Drs T A Underwood & M A Thompson

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

People were treated with kindness, compassion and respect, and their privacy and dignity were maintained. Patients were involved in decisions about their care and felt their needs were met. Staff supported independence, responded appropriately to immediate needs, and were enabled through positive wellbeing and development arrangements to deliver person-centred 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 provider 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 indicated patients were supported to understand their condition and were involved in planning for their care needs. Evidence of the diverse referrals made by the social prescriber showed how care had been tailored to individual needs.

Feedback from people who used the service was generally positive with examples given on the provision of person-centred care. We noted patient feedback directly informed changes to the reception environment to improve confidentiality.

Patients described the practice as caring and patient focused, valuing the thoughtful way staff listen to concerns and provide support.

The practice provided care to three local care homes. Feedback from the care home managers was generally positive, with one suggesting that increased in person visits along with remote reviews, could further enhance the delivery of person-centred care.

The provider 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. For example, practice staff had attended new student freshers’ events at the local university, promoting GP registration and raising awareness of local GP services. The practice also delivered targeted clinics and outreach for specific populations, including care home residents, students and people in temporary accommodation.

The service benefited from many long-standing staff in their clinical and non-clinical teams. This supported continuity of care for people who used the service and reduced the need for locum staff. Continuity was further strengthened through named GP arrangements, regular multidisciplinary reviews and proactive care planning for people with complex needs.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Communication preferences were systematically recorded and visible to all staff, ensuring reasonable adjustments were consistently applied

The practice had access to interpreter services, including British Sign Language. Information provided by the service met the Accessible Information Standard. Patients were informed as to how to access their care records.

The provider made good use of the PCN roles such as a Social Prescriber and Health and Wellbeing Coach. They were able to provide evidence of how people had been referred to services to support healthier lifestyles.

Feedback from a nearby boarding school was positive regarding support provided by the practice. They reported the practice staff had a holistic understanding of adolescent health, mental wellbeing, safeguarding and a proactive approach to health education. The practice demonstrated a population awareness through targeted outreach, onsite clinics and flexible appointments to support accessibility for students.

The provider 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.

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

The practice routinely asked patients to complete Friends and Family Test (FFT) feedback forms and reviewed the feedback for any trends or themes. Patient feedback from FFT reported compassionate and assessable care. Patients fed back they felt listened to, involved in decisions and never rushed during consultations.

We reviewed handling of complaints at the practice and saw examples where patients’ and families’ perspectives were actively considered and used alongside clinical analysis to inform learning and service improvement.

The provider made sure that people could access the care, support and treatment they needed when they needed it. The practice had implemented a Total Triage model to support access based on clinical need and to improve how patients contacted the service, including reducing demand pressures at peak times.

The recent National GP Patient Survey indicated that 53% of respondents found it easy to contact this GP practice using the NHS App, in comparison to the national average of 49%. In response to survey findings and patient feedback, the practice had reviewed and redesigned access arrangements, which included removing early morning bottlenecks and improving response times.

In addition to the National GP Patient Survey data, the practice developed their own patient survey. From the 500 patients who responded, 62% reported a positive experience of making an appointment, demonstrating improvement following changes to the access model.

Treatment rooms were available on the ground floor and a ramp and automatic door had been fitted to the entrance on both sites.

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 to the provider was positive.

Leaders proactively sought ways to address any barriers to improving people’s experience. Staff we spoke to suggested that the recent introduction of the ‘Total Triage’ system had enabled the practice to take more proactive and consistent approach in managing access, improving clinical oversight of demand to meet the population needs.

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.

People were supported to plan for important life changes so they had enough time to make informed decisions about their future, including at the end of their life. This included structured anticipatory care planning for patients who may be at increased risk of deterioration.

Our records review showed people were supported to consider their wishes for their end-of-life care. This information was documented and shared with other services when necessary to support coordinated care, including with urgent and out-of-hours services.

We noted that all care home residents had documented Advanced Care Plan in place which were regularly reviewed. Systems were in place to review hospital admissions and emergency attendances to help identify patients who may benefit from earlier planning and personalised support.

The provider had contributed to the development of the local Medical Examiner service,to support patients and families with learning and transparency in end of life care.