Wrenbury Medical Practice

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

Staff used innovative and personalised approaches to involve people, their families, friends, and carers in care, treatment, and support planning. As a result, people felt consulted, empowered, listened to, and valued. Staff were trained to direct people to the most appropriate clinician or service to meet their needs and clinicians were available to see people on-the-day for all types of appointment requests.

Feedback highlighted that staff had an exceptional understanding of individuals’ needs, including those related to protected characteristics, social and cultural backgrounds, and personal values and beliefs that shaped how they wished to receive care. According to results from the GP patient survey, the service was always easy to access. Of those patients who responded 99% found it easy to get through to the practice by phone, 79% found it easy to contact using their website and 86% found it easy to contact using the NHS app. In addition, 99% found the reception and administrative team helpful and 84% usually got to see or speak to their preferred healthcare professional. All these results far exceeded local and national averages, in some cases by more than 40%.

This service scored 96 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We saw the use of innovative and individualised ways of involving people and their families and carers in their care and treatment, such as educational events that included the wider community. The service continually ensured that 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 more than 650 people who responded directly to CQC said they were well supported to understand their condition and felt involved in decisions about their care and treatment and in planning for their future needs. We reviewed 12 months of data from the Friends and Family Test, with an average of approximately 330 patient responses each month. The vast majority of feedback was rated as either "good" or "very good." Over the entire year, only 20 responses were rated as "neither good nor poor," and just 6 responses were marked as "poor" or "very poor. We also saw many written letters of thanks. Feedback included phrases like no faults whatsoever, polite and caring, a great sense of humour, didn’t reel rushed, efficient and thorough, very lucky to have and second to none.

The National GP patient survey results showed that the practice exceeded local and national averages in all areas. 83% of people who responded to the survey (42% completion rate) felt they had enough support from local services or organisations in the last 12 months to help them manage their long-term conditions. 98% felt they were involved as much as they wanted to be. 98% had confidence and trust in the healthcare professional they spoke to and 97% felt their needs were met during their last appointment.

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 person centred approach to their work and we observed staff who were supportive of patients during our assessment. 99% of people who responded to the National GP patient survey said they found the reception and administration team helpful, which was above local and national averages of 84% and national average of 83%. We spoke to 4 people who used the service and they were complementary about the way staff had taken the time to make sure their needs were met holistically.

We saw how the diverse health and care needs of people and local communities played a pivotal role in the design of care provision, so that care was joined-up, flexible and supported choice and continuity. The practice worked in partnership with many other services to meet the needs of its patient population. Eight partner organisations that we contacted took the time to feedback directly to CQC about the productive interactions and positive relationships they had with the GP practice. One organisation described excellent interaction across all roles within the surgery and said nothing was ever too much trouble. This organisation quantified how their collaboration with the practice enabled patients and their families to have a seamless service with avoidance of unnecessary or inappropriate admission to hospital or hospice.

The clinical staff team was constant with limited requirements for locum staff. However, when locum staff were used, they were longstanding. We observed the appointment system with staff who demonstrated how people were able to request and see the same healthcare professional and continuity of care was encouraged. Staff had forged excellent working relationships with many multi-disciplinary professionals to meet the needs of patients and all staff we spoke with were familiar with the patients who attended the practice.

Our review of the clinical system demonstrated that 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, and was able to demonstrate how they encouraged patients to attend for follow up appointments, screening programmes and child immunisation uptake. The provider worked closely with the Primary Care Network (PCN) and also helped to plan, develop and deliver services across the locality with a view to improving patient satisfaction.

We saw that people were provided with a range of accessible information about their care, treatments, and support, including how to keep themselves safe and how to report any concerns. The practice website was very user-friendly and included a wide range of information, such as how to arrange transport, and how to access local charities, support services, and other local providers like dentists and eye care services. This information was also available in the reception area.

People could choose to receive notifications with information about their care or specific conditions. If information was not readily available, the service worked with other professionals and stakeholders to fill any gaps and help people make informed decisions. This approach was supported by the positive feedback we received from all partner organisations.

The provider used systems that shared patient information effectively across services. Safety netting advice was given when patients were at risk of deterioration.

Feedback from people who responded to the National GP Patient Survey showed that 99% knew what the next step would be after contacting their GP practice. This was significantly higher than the local and national results of 82% and 83%. 94% knew within two days of contact.

Interpreter services were available for people who did not speak English as their first language. The practice website also featured NHS information about health conditions and available support services.

The service was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. More than 650 patients who responded directly to CQC, in addition to 12 months of Friends and Family data demonstrated positive responses about feeling involved in decisions about their care and treatment.

Responses to the National GP Patient Survey were also extremely positive in this area. 98% were involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment exceeding local and national results. 96%said the healthcare professional they saw or spoke to was good at listening to them during their last general practice appointment.

