Noakbridge Medical Centre

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. 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. However, the practice did not utilise all expected ways for people to share feedback and ideas, and people did not always feel listened to. The practice did not have an active patient participation group (PPG) but had an active recruitment campaign in place.

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 patients including those related to protected characteristics under the Equality Act. Our review of clinical records showed patients were supported to understand their condition and were involved in planning for their care needs. They were also involved in decisions about their care.

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.

We saw the practice worked in partnership with other services to meet the needs of its patient population. The practice had tailored its services to meet the diverse needs of its community. There were established mechanisms for engaging with local community healthcare providers.

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 was available in a range of languages. The practice had access to interpreter services, including British Sign Language. Information provided by the service met the Accessible Information Standard (a legal requirement to ensure individuals with disabilities or sensory loss receive information in a way they can understand and receive necessary communication support). Patients were informed as to how to access their care records.

The service did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

Results from the National GP Patient Survey indicated that 71.7% of respondents felt the healthcare professional they saw at their last appointment was good at listening to them. This figure was lower than the national average at 85.3%. In additional, 51.6% of respondents described their overall experience of this GP practice as positive, compared with a 73.9% national average. However, feedback received during the assessment to CQC was overall positive, people described staff as ‘helpful’ and ‘empathic’.

A patient participation group (PPG) had previously been formed, however, at the time of the inspection, the practice told us they had not been successful in recruiting anyone to the group. There was therefore no evidence of feedback from the PPG being acted upon.

We saw complaints were managed in line with the practice’s policy. We reviewed minutes of staff meetings, in which complaints were a standing agenda item. Learning from complaints was evident and staff were able to identify changes made as a result of patient feedback, including complaints.

The practice made sure that people could access the care, support and treatment they needed when they needed it. The provider had developed its own triage systems and trained reception staff to identify the most appropriate service pathway for people, for example community pharmacy services. This meant people could receive the right type of appointment when they needed it. People could access the service to suit their needs for example online, in person and by telephone. Staff could refer people with social needs, such as those experiencing social isolation or housing difficulties, to a social prescriber who was employed by the local Primary Care Network (PCN). People who needed mental health support could be referred to local mental health services to support them.

However, results from the National GP Patient Survey indicated that people had difficulty accessing the practice. From the respondents, 47% responded positively to the overall experience of contacting the practice, this was below the expected 67.3%. The practice shared improvements identified and implemented to improve access for people. In response to the National GP Patient Survey data and from feedback from members of the community the practice leadership team had identified changes to improve access to the service. For example, a cloud-based telephone system had been introduced; practice website site had been upgraded, and an electronic consultation appointment system was being introduced.

Treatment rooms were available on the ground floor. Observations of the premises raised concerns regarding accessibility. An automatic door was not in place in the reception area. Leaders recognised this was difficult for people with poor mobility and confirmed that there was not an intercom system in place to support people to request assistance. The practice took immediate action and provided assurances that a doorbell would be installed as an interim measure to people.

Staff and leaders actively listened to information about people who are 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, both to the provider as well as to CQC, was overall positive. Staff treated people equally and without discrimination. Leaders proactively sought ways to address any barriers to improving people’s experience and worked with local organisations, including within the voluntary sector, to address any local health inequalities. The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people. Staff used appropriate systems to capture and review feedback from people using the service, including those who did not speak English or have access to the internet.

The provider shared details of community services available to support people, for example a weekly wellness café run by the Primary Care Network (PCN) which offered community connections and support for people.

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. Concerns were discussed regularly and documented. The practice worked within a multi-disciplinary approach with services to support the frail, elderly and vulnerable population as part of Basildon Early Response Team (BERT). The team included GP’s, social prescriber and care co-ordinators, district nurses, occupational therapist, social workers, palliative care and mental health support teams, and continuity of care was prioritised for palliative patients.