Burn Brae Medical Group

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 Outstanding. At this assessment, the rating has changed to Good. At this assessment we found that some of those areas previously regarded as outstanding practice were now embedded throughout the majority of GP practices. While the provider had maintained this good practice, the threshold to achieve an outstanding rating had not been reached. The practice is therefore now rated good for providing responsive services.

This service scored 79 (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 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. Care plans reflected physical, mental, emotional, and social needs of patients including those related to protected characteristics under the Equality Act. Our review of clinical records showed patients were supported to understand their condition and were involved in planning for their care needs.

People told us that staff have an excellent understanding of their individual needs relating to their protected equality characteristics, social and cultural needs, and their values and beliefs that may influence their decisions on how they want to receive care, treatment and support. National GP Patient Survey data showed 100% of people surveyed who responded felt they were involved in decisions about their care, which was higher than the local and national averages of 93%.

The service understood the diverse 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. The practice had tailored its services to meet the diverse needs of its community, for example, building relationships with community groups to promote the take up of vaccination programmes. There were established mechanisms for engaging with the community healthcare provider.

The service was exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual needs. They were innovative in their approach to providing information, for example the practice had produced “sick day” cards as a simple visual reminder to patients of what regular medication they should avoid taking on days when they felt acutely unwell.

Information to promote the take up of screening and immunisation programmes was available in a range of languages. The practice had access to interpreter services, including British Sign Language, and had invested in translation machines at reception to help patients communicate with staff after identifying a relatively-large population of non-English speaking Ukrainian patients had joined the practice. There were 58 Ukrainian patients on the list at the time of assessment. The practice had Information provided by the service met the Accessible Information Standard. Patients were informed as to how to access their care records.

Thought was also given to the best placement of information inside the practice to ensure it had the best possible chance of being noticed by patients. For example, there was a children’s play area which included information about childhood illnesses and vaccination programmes. There was also a mural painted which included a measuring chart so that parents could measure their children before an appointment.

The service was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. They always involved people in decisions about their care and told them what had changed as a result.

There was a systemic review of concerns and complaints through regular audits to ensure improvements were made and complaints were managed in line with the practice’s policy. Learning from complaints was evident and staff were able to identify changes made as a result of patient feedback, including complaints.

We saw multiple examples of changes and improvements made as a result of patient and staff feedback. These included changes to the waiting areas, such as upgrading the check-in screen in reception to a touch-free machine to improve infection control, adding a BMI (Body Mass Index) and BP (Blood Pressure) machine, and installing a digital display to inform patients of the current waiting time. Online booking for cervical screening was introduced, as well as extending the length of time in advance patients could book appointments for B12 injections. Investigations were comprehensive and smaller, informal suggestions were acted on too, such as moving the location of posters to make them more noticeable, and changing the type of cups used in the water dispenser. Following feedback from reception staff about the stressful nature of the role, changes were made to rotate staff between reception and administrative duties more frequently, and steps were taken so reception staff had more time on breaks to eat and make drinks.

The service was good at ensuring people could access the care, support and treatment they needed when they needed it. The practice operated a triage system in which a duty team of 2 Advanced Nurse Practitioners and 1 GP assessed patients who called and gave them an appointment at the nearest available opportunity on the day, up to 6.30pm. Clinics were structured flexibly so that patients who needed appointments more urgently could be offered them right away. We were told that this meant patients were never told there were no appointments available or to call back at another time. Demand was monitored closely at all times, and had been regularly monitored since the covid pandemic so that more staff could be added when needed. The practice had recruited additional staff to ensure there were enough clinicians to manage demand. We checked the appointment system in real time on the day of the inspection and saw patients being booked in at a time that suited them. We also saw there were multiple appointment slots left in the day for those who needed them. For those who were not deemed in need of an urgent appointment, they could either be immediately signposted to another service over the phone by the clinician or offered a routine appointment at another time. We saw there were appointments available within the next 7 days for those patients. Feedback from patients was highly positive about access, and data from the National GP Patient Survey showed that 86% of respondents were offered a choice of time or day when they last tried to make a general practice appointment, which was higher than the local average of 59% and the national average of 54%.

Staff understood the importance of providing an inclusive approach to care and aimed to ensure equity in people’s experiences and outcomes. People could access the service to suit their needs for example online, in person and by telephone. Patients were asked by staff at Reception and Nurse Reception if they needed any assistance in setting up the NHS App in order to access services. The National GP Patient survey indicated that 87% of patients found the app easy to use, which was higher than the 49% national average and 54% local average. It also showed that 80% of patients found it easy to access the practice by phone, compared to 57% of patients locally and 53% nationally.

There were extended appointments for people with a learning disability. Treatment rooms were on the ground floor and the entire practice was level access with no steps.

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

Feedback provided by people using the service, both to the provider as well as to CQC, was positive. Staff treated people equally and without discrimination. Leaders proactively sought ways to address any barriers to improving people’s experience and worked with local organisations, including within the voluntary sector, to address any local health inequalities. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience 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. Staff used appropriate systems to capture and review feedback from people using the service, including those who did not speak English or have access to the internet. Those with no fixed abode could register the practice as their address in order that they could access secondary care.

The practice proactively sought out ways to address barriers to improve people’s experience, act on information about people's experiences and outcomes, and allocate resources and opportunities to achieve equity. For example, the practice had identified that Ukrainian patients made up their largest non-English speaking cohort and invested in translation machines at reception in order to help them communicate with staff.

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 cardiopulmonary resuscitation. This information was shared with other services when necessary. The practice introduced a yellow envelope for DNACPR documentation to make it clearer to clinicians so that it was less likely to be missed when reviewing records.