The practice demonstrated the importance of listening to all feedback which was included for discussion every month at practice learning events where the minimal negative responses were shared and discussed in an effort to make improvement. We saw evidence that even the smallest concerns led to changes, simply because one person, or a group, felt it was important enough to share their feedback.

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. People were encouraged to write in to the practice if they wished to complain about their care, treatment and support, and complaints were responded to appropriately with a full response and an apology. Equally, reception staff and dispensary staff in particular, told us how they dealt with people’s concerns on a daily basis and reacted to concerns before they escalated. This verbal feedback was also documented to enable the practice to manage trends.

The practice recognised the growing complexity of patients in a local nursing home and responded by allocating dedicated GP time to improve care planning and strengthen joint working. Monthly palliative care MDT meetings were introduced at the home, ensuring residents' needs were regularly reviewed in a structured, collaborative way. Feedback from nursing home staff led to the adoption of a clearer, regionally used personalised care plan. This made treatment escalation decisions easier and ensured alignment between the practice, care staff, and families. The plan was updated regularly and well received by all involved. Education sessions were delivered in response to staff requests, covering key topics like end-of-life care and treatment planning. These sessions shaped further practice improvements. A palliative care coding system was co-developed and embedded across both the nursing home and practice systems, enabling clear tracking and shared understanding of patient status. Joint clinics and coordinated vaccination programmes further strengthened proactive, integrated care. As a result of the Collaborative Practice and Nursing Home Project the Nursing Home have now been short listed for an award.

The provider demonstrated how people who may face barriers based on their protected characteristics could access the care, support and treatment they needed when they needed it. They accessed this in a way that worked for them, promoting equality, and removing barriers or delays. Services were designed to make them accessible and timely for people who were most likely to have difficulty accessing care. When there were barriers, they were removed. Patients at high risk of admission or frequent attenders at accident and emergency were identified, and received targeted input.

As a dispensing practice they offered a small home delivery service to patients with difficulty accessing care, support or treatment. They worked closely with the End of Life Partnership and were currently providing a 6 week programme to support their carer patients on patients with Dementia. They scheduled 30 minute appointments for immunisation clinics to support parents and children and ensure there was enough time for all needs to be identified and met.

The provider prioritised and allocated resources and opportunities as needed to tackle inequalities and achieve equity of access. They were Veteran Friendly and recently contacted their entire patient list to complete a short questionnaire regarding military veteran status. Those patients identified from the questionnaire had been coded so as to reinforce their awareness of services available to support them.

The practice offered 132 appointments per 1,000 which was significantly above the Cheshire East (CE) average of 106 appointments. Their delivery of face to face appointments was 73%, higher than the CE average of 62% and the average ‘booked to seen time’ was 9.8 days again exceeding the CE average of 11.4 days.

Leaders and staff prevented discrimination and inequality that could disadvantage distinct groups of people using their services, whether from wider society, organisational processes and culture or from individuals. They proactively sought out ways to address those barriers to improve people’s experience, act on information about people's experiences and outcomes and allocate resources and opportunities to achieve equity. People’s care, treatment and support promoted equality, removed barriers or delays and protected their rights. For example, appointments for patients with a learning disability were structured and arranged to meet their needs and this was demonstrated by the fact that all patients on the learning disability register had attended for their annual review this year. We saw how the practice supported the transient community by inviting members in to educate staff about their specific needs.

People felt empowered by the service and its staff to give their views and understood their rights, including their rights to equality and their human rights. People knew their experiences of discrimination and inequality would be used to inform improvements of care and we saw that the practice shared and promoted best practice with other organisations. These shared initiatives were then used across the wider region.

The results of the National GP Patient Survey showed that 97%of respondents felt their needs were met during their last general practice appointment compared with 81% and 90% locally and nationally respective. 99% described their overall experience of the practice as good, which exceeded local and national averages of 76% and 74%, respectively.

The provider and leaders within the practice demonstrated exceptional skills and commitment in helping people, their families and/or carers to explore and record their wishes about care at the end of their lives and to plan how those would be met. We saw testimonials from patients where they said they felt consulted, listened to and valued.

We saw that people’s needs were prioritised as part of the end-of-life care plan and these had taken account of ability to understand and capacity to make best interest decisions.

People’s needs had been prioritised as part of the end-of-life care plan and this had taken account of language, communication, ability to understand and capacity when decisions were made. It also took account of people’s desire to remain in their own homes for as long as possible, regardless of where that home was. There were members of staff with specific skills to understand and meet the needs of people and their families in relation to emotional support and the practical assistance they needed at the end of the person’s life. A testimonial from a partner organisation described the practice staff as extremely responsive and said that nothing was too much trouble.

There were strong support and wellbeing arrangements in place for staff when impacted by the death of people they cared for.