Thorntree 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 provider 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.

The National GP Patient Survey showed 89%of respondentssaid they were involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment, in line with the local average of 92%and the national average of 91%.

Care plans reflected physical, mental, emotional, and social needs of patients including those related to protected characteristics under the Equality Act. These were regularly reviewed and discussions with family documented. Our review of clinical records showed patients were supported to understand their condition and were involved in planning for their care needs, and in decisions about their care.Clinicians told us they promoted shared decision-making during consultations.

The provider understood the health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. Services were adapted to meet local deprivation need, including access to mental health and substance misuse services. We saw the practice worked in partnership with other services to meet the needs of its patient population, including various charities.

Our review of the clinical system demonstrated that referrals to other services were made promptly, and information shared by other services was managed effectively and timely to support good outcomes for people. The provider worked closely with the federation and Primary Care Network (PCN) with a view to improving patient outcomes.

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

Information provided by the practice met the Accessible Information Standard. Individual communication needs were noted on the patient’s record. Staff told us they supported patients with using online services, as many faced digital barriers. Leaflets were available in the reception area and posters were displayed to provide patients with information on the practice and the different services available to them. Patients were also provided with information on how to access their medical records, or for others on their behalf.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

There was a complaints process in place, which included a designated complaints lead and a policy. Information on how to make a complaint was available on the practice's website. Staff showed a good awareness of complaints procedures. Complaints themes were analysed quarterly and shared with all staff, along with changes implemented. Named members of staff monitored complaints progress and escalated where necessary.

We reviewed several complaints and found they were actioned in line with their policy. Where appropriate, patients were provided with an apology and signposted to the Parliamentary and Health Service Ombudsman. The practice held regular reviews and discussions of complaints which looked at themes, learning points, changes made and other planned actions.

The latest National GP Patient Survey data showed 60 %of respondents described their overall experience of contacting this GP practice as good, below the local average of 73 %and the National average of 70 %. Fifty-six per cent of respondentsfound it easy to get through to this GP practice by phone, in line with the local and national averages of 57%and53% respectively. However only 27 %of respondentsfound it easy to contact this GP practice using their website, below the local and national averages of 53%and 51%.

The provider had created an action plan in response to patient feedback, such as promoting the E-consult system which currently had very low uptake and introducing a callback system at peak times. The provider continued ad hoc engagement with patients to assist them with using online services.

Due to close links and shared staffing with the provider surgery, 19% of respondents were offered a choice of location when they last tried to make a general practice appointment, above the local average of 15% and the national average of 14%.

A mixture of same day or pre-bookable appointments were available, either through telephoning the shared telephone number or online through the E consult system. Enhanced Access appointments were available through Central Middlesbrough PCN, at the providers surgery, Monday – Friday 6:30pm-8pm and Saturday 9am-5pm. Patients could see a range of clinicians, Physiotherapists and Pharmacists.

We checked the appointment system on the days around the inspection and in the afternoon, there were still some limited GP appointments available for the remainder of the day. Patients could also attend extended access appointments available for later in the day at the practice’s provider surgery.

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.Leaders and staff worked to prevent discrimination and inequality that could disadvantage distinct groups of people using their services. They proactively sought out ways to address barriers to improve people’s experience and acted on information about people's experiences and outcomes.

The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers. Patients could fill registration forms in online.

Staff used appropriate systems to capture and review feedback from people using the practice, including those who did not speak English or have access to the internet.The webpage for the practice had a translate function embedded in it.

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 do not attempt cardiopulmonary resuscitation (DNACPR) orders. This information was shared with other services when necessary.Regular clinical and multi-disciplinary meetings with care partners were held.