Millcroft Medical Centre

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 assessed all quality statements from this key question. The rating given is Good.

Staff worked to reduce health and care inequalities. Continuity of care was offered to patients where required or when requested and longer appointments were available if necessary. The practice worked within the Primary Care Network (PCN) and supported local service developments as part of this. However, indicators around access, when benchmarked against other local practices, was below expectations.

Information about how to raise a complaint was provided and the sample of complaints we looked at had been investigated, although not always thoroughly documented. Information from complaints was discussed with required individuals but was not shared with the entire team for the benefit of learning and improvement. The premises were purpose built and fully accessible for people with disabilities including quiet areas where patients could have 1-1 discussions with staff or be alone with relatives.

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.

Staff said they ensured 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 attended multi-disciplinary meetings with relevant professionals and services to discuss and plan patient care and treatment so that people’s needs could be met holistically. Staff demonstrated a person centred approach to their work and we observed staff who were supportive of patients during our assessment. Results from the patient GP survey showed that 57% of people said they had enough support from local services or organisations in the last 12 months to help manage their long term condition or illness compared to 71% locally and 69% nationally. Another 78% of people who responded to the National GP patient survey said they found the reception and administration team helpful, which was lower than local averages of 85% and national average of 83%.

The practice worked in partnership with other services to meet the needs of its patient population. The clinical staff team was large and were able to provide continuity of care. Staff worked with multi-disciplinary professionals to meet the needs of patients. Staff told us that, where appropriate, patients were able to request and see the same healthcare professional. This was not supported by the National GP Patient Survey results, in which 27% of respondents confirmed this was their experience compared with 39% locally and 40% nationally. Referrals to other services were made promptly and information shared by other services was managed effectively and timely to support good outcomes for people. The practice staff said they tried to encourage patients to attend for follow up appointments, screening programmes and child immunisation uptake, although results in these areas were lower than average. The provider worked closely with the PCN to plan, develop and deliver services across the locality.

Staff communicated and provided information in a way that helped people to understand their care. People received information about their health and treatment options to enable them to make an informed decision and the practice website contained NHS information about health conditions and support services. The provider used systems to share information about patients effectively across services. Safety netting advice was provided when patients were at risk of deteriorating. Feedback from people who responded to the National GP Patient survey showed that 83% knew what the next step would be within 2 days of contacting their GP practice, which was the same as the local and national averages.

At the time of the assessment the practice had limited access to interpreter services to support people who did not use English as their first language but could make information available in a patient’s preferred choice when required. We noted a language toggle for other languages on the practice website, but this was limited and did not cover every language. On the day of the assessment, we saw a patient who did not speak any English and whose language was unknown, being supported, but with difficulty, to access services.

Information was available at the service and online so that people knew how to give feedback about their experiences of care and support, including how to raise any concerns, complaints or issues. Feedback was collected through the NHS Friends and Family Test and complaints, but the feedback was not analysed to inform improvement. People were encouraged to write in to the practice if they wished to complain about their care, treatment and support, and complaints were responded to appropriately with a full response and an apology. Reception staff told us how they dealt with people’s concerns daily and addressed concerns before they escalated. Verbal feedback was also documented but the practice did not always document outcomes and learning from this. We discussed these missed opportunities during the assessment with staff and leaders who were receptive to our feedback with plans in place to rectify this.

The provider was aware of the requirements to meet the accessible information standards. The patient record system was used to alert staff to any particular communication or health related needs. Longer appointments were booked for patients who required the services of an interpreter and for those with a learning disability or complex long-term conditions. The provider tried to ensure that people could access the service easily and quickly so that they got the support and treatment they needed when they needed it. Staff said that most patients who requested it could see a GP on the day of request or were signposted to a more appropriate person or service to meet their needs that day. An on-call GP was available to see people for urgent appointment requests. Staff were trained to direct people to the most appropriate clinician or service to meet their needs. The provider monitored patient access effectively and made changes in response to ensure patient satisfaction.

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 and understood the importance of providing an inclusive approach to care which was adjusted to support people’s individualities. There were processes to ensure people could register at the practice, and people in vulnerable circumstances such as homeless people and Travellers were treated equally. Staff used appropriate systems to capture and review feedback from people using the service, but this did not always include people whose first language was not English. However there were initiatives the practice could become involved in that could benefit people who might experience inequality.

People who used the service were provided with information to make informed decisions about their current and future care and treatment and supported to plan for these. 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 as necessary. Multi-disciplinary meetings were held on a regular basis to discuss the needs of people receiving end of life care.