Manchester Road East Medical Practice

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 this key question. Our rating for this key question has improved from requires improvement to good. During this assessment we found that patients could access care and treatment in a timely way. There was an improved system to manage complaints in a way that demonstrated duty of candour and in accordance with regulatory requirements.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People received the most appropriate care and treatment for them. The provider made reasonable adjustments where necessary. 88% of people who responded to the most recent GP patient survey said the healthcare professional they saw or spoke to was good at listening to them during their last general practice appointment and 85% said the healthcare professional they saw or spoke to was good at treating them with care and concern during their last general practice appointment.

Staff and leaders gave examples of people receiving the most appropriate care and treatment for them as the provider made reasonable adjustments where necessary.

This was a small practice where the provider had been the lead GP for generations of families where patients were well known and their needs were well understood. Other staff also demonstrated this knowledge and understanding. There was continuity in care and treatment because services were flexible. All staff had undertaken Equality and Diversity training and the needs and preferences of people were taken into account when delivering care and treatment.

Partners had no specific feedback on this area.

People’s care and treatment was delivered in a way that met their assessed needs. The provider worked with services in a co-ordinated and responsive way. Wherever possible people’s care and treatment was delivered in a way that met people’s assessed needs from services that were coordinated and responsive.

People received information and advice that was accurate, up to date and provided in a way that they could understand. 89% of people who responded to the most recent GP patient survey felt the healthcare professional they saw had all the information they needed about them during their last general practice appointment. 83% were involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment.

Staff and leaders told us that information was provided in an accessible way where people with individual needs were identified and their specific requirements were highlighted and shared with all staff. All staff had completed Information Governance training which included General Data Protection Regulation (GDPR). The practice had organised educational evenings to help people to understand how to make appointments and order prescriptions online.

The provider had up to date policies around accessible information and information governance which had been improved since the previous inspection. There were processes to assist people who did not use English as their first language such as language line, interpreters and members of staff who were multi-lingual.

People were encouraged and enabled to feedback about their care in ways that worked for them, and they knew how it was acted on. There was a Primary Care Network (PCN) patient participation group (PPG) where patients from the practice could attend. However, there was no direct PPG for the practice and this was somewhere the practice planned to make further improvement.

Learning from complaints and concerns had improved since the previous inspection and the practice saw concerns and feedback as an opportunity for improvement and learning. However, we discussed how further improvement could be achieved by encouraging staff to document and report verbal feedback such as positive or negative information received from patients throughout the day. This would provide the practice with an opportunity to analyse trends and understand where they were meeting or not meeting people’s needs. The practice agreed this was a protocol they could introduce. The lead GP was responsible for dealing with complaints about the practice but there was no independent reviewer of this.

The provider had updated their complaints policy and procedure since the previous inspection but some parts of this remained inaccurate. We discussed this with the practice manager who advised they would make the required updates. A spreadsheet was to record formal complaints and there had been one new complaint since the previous inspection. All complaints had been acknowledged with either a telephone call or a letter and had been discussed at practice meetings with all staff present. There was no evidence of any specific changes having been made following any of the complaints although actions via informal discussions were apparent.

People could access care, treatment and support when they needed to in a way that worked for them, which promoted equality, removed barriers or delays and protected their rights. 79% of people who responded to the most recent GP patient survey said they were offered a choice of time or day when they last tried to make a general practice appointment. This was 20% higher than the Integrated Care System (ICS) and National results. 82% felt they waited about the right amount of time for their last general practice appointment which was 16% higher than ICS and National results.

Leaders showed us an access action plan and outcome response which demonstrated improvements that had been made since the previous inspection. Websites had been upgraded and the practice noted more patients ordering prescriptions online and using the website for queries which were monitored and responded to. A new telephone system had been introduced which provided a call back service so that patients did not have to queue. Staff had been trained in care navigation and since then more pre-bookable appointments were available.

The provider offered appointments 15 minutes in length. People could make an appointment by calling the practice, attending in person, or online. Patients could choose whether they had a face to face or telephone appointment and home visits were available should a patient require this clinically. Routine nurse and doctor appointments could be made in advance as well as urgent appointments which were available on the day or in advance. On the day of the inspection we noted that appointments were still available with a GP. Medication reviews were also available by telephone with a pharmacist. People did not need to ring on the day to make an urgent appointment and if an appointment was free the following day that could be used.

Feedback provided by people using the service, both to the provider and via the GP patient survey was positive about the experience of the care and treatment they received. 89% of people who responded to the most recent GP patient survey felt the healthcare professional they saw had all the information they needed about them during their last general practice appointment.

The provider looked for ways to listen to information about people most likely to experience inequality and tailored the care and support in response. Staff understood the importance of providing an inclusive approach to care and adjusted the service to support people’s needs. The practice was small and all staff were familiar with the needs of their population.

The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people. Staff used appropriate systems to capture and review feedback from people, including those who did not speak English or have access to the internet. All patients, including deaf patients, were able to access interpreters when required, including at first registration.

There was no specific feedback from people planning for the future.

Staff told us people were supported to plan ahead for important changes in their lives and acted without discrimination when supporting people and their families to make decisions. They made sure when people wanted to express their wishes about cardiopulmonary resuscitation (CPR), they were supported to do so and were able to change their mind if they wished. Leaders made sure external services were involved or updated when needed.

The provider had processes in place to help people plan ahead for important changes in their lives. However, during the clinical searches there was very little evidence of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) documented in patient records. Being proactive and documenting active treatment escalation plans rather than just discussing resuscitation at the end of life was discussed with the provider. If the practice were to broaden the scope of the process it could improve outcomes for patients and the provider agreed to this. We also discussed the importance of documenting power of attorney wishes while a patient had capacity to make decisions.