Hollyns Health and Wellbeing

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

At our last inspection in April 2023, we rated this key question as requires improvement due to declining patient satisfaction regarding access to services. There were also issues relating to the premises and its environment which we have addressed under the key question safe. At this assessment, the rating has changed to good as we found the practice to have taken appropriate steps to try and address the issues identified. Patient satisfaction regarding access to services remained low, however leaders were aware of the challenges and were taking action in response to this. There was an active Patient Participation Group (PPG) in place and the practice actively sought patient feedback. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. Leaders had a good understanding of the diverse health and care needs of their patient population and worked in partnership with other services to meet these needs. There was an effective complaints process in place, which included learning and improvements being made.

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.

Staff and leaders told us that they involved patients in their care and treatment. They told us they did this by having discussions, offering choice, and by providing patients with the support they needed to understand, for example by offering support with any communication needs.

Leaders had a good understanding of the diverse health and care needs of their patient population at both sites, and had been involved in a review of local needs at the primary care network level.

We saw the practice worked in partnership with other services to meet the needs of its patient population. For example, the practice worked with HALE (Health Action Local Engagement), a charity based in Bradford which focuses on enabling people to improve their health and wellbeing.

Where referrals were made to external services, these were monitored and followed up appropriately. There was an integrated approach to patient care, and services worked well together.

Some services, for example first contact physiotherapy, were offered onsite to support provision of care.

The practice website contained information on, for example, opening times, prescription ordering, patient registration, available services, and complaints.

Reasonable adjustments were made at the practice to support communication, including the use of interpretation services. Individual communication needs were noted on the patient’s record where relevant. Leaflets were available in the reception areas and posters were displayed to provide patients with information at both sites.

A recent patient newsletter and meeting minutes from patient participation groups were also made available to patients to keep them updated on the practice.

There was an access to records policy and an information governance policy in place and staff undertook training on data protection.

There was an active Patient Participation Group (PPG) in place which met every few months. PPG meetings were also often attended by members of the practice including the practice manager and a GP partner. Minutes of these meetings were made available to patients.

The practice routinely sought patient feedback following an appointment at the practice and had carried out another more extensive patient survey in October 2024, with questions reviewed and agreed with the PPG in advance. Questionnaires were distributed during flu clinics and over 250 responses were received. We saw that responses to patient surveys were reviewed, themes and trends were gathered, and action was taken where possible.

We were informed about the different ways that patients could share feedback and raise complaints. This included the NHS Friends and Family Test (FFT), and the complaints process. There was a complaints policy and complaints lead in place. Staff we spoke with understood the complaints process and how to assist patients with any complaints or concerns they may have. Information on how to complain was also available on the practice website. We reviewed 2 complaints and found they were actioned in an appropriate and timely manner, discussed in meetings, and learning shared with staff. Where appropriate, patients were provided with an apology and signposted to the Parliamentary and Health Service Ombudsman. Staff told us how learning from complaints was used as an opportunity for improvement. For example, a complaint regarding a delay in access to an appointment for a patient following a stroke led to an investigation by the practice whereby guidelines on stroke management were shared with staff for learning from the event. We saw that the practice had discussed the complaint in a clinical meeting, raised it as a significant event, and issued an apology to the patient.

As part of the assessment process, we asked the practice to invite patients to share their experience of the service via the Give Feedback on Care form on the Care Quality Commission website. We received 136 responses. In the last 12 months we had received 158 responses overall. Of these, 45% were positive about the service they had received from the practice. The less positive responses were largely related to issues around accessing appointments.

In addition, the practice’s results for the National GP Patient Survey 2024 indicated that patient experience of access was generally lower than local and national averages. For example, of 109 respondents 28% said they found it easy to get through to the GP practice by phone compared to the national average of 50% and local average of 47%, and 45% felt they waited about the right amount of time for their last general practice appointment compared to the national average of 66% and local average of 68%.

