Wargrave House 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.

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 decisions and worked in partnership with them to respond to any relevant changes in their needs. Patients had access to appointments provided by a range of clinicians. Clear information was provided to patients on how to raise concerns or make a complaint. The practice demonstrated a strong understanding of its population and used patient feedback to identify areas for improvement and made necessary adjustments to ensure patient care was optimum. Accessible standards and barriers to care were considered for people, as alerts were added to medical records so that reception were aware upon contact that the person had additional needs. For example, people who were hard of hearing had access to the hearing loop and people with autism or a learning disability were offered a quiet place to wait for appointments.

The practice understood the diverse health and care needs of people and their local communities, so care was flexible and supported choice and continuity. The practice worked in partnership with other services to meet the needs of its patient population. Information about patients care and treatment needs was available to share between services as required. 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 63% of respondents felt they have 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 lower than 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. 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. Complaints were dealt with in line with their policy. Staff used a complaints template to ensure all the necessary information including information about the Parliamentary and Health Service Ombudsman was provided to patients. The lessons learnt from complaints were discussed and shared in staff meetings to ensure all staff were aware of the consequential changes. Patients were informed about how to access their care records. A range of health and wellbeing leaflets and posters were on display for patient information.

The practice made it easy for people to share feedback and ideas about their care and treatment. Patients were encouraged to leave feedback. Feedback could be given verbally or written via suggestion boxes, surveys, social media channels, and the re-established Patient Participation Group (PPG). Although the practice had not had any meetings with their PPG, following our visit, the practice assured us that quarterly meetings have been arranged with the PPG for the coming year. We spoke to representatives from the PPG during the assessment period and they were keen to be involved to share their views and act on behalf of those using the service. The PPG told us they had a good relationship with the practice and felt listened to. The practice had a complaints policy. We saw complaints were discussed and reviewed to improve the quality of care. Learning was shared with staff. The practice involved people and listened to their preferences when making decisions. NHS Friends and Family Test Feedback was reviewed monthly. The NHS National Patient Survey data reports that 72% 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 88% and lower than the national average of 87%. Following this feedback, the practice initiated their own in house survey to identify service improvement and enhance patient experience. They selected 3 patients per clinician daily to receive a questionnaire. Key themes were identified to focus improvement.

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. Patients had extended access to appointments in the evenings and the weekends and out of hours services were available. Data from the National GP Patient Survey highlighted that the practice scored lower than the national average for all questions related to access. 29% of respondents found it easy to contact the practice by telephone, in comparison to the national average of 53%. 39% of respondents found it easy to contact the practice by their website, in comparison to the national average of 51%. 19% of respondents found it easy to contact the practice by the NHS app, in comparison to the national average of 49%. To address the lower scores related to access, the practice implemented an online triage system in hope to reduce the telephone wait time. The practice completed a telephone waiting time audit, to assess the number of incoming calls and the waiting time before their call was answered. The practice intends to complete the same audit to review the results. 66% of respondents found the receptionists helpful, in comparison to the national average of 83%. Various appointment types were available such as online, in person or telephone consultations. For patients that experienced difficulty completing the online appointment forms due to limited digital access, receptionists provided support and submitted online request forms on their behalf to ensure inclusivity and equity of access. The wellbeing team provided additional support and education for those who had difficulty using the NHS app. The practice was accessible for wheelchair users, and consultation rooms were accessible on the ground floor. Leaders shared plans to extend the building into the garden to create more accessible clinical rooms on the ground floor. There was a car park at the back of the practice with designated disabled parking spaces and a ramp at the rear entrance of the building.

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 treated people equally, without discrimination. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. For example, partially sighted or hard of hearing patients had a flag on the system so staff were aware and knew what support was needed to ensure that patient received appropriate care. Leaders proactively sought ways to address any barriers to improve people’s experiences. For example, a staff member was involved in obtaining a local attention deficit hyperactivity disorder (ADHD) pathway as this was identified as a topical area as the practice had patients requesting such a service and had since benefitted from this development. An audit was completed by an external company to identify improvements to enhance the experience of patients with learning disabilities. Following this audit, the practice has implemented a quiet area, accommodated a quieter time of day or a longer appointment, had a sensory box available, laminated information in a matte format instead of shiny and includedpictures, not only words. 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, including cardiopulmonary resuscitation. This information was reviewed regularly and shared with other services when necessary. The practice also offered home visits where appropriate. Palliative patients were coded, and open conversations were had about their treatment and future. Palliative patients were discussed during monthly multi-disciplinary meetings.