The Spa Surgery

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment, we rated this key question as good. At this assessment, the rating is now outstanding.

This service scored 90 (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 was exceptional at treating people with kindness, empathy and compassion and in how they respected people's privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

The practice gathered Friends and Family feedback which reflected high levels of patient satisfaction. Data gathered from the Friends and Family test showed that from 600 responses, 84% were rated as very good with a further 11% rated as good. Patients gave feedback directly to CQC via email and telephone. There was technical fault with the CQC’s digital feedback webform during the period leading up to and during our assessment. Feedback from patients was mainly positive regarding the care they received from staff.

The practice had identified the need for longer appointments for those in mental health crisis. These were additional appointments so did not impact on the availability of other appointments. The practice had also been offering a clinic to support homeless patients for a number of years. They worked closely with advocacy services on patients behalf and with the local council regarding housing support.

We observed reception staff respecting patient’s privacy and dignity. Arrangements were in place to promote patient’s privacy. Staff across the practice demonstrated understanding and non-judgmental attitude, they provided patients with timely, clear information about their care. Processes were in place to ensure confidentiality in the reception area; for example, distressed patients or those wants a private space were offered a separate space to speak confidentially to staff.

The practice worked closely with their patient participation group to provide support where necessary. For example, they had introduced drop-in digital support sessions to help those patients who need extra input when using the NHS App or accessing online medical information.

The practice had a memory support advisor where patients could book an appointment directly.

The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Patients’ personal, cultural, social, religious and equality characteristics needs were understood and met. Patient communication needs were met to enable them to be fully involved in their care.

The practice maintained an up-to-date register of carers so that targeted support could be offered. For example, health checks, social prescriber support to help with carers allowance etc. The practice had identified a cohort of patients that were not digitally literate, to assist these patients the practice offered "digital access appointments". These appointments were used to assist and show patients how to use systems like the NHS App and other digital pathways.

The practice had a high prevalence of patients with learning disabilities and for patients with severe mental illness (SMI). Despite this, the provider had achieved a high rate of health checks for both these cohorts of patients. The work the practice had done for managing these groups of patients had been shared across the local Integrated Care Board and the Humber and North Yorkshire SMI Steering Group. Bespoke appointments were offered to patients to take into account any reasonable adjustments they required. Following feedback from patients, an artificial intelligence (AI) scribe software was introduced to record consultations as patients preferred when clinicians were not typing while speaking with patients.

The practice was a veterans accredited service and had been registered as a "safe surgery". A safe surgery is a GP practice which commits to taking steps to tackle the barriers faced by many migrants in accessing healthcare.

Feedback received from patients told us the practice was “polite, helpful and positive staff”, “plenty of empathy” and “very professional, caring and responsive”.

The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Staff helped patients and their carers to access advocacy and community-based services. Administration staff were able to support patients and assist them to obtain support in the community including supporting their referral to other service and social prescribing services.

Latest results from the National GP Patients survey showed that 43% of patients felt they were offered a choice of time or day when they last tried to make an appointment. This was lower than the local average of 55% and national average of 54%. The practice had introduced a range of appointments available for patients including, same day, routine, serious mental health appointments to improve access. Recent feedback from Friends and Family Tests were either very good or good and included comments such as ‘filled in an eConsultation and got an appointment the same day’ and ‘the service was prompt, efficient and effective’.

The practice also provided a range of services to maintain patients independence, choice and control. These included, homeless clinic, home visits for patients and learning disability and serious mental illness health checks for their patients. The practice also engaged with local community groups, such as Harrogate District Disability Forum and the cancer collaborative.

The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

There was a system for appointment triage that ensured people with immediate needs had access to services. Staff we spoke with knew the process for referral to emergency support, including mental health crisis teams and appointments.

The provider had developed a care navigation toolkit that was used to effectively care navigate patients to the most appropriate appointment or advice on what to do next.

As part of the assessed we observed the administration staff utilising the care navigation toolkit to help with support and safety netting for patients. For example, a patient was referred for clinical triage and booked in for an emergency appointment the same day. The introduction of the care navigation toolkit to support administration staff in their role was seen as a positive for both patients and staff.

Latest National GP Patient survey showed that 94% of patients were involved as much as they wanted to be in decisions about their care and treatment during their last appointment. Compared to the local and national averages of 91%.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Staff told us they were valued by leaders. Leaders had taken steps to recognise and meet the wellbeing needs of staff, which included the necessary resources and facilities for safe working, such as regular breaks and rest areas. Staff reported being supported if they were struggling at work. We saw daily huddles were established within the practice. Feedback from staff was positive.

The practice carried out annual staff surveys to monitor wellbeing across the practice. As a result of feedback from a staff survey, the practice had introduced mental health crisis slots to allow staff additional time for when handling complex mental health cases.

The surgery was a training practice for medical students and GP registrars, feedback from students was consistently positive about the training they had received. The practice was awarded a "green card" which acknowledges that the practice is a high-performing training environment.