator was available via the Primary Care Network, and there was a GP End of Life Care Lead within the practice. The National GP Patient Survey showed that 75% of respondents say they had enough support from the service in the last 12 months to help manage long term conditions. This was higher than the national average response.