The Nile 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

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 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.

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. This was supported by the National GP Survey which showed that 93% of respondents stated that during their last appointment they were involved as much as they wanted to be in decisions about their care and treatment. This was comparable with the national average of 91%.

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.

The practice worked in partnership with other services to meet the needs of its patient population. For example, the Primary Care Network and the palliative care team. The practice had tailored its services to meet the diverse needs of its community. For example, people with a learning disability were provided with easy read invite letters and provided with home visits if they were unable to attend the practice. Systems were in place to support people with gender transition

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 were available in the waiting rooms. The practice had access to interpreter services, including British Sign Language. Information provided by the service met the Accessible Information Standard. Patients were informed as to how to access their care records.

To support people who struggled to understand or navigate digital technology and the internet, digital champions had supported people to access information through the NHS app. The service planned to repeat this service for people.

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. A member of the Patient Participation Group (PPG) told us that their views were listened to and acted on. Data from the GP Patient Survey showed that 81% of respondents stated that during their last appointment, the healthcare professional was very good or fairly good at listening to them. This was comparable with the national average of 87%.

Verbal and written complaints were managed in line with the practice’s policy. Learning from complaints was evident and learning was shared with staff at team meetings. Staff were able to identify changes made as a result of patient feedback, including complaints. For example, following a complaint regarding the treatment provided for a skin condition, training was provided on the different rashes clinicians may see.

The service was good at ensuring people could access the care, support and treatment they needed when they needed it. People could access the service to suit their needs for example, through the NHS app, website, over the telephone or in person. People could pre-book appointments, either face to face or via the telephone, 2 weeks in advance with a GP and 4 weeks in advance with a nurse. Pre-bookable appointments were also available on Tuesday and Thursday evenings. We reviewed the appointment log and found that waiting times for appointments was 1 week. For more urgent appointments, people could call for on the day appointments. The service had recently introduced a duty doctor system to support with on the day appointments. The service also had access to the winter pressure clinic appointments and extended access appointments.

Patient satisfaction with access to appointments was very good. Data from the GP Patient Survey showed that 78% of respondents responded positively to their overall experience of contacting their GP practice. This was comparable with the national average of 70%. Data also showed that 72% of respondents felt positive to how easy it was to contact their GP practice on the phone. This was above the national average of 53%.

There was level access to the practices and automatic door entrance. Treatment rooms were available on the ground floor.

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.

Feedback through the Friends and Family test was very positive. Feedback from some of the patients showed that staff members invested time in understanding peoples’ needs and provided support when required. Staff treated people equally and without discrimination. Leaders proactively sought ways to address any barriers to improving people’s experience. For example, home visits for housebound people with a long-term condition and longer appointments for people whose first language was not English.

Staff understood the importance of providing an inclusive approach to care and adjusted support equity in people’s experience and outcomes.

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.

Regular meetings with the wider multi-disciplinary team meetings were held to discuss the care of this group of people. 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. We found that Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions were appropriately completed when put in place by GPs although systems for reviewing them was not in place. When DNACPR decisions were made in hospitals however, a copy was not retained in the patients’ GP records.