Trinity Medical Centre

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 have rated the practice as good for providing responsive services as patients were able to access suitable appointments, based on clinical need and vulnerable people or those with protected characteristics were able to access care and treatment in ways that met their personal circumstances. We found patients were involved in decisions about their care. The practice provided information people could understand. The practice worked to reduce health and care inequalities externally through engagement and initiatives with local communities and internally through staff support and training to provide person-centred care.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Discussion with leaders showed that they understood the needs of their local population and had developed the service in response to those needs. They demonstrated a good understanding of the practice’s demographics, challenges they faced and systems in place which placed patients at the centre of care. Referral systems ensured patients received consistent, coordinated care when they moved between services. Staff told us that they involved patients in their care and treatment. They told us they did this by having discussions, offering choice, and by providing patients with the support they needed to understand, for example by offering support with any communication needs. They said they put patients at the centre of their care and treatment. Some staff had specialist areas of work and supported people to understand their condition, care and treatment options.

There were systems and processes in place to ensure patient’s care and treatment was delivered in a way that meets their assessed needs. The practice’s access model enabled GPs and advanced care practitioners to book their own patient follow-up appointments to enable timely continuity of care. Similarly, patient consultation follow-up requests within a 3-month period were directed to the same clinician to maintain continuity. The practice held registers of different patient groups, including those with a learning disability or a carer. The practice registered patients with no registered GP or fixed abode by using the practice as their address.

The practice provided appropriate, accurate and up-to-date information in formats that were tailored to individual patient needs. The practice complied with the Accessible Information Standard. Patients could request information in more accessible ways, such as in large print. Individual communication needs were noted on a patient’s clinical record. The practice website was accessible and had the functionality to translate to other languages. It included up-to-date information, for example, opening times, out of hours information, patient registration, clinics and services, health information and support, complaints and suggestions, and how to access medical records. Reasonable adjustments were made at the practice to support communication, including a hearing loop and use of interpreters. Information was shared with patients via a practice newsletter and 2 social media platforms.

Staff told us the different ways that patients could share feedback and ideas and raise complaints. This included the NHS Friends and Family Test (FFT), the complaints process and through compliments. We saw information about the complaints process, with access to the complaints form, was on the practice website. Staff we spoke with understood the complaints process and how to assist patients with any complaints or concerns they may have. There was an effective complaints process in place which included a lead and policy. We reviewed complaint records and saw complaints were actioned in an appropriate and timely manner, discussed in meetings, and learning shared. Where appropriate, patients were provided with an apology and signposted to the Parliamentary and Health Service Ombudsman (PHSO).

There were established and effective processes in place to monitor and respond to patient capacity and demand. We saw that the practice held weekly access meetings to review capacity forecasts and to ensure there were sufficient resources to meet demand.

The practice had been early adopters of the total triage principle in 2021 and had refined this model to its current system. There was a clear process for patients to access appointments, which was outlined in an access policy. The practice had produced a patient journey diagram following feedback from patients which was on their website. Patients could access advice via the telephone, in-person or on-line and were prompted to state whether it was an urgent or routine request. The practice had introduced a dedicated non-clinical access team, who were trained care navigators, to manage incoming patient requests and signpost to the appropriate service, for example community pharmacy, or book a telephone or face-to-face appointment with a practice clinician. The access team were supported in real-time by a GP, with protected time in this role, to oversee that requests were handled appropriately and in the correct timescale. The care navigators could also signpost to the practice’s clinical assessment service, which was a telephone triage service staffed by clinicians which included advanced nurse practitioners (ANPs), advanced clinical practitioners (ACPs) and paramedics. They were supported by a daily duty GP or ANP/ACP. This was a unique service and operated both in core hours and formed part of the out-of-hours service provision for the area. There was an inclusion and exclusion criteria for signposting to this service and outcomes could include signposting to other services, for example talking therapies, physiotherapy, a face-to-face assessment or self-care advice.

Feedback regarding access showed that 71.7% responded positively to the overall experience of contacting their GP practice (national average 67.3%), 44% responded positively to how easy it as to contact their GP practice by phone (national average 49.7%), 69% found it easy to contact the practice using their website (national average 48%) and 70% found it easy to contact the practice using the NHS App (national average 45%).

We saw that staff and leaders actively listened to information about patients who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. Reasonable adjustments were made for patients who experienced difficulties accessing services for example, a translation service was available. We saw that the practice website had the functionality to translate to other languages. Patients were offered longer appointments if they required them, for example, those with complex health needs. The practice had processes in place to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people.

People were supported to make informed choices about their care and plan their future care while they had the capacity to do so. Decisions and choices made by people were documented and reviewed as required. Patients at end of life were reviewed in multi-disciplinary team meetings. People’s decisions and what mattered to them were delivered through personalised care plans that were shared with others who may need to be informed. Processes were in place to support patients to make informed decisions about their future, and to review patients at the end of their lives. Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) and Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) forms were completed in line with guidance and with the input of patients, and when necessary, their carers.