Merridale Medical Centre - RP Tew

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 practice made sure people were at the centre of their care and treatment choices. Patients had access to appointments provided by a range of clinicians. The practice used patient feedback to identify areas for improvement and made necessary adjustments to ensure patient care was optimum. For example, reception staff had been care-navigation trained to ensure that each patient received the appropriate care from the appropriate clinician or service.

Data from the National Patient Survey showed that 83% of respondents felt theywere involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment, which was slightly below than the national average of 91%. Friends and Family Test data was reviewed monthly and was showcased in an area of the patient waiting room. The latest Friends and Family Test data found 73% of patients surveyed said they found their care at the practice to be either ‘Very Good’ or ‘Good.’

We also spoke with 10 patients and asked for their feedback about the care they received from the practice. The vast majority of patients we spoke with told us they felt listened to, involved in their care, and treated as individuals.

National GP Patient Survey results highlighted 59% of patients felt they have had enough support from local services or organisations in the last 12 months to help manage their long-term conditions or illnesses which was lower than the national average of 69%.

The practice understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. The practice worked in partnership with other services to endeavour to meet the needs of its patient population.

For example, the practice held regular multi-disciplinary team meetings with other healthcare professionals; and information about patients’ care and treatment needs were available to share between services as required. The practice gave us examples of over 20 community services they worked closely with to help patients manage their long-term conditions and other health needs, including: Interface Clinical Services, Befriending services, Age Concern, Turning Point, Veteran Society, Bereavement Support, Action Deafness, Be-Inspired and Manor House Food Bank. Staff also provided us with evidence of the use of the ‘Joy App’ which is a digital platform designed to enhance social prescribing by connecting healthcare professionals and patients with local services to improve well-being and reduce isolation.

The practice supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Information provided by the service met the Accessible Information Standard. The practice had access to interpreter services, including British Sign Language. Patients were informed about how to access their care records. If patients had difficulty using digital services, patients could be referred to the social prescriber to support patients, providing online inclusivity. A range of health and wellbeing leaflets and posters were on display in the waiting area for patient information.

88% of respondents from the National GP Patient Survey Data felt the healthcare professional they saw had all the information they needed about them during their last general practice appointment.

The practice website was available in different languages and included information about how to make a complaint. The practice had a complaints policy, and the Operations Manager was the lead for handling complaints. Patients were signposted to the Parliamentary and Health Service Ombudsman (PHSO) if they were not satisfied with the outcome of the complaint. The practice had received 12 complaints in the last 12 months and we found they had been addressed appropriately.

Complaints were discussed during practice meetings and the lessons learnt were shared with staff. Staff shared an example of learning from a complaint relating to the nasal flu vaccination. Learning as a result of this complaint included any patients telephoning to make an appointment for a flu vaccination are now asked by staff if they have any religious reasons to make them unsuitable for the nasal vaccination which contains gelatine. In addition, nursing staff are also now prompted to ask this question also before administering this vaccine to patients.

The practice made it easy for people to share feedback and ideas about their care and treatment. Feedback could be given verbally or written. Patients were encouraged to leave feedback, and we saw a patient feedback and suggestions box on the reception desk counter was available for patients to share their views. The practice had a complaints policy. We saw complaints were discussed and reviewed to improve the quality of care. Learning was shared with staff to ensure improvements were made.

We discussed with leaders changes that had been made as a result of feedback from patients. Staff told us they had reviewed the telephone system and had introduced a call-back function; between 8am and 10am all non-clinical staff are instructed to answer the practice telephones to accommodate the busy periods; and telephone statistics are now analysed on a monthly basis to monitor the telephone system. In addition, in response to patient feedback, the practice was in the process of recruiting another GP to the practice team.

The practice listened to patient preferences when making decisions about their care. The NHS National Patient Survey data reported 83%of respondents said the healthcare professional they saw or spoke to was good at listening to them during their last general practice appointment, which was in line with the national average of 87%.

The practice was open from 8.00am to 18:30pm Monday to Friday. Patients could receive extended access appointment at the practice Monday to Thursday from 18:30pm to 20:00pm. On Friday patients could receive extended access appointments at a local surgery within the Primary Care Network (PCN) between 18:30pm to 20:00pm; and 9:00am to 17:00pm on Saturday.

Various appointment types were available such as in person, online or telephone consultations. A duty GP was available to assist in the patient triage process.

As part of our assessment, we spoke with 10 patients and asked for their feedback on their experience of access to the service. The feedback we received was mixed. Some patients were positive about their experience accessing appointments whereas some patients expressed difficulty in getting appointments and dissatisfaction with the process of telephoning the practice at 8am to request an appointment.

We also reviewed data from the National GP Patient Survey relating to patient access to the service. Whilst the practice data was mostly in line with national data, the majority of access statistics were below 50%. For example:

46% of respondents found it easy to contact the practice by telephone compared to the national average of 53%.

37%of respondents said they usually got to see or speak to their preferred healthcare professional when they would like to, compared to the national average of 40%.

40% of respondents found it easy to contact the practice by their website, which was below the national average of 51%.

38% of respondents found it easy to contact the practice by the NHS app, which was below the national average of 49%.

71%of respondents however felt they waited about the right amount of time for their last general practice appointment, compared to the national average of 67%.

We discussed access with leaders and the challenges related to patient access. Staff explained they had experienced patients from eastern European countries requesting all of their appointments to be with a “GP” and so the practice had been working on patient education about the other services available from the variety of healthcare professionals at the practice.

The practice was accessible for wheelchair users, and all consultation rooms were accessible on the ground floor. Disabled toilets were available as well as baby feeding and changing facilities. There was a car park on site with designated disabled parking spaces.

Staff treated people equally, without discrimination. 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 proactively sought ways to address any barriers to improve people’s experiences. For example, as an accredited Veteran Friendly Practice, they demonstrated a proactive approach to supporting former members of the armed forces.

Processes were in place to ensure vulnerable people could register at the practice such as homeless people and Travellers.

For patients with learning disabilities, the practice had a Learning Disability Champion who worked to get to know patients and their carers and act as a point of contact for them within the practice and assist with accessing external resources for them. Staff told us extended appointments were available for patients with learning disabilities and staff endeavoured to try to meet as many needs of these patients in 1 visit. We saw there were sensory packs available for patients who needed them and patients could access quieter areas in the practice if required. Leaders told us having a nominated Learning Disabilities Champion had been beneficial in the practice and staff had found patients attended the practice more frequently for appointments and health checks as a result.

For patients with visual impairments, the practice used ‘Vista’ as a resource as needed. Vista is a charity supporting people living with sight or dual sensory loss in Leicester, Leicestershire and Rutland. Leaders told us documentation in braille could be resourced for patients as required; guide dogs were welcome within the practice; and staff assisted patients by making verbal announcements in the waiting area for their appointments and escorting them to and from the consultation rooms.

For patients with hearing impairments, we saw the practice was equipped with a hearing loop system. For patients whose first language was not English, the practice was able to access interpreting services for them.

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. Palliative patients were able to have home visits and care packages to ensure their wishes were followed and carried out in their final stages of life.