Dr Kanjana Paramanathan

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.

The practice told us that they regularly involved patients in planning and making shared decisions about their care and treatment that met their needs. The majority of staff had been trained in equality and diversity, consent, deprivation of liberty safeguarding and mental capacity. We found that the clinical lead had not completed training updates in the mental capacity act.

Care plans reflected physical, mental, emotional, and social needs of patients including those related to protected characteristics under the Equality Act.

Patient satisfaction scores in the GP National Patient Survey were slightly below local and national averages, particularly in areas relating to patient-centred care. For example, 68% of people said the healthcare professional they saw or spoke to was good at considering their mental wellbeing during their last general practice appointment. This was slightly below the local average of 71% and the national average of 74%.

A review of clinical records confirmed that patients were supported in understanding their conditions and were actively involved in planning and making 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 practice worked in partnership with some services to meet the needs of its patient population. The practice had tailored its services to meet the diverse needs of its community. There were established mechanisms for engaging with the community healthcare provider.

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

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 practice website included useful information on health awareness and promotion. Information and resources were available for patients to support them to understand how to access services.

There were systems in place to support patients to access treatment, and patient records were held in line with guidance and requirements. We found the practice complied with the Accessible Information Standard (AIS) and that information about people collected and shared was in line with data protection legislation requirements. Patients were informed how to access their care records.

The service did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They did not always involve people in decisions about their care or tell them what had changed as a result.

Information about how to complain was available and patients could make a complaint in person or via the practice website. We found there was documented evidence to demonstrate the learning from complaints was shared with the practice team, however this was from formal written complaints. Staff told us that they received verbal complaints, but there was no record of these or any evidence to demonstrate these had been discussed with the practice team.

Feedback from the GP national patient survey demonstrated that 83% of patients said the healthcare professional they saw or spoke to was good at listening to them during their last general practice appointment. This was in line with the local average of 84% and the national average of 87%. We found the outcomes of the GP national patient survey were not discussed with staff. We were told that an inhouse survey had been started a few months prior to the onsite assessment, however this had not been completed or analysed to gather patient feedback. The practice didn't have an active participation group to share updates or gather feedback from on the services provided.

We spoke with patients on the day of the onsite assessment and received positive feedback on the care and treatment people received.

The service had arrangements in place to support timely access to care, treatment and support for most patients

The GP national patient survey showed 71% of respondents found it easy to get through to the provider by phone. This was higher than the local average of 48% and the national average of 53%. Patients could access appointments by telephone, face to face and online. Patients were given the option of a face to face or telephone appointment. Patients who had a request for an emergency appointment were seen the same day. The practice website provided information for patients regarding how to book an appointment. Feedback from staff demonstrated people in vulnerable circumstances were able to register with the practice, including those with no fixed abode.

Appointments with a GP were available throughout the week. Extended appointments were available for vulnerable people and those with a learning disability. The practice provided extended hours appointments on Wednesday evening until 8pm. When the practice was closed patients were able to contact 111. The practice offered appointments from a variety of additional clinical staff for example nurses and a pharmacist. Pre-booked appointments were available on weekday evenings and on Saturday through an arrangement with other local GP practices.

Treatment rooms were available on the ground floor, disabled parking and disabled toilet facilities were also available.

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.

The provider complied with legal equality and human rights requirements, including avoiding discrimination, having regard to the needs of people with different protected characteristics and making reasonable adjustments to support equity in experience and outcomes, including meeting the Accessible Information Standard (AIS). We saw examples where the practice had removed barriers for improved patient experience. For example, the practice had access to interpreters. We found the premises user friendly for people with a disability.

The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people. 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 with learning disabilities and poor mental health experienced additional care through annual reviews. People with dementia were referred to appropriate services where required.

People we spoke with on the day of assessment was positive about the services provided. 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. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes.

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.

Leaders understood the requirements of legislation when considering consent and decision making and had access to policies to support them. The practice held multidisciplinary meetings to share and discuss information relating to patient care and treatment, for example, those on the practice palliative care register.

There were systems in place to ensure staff kept up to date in training relating to the Mental Capacity Act and Deprivation of Liberty. We found that the clinical lead had not completed the required training. Following the onsite assessment, we received assurances that the clinical lead had completed all the outstanding training updates.

Our records review showed people were supported to consider their wishes for their end-of-life care, including cardiopulmonary resuscitation. Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) forms were in place and available within the clinical record.