Catterick Village Surgery

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 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Catterick Village Surgery was exceptional at making sure patients were at the centre of their care and treatment choices. They decided, in partnership with patients, how to respond to any relevant changes in people’s needs.

One leader told us, “My role in caring for [patient] highlighted to me the need to have your patient at the centre of your decision making especially when we are asked to advocate for our patients less able to speak for themselves…”

We reviewed multiple examples where staff had gone above and beyond their usual duties to support patients in need, taking people’s personal circumstances into account when helping them.

Reception staff were as flexible as possible to accommodate patients, especially those who struggled to understand the usual access routes. They ensured patients with more complex and urgent needs were reviewed by clinical staff as soon as possible. For patients who struggled to remember to attend their appointment, staff called ahead to remind them.

Staff collaborated with people’s carers, advocates and family members to provide care which best suited their needs.

The practice offered patients a choice of clinician, longer appointments where needed, and clear, reassuring communication during consultations.

We received a lot of positive feedback from patients about the care provided by Catterick Village Surgery. Some examples are:

“The practice is excellent, and I feel that patients are treated well, with quite a personal ‘service’.”

“…we have enjoyed the best of the best in terms of care and diligence from all staff including the receptionists at both surgeries. I have found that the explanations and the time allowed to give those explanations with regards to any / all medical issues or questions to be second to none.”

“Most recently I attended for an annual review and the service I received from the receptionist [name] through to the clinician [name] was person centred, flexible (I was running slightly late due to unforeseen circumstances however, this was politely accommodated and ensured that I nor other patients were inconvenienced) and kind and supportive....”

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

Due to the practice’s elderly population and high proportion of people who were frail, staff did a lot of work to help these patients and ensure they had the support in place they needed.

Staff attended regular meetings to discuss and arrange support for patients with more complex needs. They made timely referrals to partner organisations to ensure patients received advice and support from specialists when necessary. For example, the Learning Disability Specialist Team, physiotherapists, occupational therapists, the ‘Hospital at Home’ team, and the Speech and Language Team.

Staff signposted patients to local support groups and programmes available. They referred patients with social needs (such as those experiencing social isolation or housing difficulties) to a social prescribing link worker to give targeted support.

The practice supplied appropriate information in formats tailored to individual needs.

Staff identified when patients had specific information and communication needs. For example, hearing loss, visual impairment, a learning disability, or English as a second language. Staff recorded this in patient records and used digital flags to highlight people’s communication needs.

The practice could provide information in accessible formats. For example, large print, easy-read, audio or braille.

Staff accessed interpreter or sign language services if required to better communicate with patients.

However, we found the practice’s website was not fully up-to-date with access information. Access options were not always easy to find.

For example, we found the practice’s ‘Better Access’ service (providing late evening and weekend appointments) was not listed in the ‘Appointments’ section of the website, meaning information about this option was not immediately obvious to patients who need more flexibility around their appointment time.

Some negative patient feedback we reviewed about the ‘sit and wait’ appointment system indicated patients were not proactively informed about the ‘Better Access’ appointments available when these may better suit their needs.

Although patients could raise a complaint about their care and treatment with Catterick Village Surgery, we found the process to do so was not always clear, easy or well-advertised.

The practice’s website stated formal complaints should be made in writing. This could be a barrier for some people. No email address was provided to allow patients to email a complaint should they wish to do so. For patients unable to access a computer or get online, and for those unable to compose a written complaint, this could deter them from making a complaint if they wanted to.

The practice’s website did not have a complaints policy available for patients to refer to so they knew what to expect. We reviewed the practice’s ‘Complaints Procedure’. It did not set out how complaints would be managed, by whom, and within what timeframes. Leaders did not have a system in place to log and analyse any emerging themes and trends of complaints, or to ensure complaints were responded to in a timely manner.

However, we saw examples of complaints being taken seriously, investigated properly, people being listened to, and appropriate responses sent to patients.

