GP Hub Parkway

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

Staff provided care and treatment equitably and worked to overcome barriers to care. They took account of patients’ individual needs, made it easy for them to give feedback, and acted on this. People could access the service when they needed it and did not have to wait long for treatment. The service made reasonable adjustments to support equitable adjustments and listened to people’s concerns to improve the service.

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.

Staff had a deep knowledge of the local area and its social history, which reflected the medical needs and social demands on the service. They understood patients often presented with avoidable conditions due to needs relating to health inequalities and tailored care to meet these needs.

The provider developed and expanded services to meet patient demand and the needs of the local community. For example, the service ensured patients with a learning disability who presented with a chest infection had access to appropriate medicines. They also adapted care pathways for patients who repeatedly suffered from urinary tract infections to provide access to more effective treatment.

The team recognised patients often sought medicine to treat long term conditions that required an annual review by their registered GP. For example, patients with asthma were required to undergo an annual review with their GP in order to receive prescription inhalers. Where patients presented and needed an inhaler, staff checked their most recent annual review date. If this had lapsed, they prescribed an inhaler to make sure the patient was safe and required them to complete a clinical review with their registered GP. Staff shared information with the patient’s registered GP.

Staff followed clear guidelines to provide care for patients with dementia. The team knew most patients had an established care plan and liaised with other services to make sure care and treatment was appropriate.

The provider 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 GP hub was commissioned to work as part of the wider care system with an urgent out of hours service, and a nearby emergency department (ED). Streaming nurses in the hospital reviewed patients referred from the hub. The streaming process relates to an assessment of need that results in patients been sent, or streamed, to the most appropriate team in the department. Staff worked closely with the streaming nurses and senior ED colleagues to ensure smooth care between the services.

Where staff referred patients to the emergency department, they contacted the duty consultant first and made sure they understood the reasons for the referral and the level of patient need.

GPs could make referrals using the 2-week wait (2WW) list for suspected cancer. The provider’s 2WW standard operating procedure enabled GPs to maintain oversight of the pathway until diagnostic results were received, at which point they contacted the patient’s registered GP and transferred them into their care.

Staff worked with colleagues in other NHS services and the third sector to secure continuous care for patients. This included school nurses, health visitors, and community mental health services.

The service had a good track record of reducing pressures on emergency departments across the borough through effective use of the GP redirections service. By maintaining engagement with colleagues in other services, the GP hubs had accepted 25% of patients initially presenting in ED with non-urgent conditions, substantially reducing pressure on those services whilst providing patients with rapid care.

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

Reception staff kept patients up to date with waiting and treatment times when patients were in the waiting area. The team actively monitored who was waiting to be seen and let them know in advance if their clinic was running late.

Clinical staff provided patients with a printed or electronic copy of their clinical review on request along with a copy of their referral or health advice in the same format.

The service secured language translation services on request.

The provider made it easy for patients to access information about the service such as its scope, access, and opening times. This was available on the hub’s website, the provider’s website, and in information sources managed by the NHS trust.

Staff displayed contact information for specialist agencies in appropriate areas of the clinic, including in discreet locations. This included organisations that provided support with alcohol and drug harm reduction, domestic abuse, sex trafficking, refugee support, and mental health crisis services. While information was supplied by other organisations, staff in this clinic made sure it was clear and accessible to visitors.

The service met the requirements of the Accessible Information Standard by identifying, recording, flagging, sharing and meeting the information and communication needs of people with a disability or sensory loss.

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.

The service had a high rate of return for NHS Friends and Family Test response cards. The senior team incentivised receptionists to secure feedback from patients as a part of a strategy to maintain engagement and a continuous view of performance.

This location received no formal complaints in the previous 12 months. As staff worked across both of the provider’s locations, they learned from complaints made by patients at the Purley site around communication and made sure improvements were implemented.

The provider made sure that people could access the care, support and treatment they needed with as much flexibility as possible.

There was a clear focus from staff at all levels on reducing health inequalities and ensuring people could access care without bias or discrimination. Staff made reasonable adjustments for people with disabilities, those with communication difficulties, or cognitive impairment. People were listened to when they wanted to share their experience.

Staff worked to remove barriers to access for patients and had a deep understanding of the local community and its health and social care challenges. Staff listened to people who had concerns or complaints and sought ways to improve the service.

The provider had adapted opening hours to meet demand. Adults and children were cared for including those seeking treatment for mental ill health. The service worked with other healthcare professionals to provide a timely service for different healthcare needs and serious conditions needing specialist input.

Instances of patients who did not attend (DNA) booked appointments was relatively high, at 1492 (8%) in the previous 12 months. Of these, 76% were appointments booked through the NHS 111 service. The senior team worked with the NHS 111 team to identify causes of DNAs and implement opportunities to reduce them.

All appointments were available on a same-day basis and could not be booked in advance. The team had developed this model over 3 years and found it provided the greatest capacity, lowest risk of DNAs, and enabled the team to most effectively meet people’s needs. All appointments were available as booked slots through NHS 111 or directly from the provider’s website. Some appointments were ringfenced for referrals from the ED and staff made sure they would also see anyone attending on a walk-in basis.

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.

The service provided a daily wound dressing service to patients unable to obtain this through their registered GP. The provider’s contract meant patients had to secure an appointment every day through the NHS 111 service, which also restricted them to a single appointment per day. This presented barriers to care to patients with multiple conditions and those who had to take time off work to obtain healthcare. Staff worked with these patients to secure positive experiences and outcomes. For example, receptionists booked an additional same-day appointment for patients attending for a wound dressing where they had another condition to be reviewed.

The clinical lead was the learning disability lead for southwest London and maintained continual awareness of regional trends in demand and patient need. They provided training in supporting this patient group to non-clinical staff, which ensured a better experience.

Staff coordinated care for patients with specific needs. This included children and young people with autism, people living in traveller communities without electronic health records, people with impaired hearing, and those with mental health needs.

Staff had a clear understanding of the health challenges faced by local people such as deprivation, employment, and education issues and knew they contributed to health inequalities. The team monitored data relating to levels of deprivation and planned care in this context. For example, the service recognised 40% of the residents in Croydon were recognised as living in high levels of deprivation by the government. The service was part of the national ‘safe surgeries’ initiative to reduce the number of people without a registered GP in deprived communities.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

The hub provided a service for minor injuries and illness and staff were not typically involved in discussions about long-term or palliative care, or treatment decisions regarding terminal conditions. However, staff completed training on the Mental Capacity Act and made sure patients understood their care and treatment options.

In the event a patient receiving palliative care presented to the hub, staff provided end of life care prescriptions in liaison with community services the patient’s NHS provider.