Pathfields Medical Group

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 assessed all quality statements in the responsive key question. At our last assessment, we rated this key question as requires improvement. At this assessment, we rated the key question good. We observed evidence that the service met people’s needs, and that staff treated people equally and without discrimination. Requests for appointments were allocated based on clinical needs. The service understood their patient population. Changes were identified to improve the service where required.

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 people including those related to protected characteristics under the Equality Act. For example, people’s care records indicated if they had a hearing impairment which indicated to staff reviewing their appointment request they may require additional support to attend. Staff told us they got to know people and their needs during regular appointments, and they responded appropriately. Our review of clinical records showed people were supported to understand their condition and were involved in planning for their care needs. They were also involved in decisions about their care. One person told us “Pathfields has a transgender specialist on staff who has done her best to facilitate my transition, and I really appreciate the way my sense of self is respected by the staff at every appointment. Pathfields is usually very quick to respond to queries given the general understaffing of the NHS, and any problems are resolved as promptly as 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. The service considered the importance of flexibility, informed choice and continuity of care when delivering care and treatment. Systems and processes supported people through a multi-disciplinary approach. We saw the practice worked in partnership with other services to meet the needs of its patient population. The service had tailored its services to meet the diverse needs of its community, for example, building relationships with community groups to promote the take up of screening programmes. For example, staff visited local mosques to improve links and visibility to this group of patients.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. They also supported people and their carers when needed to find further information and access community and advocacy services. Information to promote the take up of screening and immunisation programmes was available in a range of languages. The service’s website contained a variety of information to support and educate people including a teenage health hub and a menopause information pack. There was a system for staff to access interpretation services to support people who did not have English as a first language. People were informed as to how to access their care records.

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. Staff were able to explain the importance of listening to people during their appointment. We saw complaints were managed in line with the service’s policy. Learning from complaints was evident as changes were made as a result of patient feedback, including complaints. The service recently collaborated with their patient participation group to gain an insight into patient perceptions of digital technology to enhance patient care. People at the service shared feedback from their recent GP appointments with CQC. One person told us: “I felt listened to and respected and [they] took my concerns seriously. [They were] honest and made me feel comfortable but also provided gentle challenge”.

The service made sure that people could access the care, support and treatment they needed when they needed it. The service had identified changes to improve access in response to the National GP Patient Survey data and from feedback patients. For example, they had extended appointments for people with a learning disability and there was a dedicated phone line and email address for healthcare professionals supporting people living in the community. People could access appointments online, over the phone and in person. Over the last 12 months, CQC had received 12 complaints, 5 of which were about access where some people told us they found it difficult to access appointments online and over the phone. One person told us the “practice is so difficult to get hold of, at least 40-55 minutes on hold when you phone, you get to number 1 quite quickly then holding on number 1 for anything up to 40-55 minutes”. However, we also received positive feedback from 35 people. One person told us “Apart from a wait sometimes to get through everyone has been kind and helpful. Appointments have been booked same day if needed.” The service had reviewed access to their service and had identified challenges including the retention of patient advisors who answered the phones. The service was considering options to further improve their phone access. Treatment rooms were available on the ground floor at each site and where necessary, there were ramps or instructions on alternative level access. People could request an appointment at the most suitable site for them.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. For example, the service’s website contained information for asylum seekers and refugees and explained the service could arrange someone to help complete registration forms. Feedback provided by people using the service, both to the service as well as to CQC, 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. The service had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people. This group of patients were coded on the patient record system and the service tried to ensure they addressed all health needs in 1 appointment. 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. The records we viewed showed people were supported to consider their wishes for their end-of-life care, including cardiopulmonary resuscitation and this was clearly documented. This information was shared and accessible to other services when necessary. We looked at 5 patient records that were coded as having a do not attempt cardiopulmonary resuscitation (DNACPR) decision documented in their care record. We identified 1 patient record that clearly documented they had changed their mind about their DNACPR decision, but this was not reflected throughout their care record. This service amended this immediately