The Fairfields 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 good. At this assessment, the rating remains the same with outstanding elements in the provision of person-centred care. This meant people’s needs were met through good organisation and delivery.

This service scored 79 (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 recognised the diverse population needs and fully understood their diverse practice demographic and language barriers. The practice had completed a Health Inequalities project to promote equitable healthcare for their patients. For example, invitations to smear clinics were available in different languages with appointment availability early in the morning and later in the evening to try and encourage attendance, and telephone translators were utilised where required. The practice worked with the PCN to provide outreach clinics in a local Mosque for covid vaccines. The ICB has commissioned a local specialised home visiting service for children who have not attended for their childhood immunisations. The practice refers patients to this service.Wellbeing and diet advice was adapted to reflect the diversity of cultures and diets. Quiet rooms were provided for staff for prayers, and reasonable adjustments were implemented when staff members were observing Ramadan.

Accessible standards and barriers to care were considered for people, with alerts being added to medical records, people with a sight or hearing impairment were collected from the waiting room by the clinician. Recall letters in pictorial formats were provided to people with learning disabilities and wellbeing advice was provided in appropriate formats. 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.

People’s urgent needs were responded to promptly and where appropriate people were referred to external stakeholders for further investigation within the prescribed time frames. 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. Clinicians spoke highly about effective signposting by the reception team; they felt people were directed to the right clinician the first time, which enabled them to provide effective person-centred care. For example, referring people to the pharmacy for minor illnesses.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The service had access to interpreter services, including British Sign Language. SMS texts or letters were sent to patients in their own language, or an interpreter was used to book appointments and translate during consultations. Information about the need to book for an interpreter was recorded on people’s records and additional time was provided for appointments. Staff told us they had access to services for translating documents into appropriate languages, including English. A hearing loop was also available. People were informed as to how to access their care records.

The service encouraged feedback from people and made it easy for people to share feedback and ideas in various formats, such as complaints and compliments, surveys or suggestions about their care, treatment and support. The practice told us that they actively listened to the complainants and tried to resolve issues at a local resolution stage. We saw complaints were managed in line with the service’s policy. Complaints reviewed showed the practice responded to feedback appropriately, openly and in a non-defensive manner. Learning from complaints was evident and staff were able to identify changes made as a result of patient feedback, including complaints. The service involved people in decisions about their care and told them what had changed as a result. The service routinely asked people to complete Friends and Family Test feedback forms and reviewed the feedback for any trends or themes.

The service made sure that people could access the care, support and treatment they needed when they needed it. They responded to an increase of over 1,000 patients in their list size following the closure of a nearby practice by employing 2 salaried GPs and a practice nurse to meet the additional demand.

The service provided total triage for appointments and requests, whereby people telephoned, attended reception in person or submitted their request online.GPs were responsible for triaging the information. People were offered an appointment appropriate for their assessed need or directed to an alternative service, for example, pharmacist, health visitor or dentist, dependent upon the person’s problem. People who required routine appointments outside of the usual working hours had access to evening and weekend appointments. These appointments were booked on behalf of people by the service. Housebound people were offered home visits for consultations, blood tests and foot checks. National GP Patient Survey data and the majority of feedback received from people was positive about their experience of contacting the practice. Indicators showed 67% of respondents were positive about their overall experience of contacting the practice which was above the national average of 67%.

The practice also participated in national programmes such as the NHS England Accelerate programme this involved a 20-week structured support program with a facilitator and focused on implementing specific modules from the Productive General Practice Quickstart programme.

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 provided by people using the service, was positive. Staff treated people equally and without discrimination. The provider had processes to ensure people could register at the service, including those in vulnerable circumstances such as homeless people and Travellers. We were advised that the practice had refuges and asylum seekers registered at the practice, who were provided the opportunity to have a support organisation attend the practice with them to help explain the NHS system and support them with any language barriers in the initial attendances.

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. For example, the out of hours services and other health care professionals involved in the care of this group of people. We were assured that safeguards were in place to ensure that decisions were made which were in the persons best interest, and priorities for care and treatment that could help to achieve the outcome that the person would want, or what they would not want. People with legal authority or responsibility, such as carers, families and/or advocates, could make decisions on behalf of the person, and were involved in planning, managing and reviewing their care and treatment.