The practice told us of the actions they had taken to improve access. This included recruiting a women’s, newborn and infant practitioner to improve access to cervical smears and childhood immunisations. This role also involved supporting the long-acting reversible contraception (LARC) clinics which were previously run by GPs and advanced nurse practitioners. The practice had also recently enhanced the process for patients to book an appointment for cervical screening by allowing them to book directly via a link sent to them by text message. They told us they were in the process of moving towards this for other appointments such as results, minor surgery, and certain long term condition reviews.

Other roles that were now providing support included university final year medical students (since September 2024) and a mental health practitioner (since April 2025). The GP partners had undertaken specialist training to become GP trainers. This had allowed the practice to take on GP trainees. The practice told us they were successful in retaining trainee GPs after qualification, and had therefore recruited 4 new salaried GPs in the last 18 months. The practice told us that the number of face-to-face appointments had increased since the last inspection in April 2023 (from 386 to 481 per week).

The practice routinely obtained patient feedback following an appointment at the practice to gather views on patient experience at the practice and with making an appointment. A more extensive patient survey was undertaken in 2024 which also featured questions on access.

We saw that responses to patient surveys were reviewed and action was taken where possible. For example, based on patient feedback the practice’s online consultation service opening times were adjusted. In addition, the practice found that 47% of respondents to the 2024 survey were not aware of enhanced access appointments and took steps to raise awareness of this, for example by featuring this in the patient newsletter and by asking staff to inform patients of this service during appointment bookings.

The practice also told us they had updated their website to improve patient access. Future plans for access improvement included supporting patients with digital access. We saw that there were plans in place for the practice to work alongside Carers’ Resource as part of a digital inclusion project to offer workshops on digital skills for carers at the practice.

Furthermore, after the assessment the practice told us they had installed new telephone software at both sites. This software was designed to enhance integration between the telephone system and the patient clinical system used by the practice. It would allow incoming telephone calls to be matched to patients on the system along with other information and alerts for the patient being highlighted. The practice felt this would bring a range of benefits including prompt identification of calls from housebound patients and from patients overdue certain checks or recalls.

The main practice opening times were Monday to Friday 8am to 6pm. The branch practice opening times were 8am to 6pm Monday to Thursday, and 8am to 1pm on Fridays. Appointment types included telephone and face to face. Appointments could be booked on the day by telephone or online. The practice offered a limited number of pre-bookable appointments. They told us they had limited this due to having a high incidence of pre-booked appointments not being attended, so instead they provided same day appointments for most bookings. The practice offered home visits and urgent appointments for patients where appropriate. Enhanced access appointments were available to patients on evenings and weekends at practices across Bradford and is run by Bradford Care Alliance.

Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. This included the use of interpreters and providing longer appointments where needed.

Staff received equality and diversity training. Health checks were routinely offered to patients.

Leaders told us about the ways in which they supported national initiatives to engage with and educate patients, for example signposting or referring patients for weight management and smoking support. The practice offered services such as a mental health worker and a drug and alcohol worker to support patients at the practice.

Home visits were carried out for housebound and vulnerable patients. The practice also offered support to patients at 6 local care homes. There were dedicated GPs who were responsible for carrying out weekly ward rounds for each of these care homes. The nurses also conducted long-term condition reviews and administered flu vaccinations for care home patients.

The practice worked alongside their primary care network (PCN) to review the needs of the local population. This work led to the creation of a New Families project in September 2024 which focused on educating and supporting pregnant women and mothers, for example through workshops providing access to advice from healthcare professionals and through education around maternal vaccination and childhood immunisations. In addition, there had been ongoing work to support patients with their mental health. This involved identifying patients who had disengaged with practices in the PCN for their annual health checks followed by contacting patients to encourage attendance and offer support during appointments.

Staff understood the requirements of legislation when considering consent and decision making, and had access to policies to support them. Staff supported patients to make informed decisions about their future, including at the end of their life. The practice had 160 patients on their palliative care register, and these patients were reviewed in monthly multi-disciplinary meetings. Staff told us how they worked with patients, and their carers, to support them to understand their options regarding Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) decisions. We saw that DNACPR and ReSPECT forms were completed in line with guidance and with the input of patients, and when necessary, their carers.