Gravel Hill 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 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 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.

Patient feedback was that the service supported them and ensured any requested adjustments or queries were acted upon. Patients told us they felt well looked after and staff ensured their individual needs were met.

Reasonable adjustments and personal adjustments were recorded. There was access to an interpreter, quiet waiting areas and home visiting for housebound service users, as required.

There was clear advice and information communicated in various ways, access to easy read documents was available as needed. The notice boards were uncluttered with clear up to date information including carers, young people and cancer support.

There was a high use of the online triage system within the demographic, the service had enabled the function to specify a preferred clinician and we saw evidence that they met this request where possible.

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.

People could access the service in a variety of ways, including visiting in person, using the digital triage system, or booking by telephone. A range of appointment types were offered, including same-day urgent appointments, telephone and face-to-face consultations, and longer appointments for those with complex needs

We saw the practice worked in partnership with other services to meet the needs of its patient population.

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. Information provided by the service met the Accessible Information Standard and the service had posters indicating that information was available in various formats, there was use of easy read and picture information for key areas such as toilets and reception. Service users were informed as to how to access their care records and staff were able to demonstrate how they would meet various requests for additional support such as larger print on letters or braille.

During the launch of the online triage system the service had used various communications, for example letters, screen slides and face to face meetings to demonstrate how to use it from a service users point of view. Letters had been hand delivered and explained during home visits as well as staff trained on how to explain the steps, patients were encouraged to ask for support and help given where needed.

Notice boards were clearly laid out, with relevant up to date information.

The service 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 service policy. Learning from complaints was evident and staff were able to identify changes made as a result of patient feedback, including complaints.

There were daily mini huddles to allow staff time for valuable handover between shifts to share information and updates that may be relevant.

Patient survey results were shared and discussed in the Patient Participation Group (PPG) as well as shared on a notice board. The staff meetings also included PPG feedback as part of the agenda to ensure the staff listened to service users and learnt what was working well, identify and action learning.

Service user feedback was used throughout the service planning and development, supporting the identification of needs and preferences of the demographic and providing staff with a sense of pride in their work.

The service made sure that people could access the care, support and treatment they needed when they needed it.

People could access the service to suit their needs for example online, in person and by telephone. There was a hearing loop available and the service promoted and shared information relating to accessible information standards and encouraged service users to communicate their preference and additional needs so they could be recorded and supported. Staff were knowledgeable and willing to support service users’ needs and preferences and had all completed the Oliver McGowan training on learning disabilities and autism.

The service had completed an accessible information self-assessment to support and identify any areas of improvement, actions were recorded and added to the business plan as required. The service had acknowledged that the access to the building required improvement as there were no automatic door functions, to gain access from outside into one of the waiting areas was through 3 doorways, of which none had automatic door functions. The building development had already had this improvement planned in and a bell to request support had been installed until the change had been made.

The service users had access to support to enable better use of the NHS app from the Primary care network (PCN) care coordinator.

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 was 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. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes.

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.

We reviewed the recording of decisions relating to palliative care and resuscitation. All DNACPR (Do Not attempt CPR) decisions were recorded correctly in the sample that was reviewed, one record did not have a copy of the document scanned in, this had been completed by a consultant and was acknowledged by the service, who assured us an audit and process review would take place.