Medwyn Surgery

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked for evidence that the practice involved patients and treated them with compassion, kindness, dignity, and respect.

We received 601 feedback comments from patients using the practice. Patients told us they consistently felt respected, valued, and fully supported by staff at the practice. The practice was described as professional, caring, exceptional, and second to none by patients.

We found that the culture of the entire team was patient-centred, and staff members we spoke with told us they felt empowered to deliver high-quality, considerate and empathetic care. This was included in patient feedback we received, observation, and positive results from both the National GP patient survey and the Friends and Family Test.

At our last inspection, we rated this key question as Outstanding. At this inspection, the rating remains the same.

This service scored 90 (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 was exceptional at treating patients with kindness, empathy, and compassion and in how they respected patient’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

587 patients shared positive experiences of the practice directly with the Care Quality Commission. Comments from patients included: “Exceptional care and professionalism on every level” and “Excellent service and advice from all those I speak with from the nurses to the GPs.” We noted that the word excellent had been written no less than 200 times in the feedback received.

Less positive comments were mainly about not having continuity of care with the same GP.

The practice gathered Friends and Family scores, which consistently reflected high levels of patient satisfaction. Feedback from patients was shared with staff to encourage and reinforce good practice. The practice used all comments as an opportunity for learning and improvement.

Results from the National GP patient survey consistently scored higher than both the local and national averages. Notably, 98% of patients felt their needs were met during their last general practice appointment. This was above the local average and national average of 90%. Similarly, 96% said the healthcare professional they saw or spoke to was good at treating them with care and concern during their last general practice appointment, (the national average was 86%). 95% of patients found the reception and administrative team at this GP practice helpful, compared to the national average of 83%.

Arrangements were in place to promote patients’ privacy. Staff that chaperoned patients were aware of their responsibilities in maintaining a person’s dignity and safety during an intimate examination, and we observed notices around the practice advising that chaperones were available and how to request one. National GP patient survey data reflected that 96% of patients felt listened to (national average 87%). Staff we spoke with understood Gillick competency and there was a process to ensure young adults had control over their own privacy and the amount of parental involvement in managing their care and support.

The practice treated patients as individuals and was exceptional in how they made sure patient’s care, support and treatment met patient’s needs and preferences. The practice took account of patient’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

All staff had received training regarding autism and learning disabilities and were able to support patients who found it difficult to be independent and access services.Patients on the learning disability register received an easy to read ‘warm-up’ letter explaining the purpose of a health check. As well as a confirmation letter and easy read pre-check questionnaire. Where suitable, health checks were held at the practice to build familiarity, if not, home visits were completed, and patients were booked into appointments with known staff. One of the nurses who completed learning disability health checks also had basic Makaton/sign language skills.

The practice worked closely with a range of local organisations to support patients’ health and wellbeing. Social prescribing referrals were made proactively from consultations, and we saw evidence of these services being promoted in the waiting area. Examples included Men’s Shed, food banks, food vouchers, ‘Live Well’ multidisciplinary holistic support services at DHC Federation, breastfeeding support groups, menopause services, and Mary Frances Trust for mental health. The practice also supported combating period poverty.

The practice supported all patients, including refugees and homeless people, to access healthcare. Patients with no fixed abode could use Medwyn Surgery as their address. Walk-in homeless patients were discussed with the duty GP and seen the same day on a sit-and-wait basis. Reception staff could offer tea and phone charging, and NHS health checks were proactively offered. The registration process was simplified for refugees and asylum seekers. The practice was able to use translation services and safeguarding, and social prescribing teams were involved early to address housing, food, or trauma-related needs.

Population health management data had been reviewed with support from the GP federation’s analytics team to identify vulnerable groups for proactive interventions. This approach was being used to identify patients with additional needs to ensure they were supported.

Patients’ personal, cultural, social, religious and equality characteristics needs were understood and met. Patient communication needs were met to enable them to be fully involved in their care.

The practice promoted patient’s independence, so patients knew their rights and had choice and control over their own care, treatment, and wellbeing.

The practice provided information in a way that patients could understand and offered time for discussion so patients could consider their options. Interpreters and accessible communication formats were available when needed. Staff had completed the relevant training required to promote independence. The practice had disabled access and hearing loops.

Nursing staff we spoke with told us about a group consultation plan for new parents to provide information about child immunisation. We noted this was in development and had been included in the practice development plan strategy.

Staff helped patients and their carers to access advocacy and community-based services.

The practice listened to and understood patient’s needs, views and wishes. Staff responded to patient’s needs and acted to minimise any discomfort, concern, or distress. There was a system for appointment triage that ensured patients with immediate needs had access to services. A duty doctor was available each day to support nonclinical staff in care navigation. Patient’s needs were usually managed on the day of contact with the practice. The remaining were either signposted or offered an appointment in the future to meet their needs rather than having to call back. Patients were directed to the most appropriate person or practice to meet their needs and ensure continuity of care where required. Staff we spoke with knew the process for referral to emergency support, including mental health crisis teams. Feedback from patients who used the practice reported positive experiences with prompt responses to appointment requests.

The practice always cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care.

Staff told us they were valued by leaders. Leaders had taken steps to recognise and meet the wellbeing needs of staff, which included the necessary resources and facilities for safe working, such as regular breaks and rest areas. Staff reported being supported if they were struggling at work. We saw team building days were established within the practice.

Staff we spoke with, and evidence seen demonstrated a high level of training opportunities for staff. Staff told us they were encouraged to expand their roles and / or achieve career progression. Leaders demonstrated the systems they had in place to support staff, and staff reported how their views and feedback were listened to, carefully considered and used to drive change. Staff were able to provide anonymous feedback via a QR code displayed in the staff areas of the practice.

All staff members were involved in shaping the new vision and values and the final proposals were agreed collaboratively. The practice used the Professionalism and Cultural Transformation toolkit to allow staff to provide anonymous feedback on culture and values. The outcome of this exercise confirmed that staff felt the practice had excellent patient care, was focused on safety, and had a caring culture. It also identified areas for improvement, including the need to refresh the mission statement and values. Other themes included a high workload and long hours particular for reception staff. Leaders took action to review workflow and redesigned triage and care navigation to reduce pressure. The leaders also took action to ensure staff felt a strong sense of team identity and shared purpose. This was developed through joint meetings and inclusive values workshops.

The practice promoted health and wellbeing through initiatives such as a walking club, Pilates, Friday socials, and a Zumba class led by a receptionist.