Well Street 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 in January 2016, we rated this key question as Good. At this assessment, the rating remains Good.

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 patients’ physical, mental, emotional and social needs, including those linked to protected characteristics under the Equality Act. Records we reviewed showed that patients were supported to understand their conditions and were involved in planning their care. Clinical templates were used during reviews to consider the person’s overall well-being, not just their immediate condition. Reception staff used alerts in the clinical system to highlight individual needs, such as longer appointments or interpreter support. Multidisciplinary reviews, for example involving GPs, nurses and dietitians, helped provide coordinated care for patients with more complex conditions. Patients we spoke with said they felt involved in decisions about their care and treatment.

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.

The practice had tailored its services to meet the diverse needs of a community. Relationships had been built with local community groups to promote the take-up of screening programmes. Regular communication with PCN hubs, ambulance avoidance teams, and community healthcare services was established, and universal care plans were shared across providers to support continuity of care for people at higher risk of hospital admission. Proactive screening recall was in place, with same-day telephone calls and SMS reminders for missed cervical screening and ongoing recall until attendance was achieved, reflected in cervical screening uptake above the national average at 80% for the 25 to 49 age group and 89% for the 50 to 64 age group. Community drop-in sessions and health education initiatives extended the practice's reach into the local population beyond the consultation room.

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, reflecting the linguistic diversity of the practice population. The practice had access to interpreter services, including British Sign Language, and a hearing loop was available at reception. Information provided by the service met the Accessible Information Standard, and easy-read formats, multilingual materials, carer information, and self-referral and wellbeing leaflets were made available throughout the practice. Patients were informed as to how to access their own care records. Patient Participation Group information was displayed with an active invitation for new members, supporting community engagement in the ongoing development of the service.

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.

Complaints were managed in line with the practice's policy, and a Patient Participation Group was in place to represent the views of people using the service. Patient feedback, including through the National GP Patient Survey and the NHS Friends and Family Test, was used to inform service development. Staff were able to identify changes that had been made as a result of patient feedback, and patient interviews during the inspection reflected high levels of satisfaction with both clinical and administrative staff, with no complaints or concerns voiced by patients we spoke with.

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

People could access the service in a range of ways to suit their needs, including online, in person, and by telephone. Flexible appointment types were offered, and disability-friendly facilities were available throughout the practice. Treatment rooms were available on the ground floor, a ramp and automatic door had been fitted to the entrance, and lift access was available across the multi-floor premises. Extended appointment slots were in place for patients with a learning disability and for patients with mental health needs, and record-level alerts within the clinical system ensured that individual requirements for additional time, interpreter support, or other adjustments were recognised at the point of booking. In response to National GP Patient Survey data and feedback from members of the community, the provider had identified and implemented changes to improve access to the service. Proactive recall systems, including same-day follow-up telephone calls and SMS reminders for missed cervical screening appointments, supported access for patients who may otherwise have fallen out of screening programmes.

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 and to CQC, was positive. Staff treated people equally and without discrimination. Leaders proactively sought ways to address barriers to improving people's experience and worked with local organisations to address 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, including extended appointments for patients with a learning disability, interpreter services for patients whose first language was not English. Social prescribing was available to support patients experiencing social isolation or housing difficulties. There were processes to ensure people in vulnerable circumstances, including homeless people and 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 speak English or 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. Universal care plans were used to capture this information and were shared with other services, including community healthcare providers and ambulance avoidance teams, so that patients' wishes were recognised across the wider system. Staff focused on identifying patients in the last 12 months of life as part of wider work to identify those at risk, and multidisciplinary working with community services supported coordinated care at the end of life.