Old Bridge 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.
People were involved in decisions about their care. The service provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. 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.
 

This service scored 75 (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.
Staff demonstrated a person-centred approach to identifying when people required individualised support. For example, staff had identified that an individual required additional support and took proactive steps to ensure they could access the necessary services. A further example highlighted how staff responded sensitively to a person’s priorities during an emergency hospital admission. Staff had recognised the importance of the person’s pet and arranged for its care, demonstrating a compassionate and holistic understanding of what mattered most to the individual.
These examples reflect a culture of responsiveness and person-centred practice, where staff are empowered to act in the best interests of those they support.
 

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. For example, where the service takes part in a multiprofessional meetings to support individuals with their mental health.
We evidenced the practice worked in partnership with other services to meet the needs of its patient population. This included working with local community volunteer groups and schools to deliver mass covid and flu vaccine clinics, resulting in vaccines being delivered in an efficient and accessible way.
The practice had tailored its services to meet the diverse needs of its community, for example, building relationships with community groups to help facilitating of screening programmes.
 

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.
Staff were able to describe the process for accessing translation services and gave an example of a booked appointment where interpretation support had been arranged.
Information was readily available throughout the practice in a variety of formats. Visual displays, including a TV screen in the waiting area, provided up-to-date information about the practice, health campaigns, and available services. A blood pressure machine was accessible for patients to use independently, supporting self-monitoring and promoting health awareness.
Printed materials were visible and relevant, including leaflets and posters offering support for veterans, sexual health services, and sepsis awareness.
Patient feedback mechanisms were in place, including forms available in the practice and digital surveys sent via SMS following appointments.
The practice website contained health promotion information, including details on NHS Health Checks, screening programmes, maternity care, and contraception. This supported patients in understanding their health needs and accessing preventative services.
 

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 formal complaints policy was in place and understood by staff. Complaints were investigated thoroughly, and outcomes were communicated clearly. Feedback from the PPG indicated a desire for greater transparency around complaints, particularly regarding outcomes and learning.
The service had systems to recognise and support carers. People’s records included pop-up alerts to identify carers, and staff sought consent from people to engage with their carers appropriately. People were able to self-identify as carers.
Feedback from the PPG was mixed but constructive. The service was responsive to requests for data and communication, often replying promptly to messages. However, the PPG expressed a desire for more structured communication and updates, noting that the practice had decreased the frequency of newsletters, which were deemed as helpful.

The service made sure that people could access the care, support and treatment they needed when they needed it.
The service monitored appointment type capacity and adjusted availability based on demand. The practice manager actively tracked how many appointments were available on specific days and made changes accordingly to improve access. The service had introduced a remote GP service to be able to increase capacity of appointments.
Feedback from the CQC Give Feedback on Care (GFOC) system highlighted ongoing challenges. Six patients reported long phone queues, limited appointment availability, and frustration with the booking system. The service was aware of telephone waiting times and was actively monitoring these, recent improvements had been noted.
Other patients reported positive experiences with access to appointments and referrals and commented “I have never had a problem getting an appointment.”, “They have always been very prompt in arranging appointments and referrals.”
These mixed experiences suggest that whilst the service had made efforts to ensure equity in access, ongoing improvements were needed to address delays, telephone system pressures.
The GPPS data reflected;
• 78.2% of people responded positively to the overall experience of contacting their GP practice.
• 64.7% of people responded positively to how easy it was to contact their GP practice on the phone.
These results were above national expectations.

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.
The service recognised the demographics of the community, which included a high proportion of individuals who may be digitally excluded. Based on this, the service decided to avoid digital triage systems. Instead, patients were able to access care via telephone and walk-in appointments, ensuring that those without digital literacy or access were not disadvantaged. Staff also told us that people could register with the service in person or through alternative channels, supporting inclusive access.
To address digital exclusion, the practice arranged additional training to help patients use the NHS App, supporting those who wished to engage digitally but required assistance.
Feedback provided by people using the service relating to equity in experiences was mixed.
Patients commented “I have not seen a doctor in person in the 5 years since we moved and joined the practice.” ‘’The last two occasions I requested an appointment to see a doctor I was told by the receptionist that I was unable to see a doctor face to face.”
Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. The service had processes to ensure people could register at the practice, including those in vulnerable circumstances or requiring additional assistance.
 

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.
Clinical records documented a do not attempt cardiopulmonary resuscitation (DNACPR) decision when it had been made. A sample of these were reviewed and were found to be in line with legislation. Where the service was able to, they provided continuity of care for people at the end of their life by providing a named GP.