Chelford Surgery

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• 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. At our last assessment, we rated this key question as good. The rating remains good following this assessment. The service met people’s needs, and that staff treated people equally and without discrimination. The service provided person centred care and treatment whereby people’s individual needs and wishes were respected and acted upon.

People who used the service provided highly positive feedback with regards to their ability to access care and treatment. People were able to access the service readily and data showed that the majority of people had their initial consultation needs met on the day of request with a small proportion of patients booked into routine appointments where this was more appropriate to meet their needs. 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 so as to ensure patient satisfaction.

People who used the service were supported to make decisions about their future care. Information about how to raise a complaint was provided to people and learning from complaints was shared effectively. The provider understood their patient population and they identified and made changes to improve their service where required. Leaders proactively sought ways to address any barriers to improving people’s experience and outcomes. The practice worked within the primary care network (PCN) and supported local service developments as part of this. Continuity of care was offered to patients where required or when patients requested consultations with specific clinicians. The premises were purpose built and reasonable adjustments had been made to ensure the premises were accessible to patients who required disabled access.

This service scored 86 (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 ensuring 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. Feedback from people who used the service was that they were well supported to understand their condition and involved in decisions about their care and treatment and in planning for their future needs.

Regular multi-disciplinary meetings were held 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 very person centred approach to their work. The culture and ethos of the service was to ensure a high level of patient satisfaction and this was clearly evident across all areas of our assessment.

The practice received very high patient satisfaction scores in the GP national patient survey for questions linked to patient centredness. For example, 98% of respondents (compared to 83% nationally) found the reception and administrative team helpful and 91% (compared to 73% nationally) said the healthcare professional they saw was good at considering their mental wellbeing and 97% (compared to 74% nationally) described their overall experience of the practice as good.

People who used the service shared examples of how staff had taken the time to make sure their needs were met holistically and people were highly complementary about staff in all roles.

Representatives from the Patient participation group (PPG) told us ‘There is no doubt that the surgery wants to do its very best for its patients and is prepared to go the extra mile in order to achieve this’.

The practice worked in partnership with other services to meet the needs of its patient population.

The clinical staff team were long standing and this provided a high level of consistency for people who used the service. Staff told us where necessary, people benefitted from seeing the same healthcare professional.

Staff worked with multi-disciplinary professionals to meet the needs of patients. 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 had tailored its services to meet the needs of its community, for example, working hard to promote the take up of screening programmes.

The provider worked closely with the Primary care network (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 were provided with information about their health and treatment options to enable them to make an informed decision.

Support was available for people with additional needs or communication needs. For example, people who required the services of an interpreter or patients who had a learning disability.

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 used the service in the National GP Patient survey showed that 98% of respondents (compared to 92% nationally) felt the healthcare professional they saw had all the information they needed about them during their last general practice appointment.

The practice website contained NHS information about health conditions and support services that people could use.

The service was good at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support.

Patients responded very positively in the National GP patient survey for questions related to the healthcare professional being good or very good at listening to them and involving them in decisions about their care and treatment.

The provider monitored patient views via the NHS Friends and Family Test and NHS and online feedback. Feedback shared with CQC directly by people who used the service was very positive with regards to people feeling listened to and involved in decisions.

During the assessment we met with four members of the Patient Participation Group (PPG) and the feedback we received was highly positive. We were told that relationships between the group and the practice were very good. Members of the PPG felt listened to, consulted with and they had made suggestions for improvements that had been acted upon. For example, a support group called ‘Digital friends’ was set up by members of the PPG to help patients to learn about using their laptops, smart phones and tablets to support them in using on-line services. This contributed to a high percentage of patients finding it easy to contact the practice by the website or using the NHS APP.

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. Complaints were investigated appropriately and complainants were provided with a full response including an apology where this was appropriate and details for referring to a second stage of the complaints process. Feedback from people who used the service was reviewed and used to support service improvement.

The provider made sure that people could access the service easily and quickly so that they got the support and treatment they needed when they needed it. Data showed that the majority of people had their initial consultation needs met on the day of request with a small proportion of patients booked into routine appointments where this was more appropriate to meet their needs or if more convenient for the patient. Clinicians were available to see people for all types of appointment requests including urgent appointments. A designated doctor triaged all patient requests and the majority of patients had their initial needs met and or treatment planned or provided on the day of request. The provider monitored patient access effectively and made changes in response so as to ensure patient satisfaction.

People who used the service provided highly positive feedback with regards to their ability to access care and treatment. The percentage of respondents in the National GP Patient Survey who responded positively to their experience of contacting the practice was very high at 94% (compared to 67% nationally) and 96% of respondents (compared to 66% nationally) felt they waited about the right amount of time for their last appointment. Patient satisfaction for finding it easy to get through to the practice by phone was high at 93% (compared to 50% nationally). A high percentage of patients were familiar with and used the on-line service to book appointments with 91% of respondents finding it easy to contact the practice using the NHS APP (compared to 45% nationally). The provider had been proactive in supporting people to use this.

The provider was aware of the requirements to meet the accessible information standards and the patient record system was used to alert staff to any particular communication needs of the patient so that staff could then communicate effectively with the patient. The premises were purpose built and fully accessible.

Leaders proactively sought ways to address any barriers to improving people’s experience. Staff and leaders ensured they were able to recognise patients who were most likely to experience inequality in experience or outcomes and they tailored the service to meet their care, support and treatment needs in response to this.

People who used the service had equal opportunities to access reviews of their care, treatment and medicines and people were invited for health screening and immunisation with high rates of uptake by the patient population.

The provider had processes to ensure all people could register at the practice, including those in vulnerable circumstances.

Staff and leaders demonstrated a good understanding of the local patient population, and the difficulties people may encounter. Staff had completed training in equality, diversity, and inclusion. We did not see evidence of discrimination when staff made care and treatment decisions.

The provider monitored data about the care and treatment provided to patients. Available data showed that people experienced similar to or better outcomes for care and treatment when compared to services locally and nationally. The results of the National GP patient survey showed that 97% of respondents (compared to 90% nationally) felt their needs were met during their last general practice appointment and 97% described their overall experience of the practice as good (compared to 74% nationally).

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.