Ledbury Health Partnership

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. This is the first inspection for this service since the two practices merged. This key question has been rated as good.

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 practice made sure people were at the centre of their care and treatment choices. The practice worked in partnership with other organisations to decide how best to respond to any relevant changes in patient’s needs. Patients had access to appointments provided by a range of professionals. The practice used patient feedback to identify areas for improvement and made necessary adjustments to ensure patient care was optimum. The patient participation group (PPG) were positive about their involvement with the practice and assured us any suggestions were taken seriously to improve patient care. The PPG helped with flu and covid clinics and attended a digital café to support patients. Patients were able to provide feedback through our ‘Give Feedback on Care’ process and told us the practice considered their individual needs by providing blood test results on paper.

The practice understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. 20%of respondents to the National GP Patient Survey felt they usually got to see or speak to their preferred healthcare professional which was lower than the local average of 42% and national average of 40%. The practice worked in partnership with other services to meet the needs of its patient population. The practice provided care for those in care homes, the same GP would attend the care home to build a better relationship with the patients and truly understand their needs. Information about patients care and treatment needs was available to share between services as required. 85%of respondents to the National GP Patient Survey felt the healthcare professional they saw had all the information they needed about them during their last general practice appointment, which was lower than the local average of 93% and national average of 92%. They tailored their services to meet the diverse needs of patients and promoted health education and preventative care initiatives. National GP Patient Survey results highlighted 69% of respondents felt they had enough support from local services or organisations in the last 12 months to help manage their long-term conditions or illnesses which was lower than the local average of 72% and in line with the national average at 69%.

The practice supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Information provided by the service met the Accessible Information Standard. A hearing loop was present. The practice had access to interpreter services, including British Sign Language. The practice website was available in different languages and included information about how to make a complaint. A range of health and wellbeing leaflets and posters were on display in different languages. The practice posted articles in their local free magazines that gave updates about the practice including staff or system changes and promoted flu clinics. The patient participant group created a newsletter in paper format available in waiting rooms and was published on the website to inform patients of practice updates and health information. Patients gave feedback through our ‘Give Feedback on Care’ process and told us that they were given clear explanations about their treatment and choices in a way they understood. Patients were informed about how to access their care records. Information about how to make a complaint was accessible. The practice had a complaints policy however, the complaint responses were not in line with this policy. Patients were not always given the necessary information about contacting the Parliamentary and Health Service Ombudsman (PHSO) if they were left unsatisfied with the practice’s response. The lessons learnt from complaints were noted and accessible to all staff on the shared drive. Following the site visit, the practice created complaint templates that included all necessary information including PHSO contact details to ensure all patients receive the required information in line with their policy.

People were encouraged to leave feedback and share ideas about their care and treatment. The practice involved people and listened to their preferences when making decisions. Feedback could be given verbally or written. Positive changes were made following feedback. For example, the plastic chairs in the waiting area were replaced with padded comfortable chairs. Patient feedback was mixed about the new online total triage system, so the practice worked with patient participation group (PPG) to create a ‘how to guide’ and promoted the idea that patients can ask for help if needed. The PPG regularly visited the practice to speak with patients to gather their feedback. The practice held quarterly meetings with the PPG as an opportunity for the PPG to share the views of others. The PPG told us they had a good relationship with the practice and felt listened to and involved in decision making. Complaints were discussed and reviewed to improve the quality of care. NHS Friends and Family Test feedback was regularly reviewed. The National Patient Survey data reported that 85%of respondents said the healthcare professional they saw or spoke to was good at listening to them during their last general practice appointment, which was lower than the local average of 89% and the national average of 87%.

Data from the National GP Patient Survey highlighted that the practice scored lower than the local and national average for all questions related to access. 40% of respondents found it easy to contact the practice by telephone, in comparison to the local average of 61% and national average of 53%. 42% of respondents found it easy to contact the practice by their website, in comparison to the local average of 59% and national average of 51%. 31% of respondents found it easy to contact the practice by the NHS app, in comparison to the local average of 58% and national average of 49%. 78% of respondents found the receptionists helpful, in comparison to the local average of 88% and national average of 83%. To address this feedback, the practice engaged with the patient participation group to develop a survey. 251 patients were surveyed, in comparison to the 107 patients that completed the National GP Patient Survey. Results from their own survey showed that 70% of patients surveyed had no problems contacting the practice which shows significant improvement. The practice also introduced a total triage system. This new system provided data dashboards to enable better workforce planning and understand patient needs. By submitting queries online, phone call waiting time had reduced, urgent cases received faster responses and patients were booked with the appropriate professional, improving overall patient experience. Various appointment types were available such as in person, online and telephone consultations. The practice made sure that people could access the care, support and treatment they needed when they needed it. The practice was open from 8.00 am to 6.30 pm Monday to Friday, with access to out of hours services provided by Taurus Healthcare. The practice promoted the use of the self-check in screen to enable receptionists to dedicate time to phone calls. The NHS App was also encouraged, and support was provided by the patient participant group for those that struggled with technology. The practice was accessible for wheelchair users. The practice had converted part of the waiting room and a storage room into 2 additional clinical rooms and an office. There was a car park on site with designated disabled parking spaces.

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. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. Staff treated people equally, without discrimination. Leaders proactively sought ways to address any barriers to improve people’s experiences. For example, the practice was modified to become sensory friendly, and printed newsletters that included health information and practice updates and handed them out locally. Health information was also accessible in the waiting areas and was available in different languages. The practice had processes in place to ensure vulnerable people such as homeless patients or Travellers could register at the practice. Staff used appropriate systems to capture and review feedback from people using the service, including those who 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. Our records review showed people were supported to consider their wishes for their end-of-life care. Staff spoke with kindness and compassion about how the information for Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) forms was gathered. They documented decisions made by patients about cardiopulmonary resuscitation on these ReSPECT forms and patient records and ensured these were regularly reviewed and updated. This information was shared with other services when necessary. Palliative patients were discussed during monthly multi-disciplinary meetings.