Great Ayton Health 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 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 79 (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. They were also involved in decisions about their care.

Results from the National GP Patient Survey showed that 96% of patients felt that, during their last appointment, they were involved as much as they wanted to be in decisions about their care and treatment. This was above the local and national average of 91%.

The most recent data from The Friends and Family Test showed that 99% of feedback was positive, with the vast majority rating the practice as very good or good.

The feedback we received from patients was 100% positive about the care provided.

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.

They regularly reviewed local demographic data, health priorities and public health reports from sources such as NHS Digital, Public Health England, and the Clinical Commissioning Group to identify prevalent health conditions, risk factors and inequalities.

There were established mechanisms for engaging with the community healthcare providers such as the Integrated Neighbourhood Team and the local Primary Care Network (PCN). For example, the practice’s social prescribers engaged the weight management enhanced service, contacting and referring patients to weight management programmes. In addition, they could also refer to befriending services, counselling support, dietary advice, drug and alcohol misuse support organisations and local services that provide social activities such as coffee mornings and “Knit and Natter” groups.

Home visits were carried out by GPs and a practice nurse for those assessed as not being able to attend the practice, providing continuity of care to these patients.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The practice website was available in multiple languages and staff had access to interpreter services. The practice could also provide information in large print or ‘easy read’ format if needed, audio or through communication support like British Sign Language interpreters or other assistive technologies. Google translate had been successfully used, for example, to assist patients whose first language was Ukrainian.

Arrangements were in place to ensure compliance with the Accessible Information Standard.

Patients were informed via the practice website 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. For example, people could provide feedback or complain online via their website, by email, letter or verbally. People were also encouraged to give feedback online, through the NHS Friends and Family Test.

The practice 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 complaints policy. Learning from complaints was evident and staff were able to identify changes made because of patient feedback, including complaints. Examples included: reception staff being updated on contact details for menopause clinics following a complaint from a patient and notes being placed on records for patients with a speech impairment to prevent reception staff hanging up on them.

Compliments were logged and shared with staff.

There was an active patient participation group (PPG) who confirmed that the practice had engaged with them, listened to them, and acted on their feedback. For example, following PPG input there was now a wider distribution of the practice newsletter in the local community and the provision of a large monitor in the waiting room to give information and advice to patients.

The service was exceptional at ensuring that people could access the care, support, and treatment they needed when they needed it.

They operated primarily as a “book on the day” surgery as they felt that this met the needs of their elderly patient demographic best. We saw on the day of our visit that appointments were still available for GPs and nurses. People could also access the service in other ways to suit their needs, for example, by telephone, completing an e-consult request, directly booking online appointments or in person.

The practice was open from 8am to 6pm Monday to Friday and an extended hours service was available through the primary care network (PCN) the practice was part of. This extended access meant that people who used the service could book nurse appointments between 6.30pm and 7.30pm on Mondays and nurse and phlebotomy appointments on the morning of the first Saturday of the month. In addition, during the week the practice could offer appointments for certain tests and menopause clinics at a local hospital. They were also able to book appointments at a neighbouring surgery every Friday morning for secondary care blood tests.

The percentage of respondents to the National GP patient survey who responded positively to the overall experience of contacting their GP practice was 94% which was significantly above the local average of 72% and the national average of 70%.

The percentage of respondents who responded positively to how easy it was to contact their GP practice on the phone was 83%, which was significantly above the local average of 56% and the national average of 53%.

In feedback to the CQC, patients commented that they could usually get an appointment to see a doctor or nurse the same day and that it was easy to make appointments and get prescriptions.

As well as clinical staff, patients had access to a range of other healthcare professionals such as a physiotherapist and mental health practitioner. They also offered dedicated clinics for patients with chronic diseases such as Asthma, Obstructive Pulmonary Disease, Diabetes, Chronic Heart Disease and Chronic Kidney Disease.

Treatment rooms were all on the ground floor and a ramp and automatic door were in place at the entrance.

The practice was an Armed Forces Veteran Friendly Accredited GP practice.

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 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 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 provider had processes in place to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and travellers. Anyone living within the practice catchment area was welcome to register with the practice and did not need to have proof of address.

The practice regularly registered temporary residents to provide services, for example, people visiting the area, visiting relatives of their patients or university students home for holidays.

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.

Five patient records were reviewed where a DNACPR (do not attempt cardiopulmonary resuscitation) decision was in place. All patients were flagged appropriately on the patient’s clinical record following notification of the decision. There was also a copy of the signed DNACPR or ReSPECT form on all five records we looked at with evidence of regular reviews.