Staff could give us multiple examples of improvements made following a patient complaint.

Catterick Village Surgery involved their Patient Participation Group (PPG) in discussions about practice issues. One PPG member told us, “Plans for change or improvement of the practice are often discussed.” Another said, “We are a small group who work with [staff member]. I personally feel that I can contact [them] anytime if I have any questions or concerns.”

Catterick Village Surgery made sure patients could access the care, support and treatment they needed when they needed it.

Premises were accessible for patients with mobility issues. There was a hearing loop for patients with hearing difficulties. Staff could access interpreter services for patients who could not speak English well (or at all) to ensure they understood and could contribute to health care decisions.

When deciding the location(s) of their service delivery, leaders considered the difficulty for some patients in being able to travel outside of their immediate local area. For example, patients who rely on (incredibly infrequent) public transport.

Staff made home visits to patients who were unable to attend the practice due to their ill health.

The practice utilised remote technology (such as online consultations) to complete regular clinical reviews of care home patients so they had access to health care. Clinical staff also completed face-to-face visits of patients in care homes to ensure their needs were being met.

Patients could attend a morning ‘sit and wait’ surgery for more urgent health concerns. For routine appointments, patients could book over the telephone, in person at the practice, or using an online form.

The practice offered additional late evening and weekend appointments via the ‘Better Access’ service to patients who struggled to attend during usual hours. However, this was not well advertised or promoted.

Most patients were positive about the access options available to them. One patient told us, “So basically I turned up with a minor injury yesterday and was referred for Xray that was taken tonight. All at my convenience. That is an excellent service...”

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

Clinical staff attended multi-disciplinary meetings (involving other healthcare professionals and community partners) to ensure more complex patients received care and support which met their needs. For example, patients who were severely frail, with a learning disability, or who were nearing the end of their life.

The practice had a GP who took the lead for patients who were frail. We reviewed multiple examples where targeted and person-centred support for frail patients prevented an inappropriate admission to hospital. They utilised established relationships with health care and community partners to ensure the best possible outcomes for their patients.

Clinical staff understood the importance of providing an inclusive approach to care. They viewed the needs of a patient holistically, considering all factors affecting their health and wellbeing overall. They made adjustments to support equity in people’s experience and outcomes.

Leaders proactively sought ways to address any barriers to improving people’s experience. They worked with local organisations, including within the voluntary sector, to address any local health inequalities.

Staff ensured patients with barriers limiting their access to health care and good outcomes had measures put in place to overcome these barriers. We reviewed action taken by staff which had increased patient safety, their access to support services, and had improved their health (and lifestyle) outcomes.

The lead GP had completed additional training and professional development to expand the scope of the practice’s delivery of women’s health services. This improved speed and ease of access, continuity of care, ongoing support and monitoring for female patients. It also reduced unnecessary referrals to secondary care services.

An advanced nurse practitioner for care homes attended a community multi-disciplinary team meeting every month to ensure there was oversight of patients who live in care homes.

Reception staff were alert to signs of patients struggling to cope. They raised concerns with the Frailty Lead GP who took appropriate action.

All staff had completed some training in supporting people with a learning disability and autistic people. Staff treated patients equally and without discrimination.

Staff routinely checked the screening and / or immunisation status of patients during consultations to offer opportunistic bookings and maximise uptake and better outcomes for people.

Patients of Catterick Village Surgery 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 about care at the end of their life.

Staff acted sensitively during difficult discussions with patients, their families and carers. One clinical staff member told us that “every effort should be made to hear the voice of our patient while including [their] family and advocates alongside this rather than in place of it.”

For patients nearing the end of their life, clinical staff developed appropriate Emergency Health Care Plans. They considered the wishes of patients regarding whether they wanted staff to attempt cardiopulmonary resuscitation (CPR) in the event their heart stopped beating and / or if they stopped breathing. This information was shared with other services when necessary.

Staff also considered the help and support needed by people caring for those patients nearing the end of their life.