Yarm Medical Practice

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 provider 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 National GP Patient Survey showed 96% of respondents said they were involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment, above the local average of 92% and the national average of 91%.

Care plans reflected physical, mental, emotional, and social needs of patients including those related to protected characteristics under the Equality Act. These were regularly reviewed and discussions with family documented. Our review of clinical records showed patients were supported to understand their condition and were involved in planning for their care needs, and in decisions about their care.

The provider understood the 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 other services to meet the needs of its patient population, including various charities.

Specialist GP services were available in the practice including a dedicated skin clinic focusing on skin lesions, which reduced unnecessary dermatology referrals and increased the speed at which patient skin lesions were assessed. A total of 6 members of the practice team were able to offer cervical screening tests, at times to suit patients.

Our review of the clinical system demonstrated that 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 provider took an active lead role in the Primary Care Network (PCN) and helped to plan, develop and deliver services across the locality with a view to improving patient satisfaction.

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

Information provided by the practice met the Accessible Information Standard. Individual communication needs were noted on the patient’s record. Staff told us they supported patients with using online services. Leaflets were available in the reception area and posters were displayed to provide patients with information on the practice and the different services available to them. Patients were also provided with information on how to access their medical records, or for others on their behalf.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

There was a complaints process in place, which included a designated complaints lead and a policy. Information on how to make a complaint was available on the practice's website, including a downloadable complaints pack. Staff showed a good awareness of complaints procedures. Named members of staff monitored complaints progress weekly and escalated where necessary.

We reviewed several complaints and found they were actioned in line with their policy. Where appropriate, patients were provided with an apology and signposted to the Parliamentary and Health Service Ombudsman. The practice held regular reviews and discussions of complaints which looked at themes, learning points, changes made and other planned actions.

The provider had faced challenges in making sure that people could access the care, support and treatment they needed when they needed it. The latest National GP Patient Survey data showed 70% of respondents described their overall experience of this GP practice as good, below the local average of 79% and the National average of 75%. Only 22% of respondents found it easy to get through to this GP practice by phone, significantly below the local and national averages of 57% and 53% respectively. In addition, 25% of respondents found it easy to contact this GP practice using their website, below the local and national averages of 53% and 51%. Access to appointments was also the most commonly recurring theme from Friends and Family data collected by the practice and by the practice’s own patient surveys.

The provider was proactively tracking and analysing patient feedback and had recently made changes to the service in response to common themes, such as implementing an online consultation and triage platform that allowed patients to submit requests for appointments or administrative queries to the GP practice via an app, website, or phone. This system was available for use from 7.30am to 6pm. Patients could be invited to book appointments at their convenience via a text link or receive a call back. Initial patient reviews gathered by the practice were positive on the ease of use of the new system, with patients receiving prompt communications and appointments. Phone, video and face to face appointments were available, with patients able to request their preferred type of appointment with a specified clinician. They could review and change their preferences until the day of consultation. Appointments were as standard, 15 minutes long.

We checked the appointment system on the days around the inspection and in the afternoon, there were still some limited GP appointments available for the remainder of the day. Patients could also attend extended access appointments available for later in the day at 4 other practices that receptionists could book patients into. This service was run by the local GP Federation. The provider was able to demonstrate some improvements over the last 12 months; for instance the calls connected rate had improved from 30% to 53%. The new online system was still in its infancy however, and as part of a restructure some roles had been lost which were not yet fully recruited to, which it was hoped would help alleviate pressure on the phone lines.

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.Leaders and staff worked to prevent discrimination and inequality that could disadvantage distinct groups of people using their services. They proactively sought out ways to address barriers to improve people’s experience and acted on information about people's experiences and outcomes.

The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers. Patients could fill registration forms in online.

Staff used appropriate systems to capture and review feedback from people using the practice, including those who did not speak English or have access to the internet.

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.

Our records review showed people were supported to consider their wishes for their end-of-life care, including do not attempt cardiopulmonary resuscitation (DNACPR) orders. This information was shared with other services when necessary.Regular clinical and multi-disciplinary meetings with care partners were held. We saw testimonials from patients where they said they felt consulted, listened to and valued. The percentage of respondents to the latest National GP Patient Survey who stated that during their last appointment they were involved as much as they wanted to be in decisions about their care and treatment was 96%, above the national average of 91%.