Friargate 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

Although the practice had embraced technology, it did not always suit or meet the needs of people who used the service. People’s feedback indicated not everyone liked the digitalised systems for patient contact in particular the triage process. In person face to face appointments could be requested but were rarely offered. Staff and the patient participation group expressed concerns the system did not meet the needs of all people within the practice population.

The practice had responded to feedback for the deaf community about the accessibility of the website. The website had been updated to include a section specifically for the deaf community with information shared via British Sign Language videos. Following feedback from people the practice had introduced a more flexible telephone system, which included a call back system.

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.

Feedback from people using the service indicated that not everyone thought they were offered person-centred care. People commented that their preference for a face to face appointment was not respected as they were unable to request this type of appointment, and requests for referral to specialist services were not actioned or an explanation given as to why this may not be appropriate. Following the inspection the provider told us they do not have access to specialist services for people with ADHD so are unable to make referrals. The service also told us there was a high rejection rate for mental health referrals within the locality.

Feedback received by the practice indicated that staff had taken into the account the specific needs of a person attending for an appointment and taken steps to ensure the appointment was a stress free as possible.

The practice held a deaf friendly flu clinic with a British Sign Language translator to support this group of people. They also planned to hold a flu clinic for people with dementia and those with impaired mobility.

Some staff had completed specialist training and had additional responsibilities linked to their role. For example, the practice nurse had training and experience in asthma management.

The use of technology enabled the GPs to be flexible around people’s individual needs in respect of time for call backs or video consultants, as well as face of face appointments. The GPs told us face to face appointments were offered based on clinical decisions.

The service had a consistent presence at local multi-disciplinary meetings in the community.

Leaders had a good understanding of the local population and complied with the accessible information standards within the practice. Staff had received training in equality and diversity.

The practice had responded by taking action to remove barriers and improve the accessibility for the website for the deaf community. The website had been updated to include a section specifically for the deaf community with information shared via British Sign Language videos.

Interpretation services were available for people who did not have English as a first language and British Sign Language interpreters for people from the deaf community. There were limited numbers of patient information leaflets available in the waiting area. Information leaflets regarding childhood immunisations were available in other languages.

There was a system in place for staff to access interpretation services to support people who did not have English as a first language. The service website contained an accessibility statement, which detailed changes that could be made to improve the accessibility for all users. The website had a section on wellbeing, which listed a range of information and services as well as links to specific health information.

The patient participation group (PPG) had been re-established last year and new members were actively being sought. Feedback from a representative from the PPG indicated it was too early to say if the practice listened to their views as they had only had 3 meetings however, the meetings felt like they were ticking a box. The practice had shared information with the PPG for example, the problem with the telephone system had been fixed. They commented that online access to appointments and consultations for younger people met their needs however, older people struggled with not being able to call the practice to book an appointment or being provided with a choice of on site or remote consultations. The PPG were unsure if the practice had any plans to address this.

Feedback from people received from a variety of sources indicated that not all people felt they were listened to or taken seriously.

Results from the 2024 National GP Patient Survey found 83% of people stated the healthcare professional was good at listening to them, and 90% of people stated they were involved as much as they wanted to be in decisions about their care and treatment, both similar to the national averages of 87% and 91%.

Information about services available for carers was available on the practice website.

Staff were aware of the process to follow if a person needed to raise a complaint about the service. Learning from complaints was shared with staff at team meetings and discussions. Information on how to complain was available on the practice website and there was a complaint leaflet available.

There was a policy in place for investigating and responding to complaints. Systems were in place to record, monitor and review complaints for trends and themes. However, barriers were put in place that prevented people from raising verbal complaints. People that wished to complain, were informed they had to submit their complaints in writing or ask someone to help them to complete the form

The practice collated feedback from people through the Friends and Family Test, although we did not see any action taken in response to the feedback. The practice had undertaken a patient survey in November 2023. The results had been analysed and areas for improvement identified. These included moving to a more flexible telephone system with a call back system (which has been completed), practice newsletters (available on the website) and options to improve the experience of using the website for the deaf community.

Feedback provided by people using the service and commissioners, both to partner organisations and CQC was mixed. Although people commented it was easy to get an appointment, these were usually over the telephone and face to face appointments were rarely offered, even when requested. Due to this approach the care home removed all of the people that lived in the care home from Friargate Surgery to an alternative surgery.

A representative from a different care home where the practice provided care and treatment indicated the practice had declined requests for home visits for people living in the home and care home staff had to chase the practice when they had requested emergency appointments through the referral service. However, the practice was responsive in providing immunisations to people living in the home.

A PPG representative commented that online access to appointments and consultations for younger people met their needs however, older people struggled with not being able to call the practice to book an appointment or being provided with a choice of on site or remote consultations. The PPG were unsure if the practice had any plans to address this.

Results from the 2024 National GP Patient Survey found 59% of respondents responded positively to how easy it was to get through to someone at their GP practice on the phone, above the national average of 48%.

Staff expressed some concerns that although the digitalised system met the needs of the younger people it did not necessarily meet the needs of older people and those with a learning disability. People had to complete an online form available on the practice website in order to book an appointment. If a person was unable to do this, receptionists completed the forms for them. There was guidance on the website informing people when to call 999 for emergencies. Reception staff were unable to book face to face appointments with a GP, this was triaged by a GP. People were informed of the day a GP would call them however, they were not informed of a time. Face to face appointments could be booked with the practice nurse.

The practice used a digitalised system for patient contact. People were able to submit information / requests to the practice 24 hours a day. Triage forms were completed for all requests for appointments. The GPs reviewed the information submitted and decided on the type of appointment offered to the person. Contact could be arranged at a time that suited the person.

People could request appointments via the website, telephone or in person, although the triage form needed to be completed for each request. Feedback from people who used the service was mixed, with some saying it was easy to get an appointment whilst other said it was difficult to get a face to face appointment with a GP. Following the inspection the provider told us they offered a range of type of appointments and face to face appointments could be either in person or via video consultation.

The majority of people liked using the digital system to contact the practice, but feedback from staff supported that some people preferred to contact the practice by telephone and received support from reception to complete the triage form. Following triage people were contacted and signposted to other services, or offered a telephone consultation, video consultation or face to face appointment. The 8am rush when people telephoned the practice no longer occurred and it was easier to get through on the telephone.

We did not see evidence of discrimination when staff made care and treatment decisions. There was no discrimination against people registering at the practice, which provided a service to homeless people and those who lived outside of the catchment area.

The internal patient survey 2023 had highlighted inequity in experience for people from the deaf community using the practice website. This was identified through feedback that not all deaf people could easily read and understand English as they were used to British Sign Language on video. The practice was exploring options to remove any barriers and seeking advice and support from the local Integrated Care Board. The practice had responded to feedback for the deaf community about the accessibility of the website. The website had been updated to include a section specifically for the deaf community with information shared via British Sign Language videos.

Feedback from a representative from a care home where the practice provided care and treatment supported that Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) plans were reviewed in a timely manner.

Staff attended multidisciplinary team meetings monthly to discuss and improve outcomes for people with complex needs. This included those people requiring support with end of life care.

DNACPR decisions were made in line with relevant legislation, were appropriate and recorded clearly. People’s wishes were recorded on their patient record which were available to local health providers who may need to access them. End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.