Carn to Coast Health Centres

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 assessed all quality statements in the responsive key question. Our rating for this key question is now good. People were involved in decisions about their care. The service provided information people could understand. People received fair and equal care and treatment and the service worked to eliminate discrimination. The service worked to reduce health and care inequalities through training and feedback. People were involved in planning their care and understood options around choosing to withdraw or not receive care. The service understood their patient population. Changes were identified to improve the service where required. Although the service closely monitored their appointment management system, we saw some people were waiting an extended period of time to get an appointment.

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 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 people including those related to protected characteristics under the Equality Act. For example, people’s care records identified if they had a hearing impairment which indicated to staff reviewing their appointment request, they may require additional support to attend. Arrangements could then be made for a sign language interpreter to attend the appointment. Our review of clinical records showed people were supported to understand their condition and were involved in planning for their care needs. They were also involved in decisions about their care.

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, having a team of social prescribers that were familiar with local community groups. Systems and processes supported people through a multi-disciplinary approach. We saw the practice worked in partnership with other services to meet the needs of its patient population.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Information to promote the take up of screening and immunisation programmes was available in a range of languages. For example, translated cervical screening leaflets are sent via text to people whose first language is not English. The practice’s website contains accessibility information and asks people to tell the service if they found it hard to read letters, wanted to be accompanied to their appointment or needed information provided in braille. People were informed as to how to access their care records.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result. The service had a dedicated Patient Advice and Liaison Officer who supported the complaints lead to investigate complaints and coordinate investigations. They were happy to speak to people who had raised complaints so they could be looked into and where appropriate, investigate and identify learning. We saw complaints were managed in line with the practice’s policy. Learning from complaints was evident and staff were able to identify changes made following patient feedback, including complaints. The service had conducted its own patient feedback survey following the poor uptake and results of the most recent National GP Patient Survey. At the time of this inspection, the service had reviewed the responses to their own survey and recommendations had been identified.

In response to the National GP Patient Survey data and from feedback from members of the community, the service had identified changes to improve access to the service. People could access the service to suit their needs for example online, in person and by telephone. Treatment rooms were available on the ground floor and some of the premises were accessed with a ramp and automatic entrance door. Appointments could be allocated to the most suitably accessible or preferred building. The service had a cloud-based telephony system to support people accessing the service by phone and an appointment management system to triage requests for appointments and prioritise those that needed to be seen urgently. We saw significant waits for people who had requested an appointment and had been triaged as non-urgent. For example, one patient had been waiting for an appointment since January 2025. We received mixed feedback from patients. One told us ‘Klinik [online appointment request form] service often closed or at capacity. Website says calls will still be answered but those are often at capacity too so you get a message saying try later. If you do get a person they tell you to go through Klinik. If you manage to get through Klinik you may not hear anything for several days and then get a text saying someone will be in touch... or you get an appointment months later’. The service told us they were aware of this issue and regularly reviewed their appointment management system to ensure it was not risking patient safety. 58% of the concerns people shared with us specifically mentioned poor access. However, we also received some positive comments, someone else told us ‘I have regular appointments with a named GP. When I am in need I always get a timely appointment’.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. A care home told us they struggled to support people living in the community to access the service and escalate their concerns. We asked the service about this, and they advised there was a dedicated phoneline for partner services and they could also indicate they are a care home on the online appointment request form. Although access was a clear challenge, feedback provided by people about their experience using the service, both to the service 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. A GP at the service had delivered a training session to all staff about the challenges faced by some of the people that lived in areas of high deprivation. The service had processes to ensure people could register at the practice, including those in vulnerable circumstances. Staff used appropriate systems to capture and review feedback from people using the service, including those who did not speak English or did not 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. The records we viewed showed people were supported to consider their wishes for their end-of-life care, including cardiopulmonary resuscitation and this was recorded on a Treatment Escalation Plan (TEP). People’s wishes were recorded on their care record and shared with other appropriate services. Where someone lacked capacity to make a decision about their care and treatment, we saw appropriate assessments had been carried out and people important to the patient were consulted.