The Dove 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

Leaders used people’s feedback and other evidence to improve access for people. Services were designed to make them accessible and timely for people who were most likely to have difficulty accessing care. Significant changes were made to the appointments system to improve access to care. The provider prioritised, allocated resources and opportunities as needed to tackle inequalities and achieve equity of access. We recognise the pressure that practices are currently working under, and the efforts staff are making to maintain levels of access for their patients. At the same time, our strategy makes a commitment to deliver regulation driven by people’s needs and experiences of care. Although we saw the practice had taken action to improve access, this was not yet reflected in the 2024 National GP patient survey data.

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 results of the most recent National GP Patient Survey (01/01/2024 to 30/04/2024) showed the percentage of respondents who stated that during their last GP appointment they were involved as much as they wanted to be in decisions about their care and treatment was 83% compared to the local average of 89% and the national average of 91%. Satisfaction had fallen when compared with the results of the survey from 2023, where patient satisfaction was 90%. Patients we spoke with were generally positive about the approach of the clinicians including feeling involved in their care and not experiencing any bias. Results of the NHS friends and family test (FFT) for August 2024 showed that of the 258 responses received, 234 patients would recommend the practice to friends and family moving to the area.

The practice understood the needs of its local population and had developed services in response to those needs. Leaders were able to demonstrate a thorough understanding of the practice’s demographics, the challenges they faced and systems implemented which placed patients at the centre of care. Referral systems ensured patients received consistent, coordinated, person-centred care when they moved between services.

Staff and leaders spoke positively about the patient population they served. They recognised their population was situated in an area of high deprivation. They were able to describe processes to ensure patients received joined-up care, for example through effective multi-disciplinary working where needed. Staff described reasonable adjustments that could be made to support patients in receiving care and the ability to offer choices where possible.

Feedback received from partner organisations working with the practice to deliver care was positive. We found no concerns and the practice was able to provide multiple examples of systems in place to demonstrate effective working with multi-disciplinary teams, the practice's Primary Care Network (PCN) and the local Integrated Care Board (ICB).

All staff had completed training in equality and diversity. Whilst only some staff had completed training on Learning Disability and Autism, the practice was prompt to ensure all staff completed part 1 of the training during our assessment and provided assurance part 2 would be completed in October 2024. Multi-disciplinary working helped provide effective safeguarding support and end of life care. The practice maintained registers of different patient groups, including those with a learning disability, those with mental health concerns and those requiring palliative care. Evidence reviewed demonstrated the provider undertook analysis of the local population and worked with other local services to support patients in the most appropriate way.

None of the patients we spoke with or received feedback from raised any concerns in relation to accessing appropriate, accurate and up to date information.

Staff and leaders assured us efforts were made to keep practice information up to date. Interpreting and translation services were used for patients whose first language was not English and for patients who used British Sign Language. Patients who had difficulty with reading, writing or using digital services were supported with accessible information.

Systems were in place to maintain accurate information. This included keeping the practice website up to date. Processes ensured patient’s individual needs for accessible information were identified, recorded, highlighted and shared. These needs were met and reviewed to support their care and treatment in line with the Accessible Information Standard. Notice boards in the patient areas were well maintained and provided an array of appropriate information for patients and carers. The practice’s opening times were well advertised, as was information on how to complain, although complaints forms were only available through collection from reception. Systems ensured sensitive and confidential information about patients met data protection legislation requirements. Patients were informed on how to access their health and care records and decide which personal information could be shared with other people, including their family or care staff.

The practice undertook its own in-house patient surveys, although the most recent survey was focused on access. None of the patients we spoke with raised any concerns about their ability to provide feedback or complain. We spoke to a member of the patient participation group (PPG) who advised they felt valued by the practice and the group were encouraged to provide feedback. They advised us the practice team made efforts to involve the group where possible.

Staff and leaders told us patient’s views were acted on to improve services and culture. Staff described how complaints were discussed in practice meetings and areas of improvement were identified and shared.

The practice had a complaints policy and process. The ability to complain was advertised in the patient waiting area, however, we noted that complaints forms had to be collected from reception staff. We saw complaints were managed by a designated individual and evidence we reviewed demonstrated investigations were thorough and timely. Patients were provided with a response to their complaints and advised of appropriate actions they could take if they were not satisfied with the outcome. 50 complaints had been received since January 2024 and none of these had been referred to the Ombudsman. There was evidence that complaints were used to drive continuous improvement.

We reviewed the practice's results from the 2024 National GP Patient Survey (01/01/2024 to 30/04/2024). This found patients’ responses to questions about how easy it was to get through to someone at their GP practice on the phone, how easy it was to contact their practice and their overall experience of contacting the practice were below the national average. In 2023, the practice’s results were significantly lower than the national average for patients who found it easy to get through on the phone, which was 19%. We saw that in 2024, satisfaction had improved slightly to 20%. Patients we spoke with were largely positive about their experiences of getting access to care and several commented positively on the recently introduced triage system. Action taken following the 2023 National GP Patient Survey showed that leaders had reviewed the results and had taken action in response to the feedback received to try and improve patient satisfaction with access. Patient feedback gathered by the practice was more positive. Although not directly comparable to the National GP Patient Survey, an inhouse patient survey undertaken by the practice in August 2024 showed increased levels of satisfaction. For example, of 70 patients who responded, 73% had said they found it very easy or easy to contact the surgery. However, 65% of those contacted said they had been put off contacting the surgery because of wait times. 88% of patients had used the online system to try and arrange appointments. Patients whose first language was not English or who had other communication needs could access interpretation services through the practice. The practice was accessible to patients with mobility needs, with ramp access to the premises and a large waiting area.

Leaders and staff demonstrated they were aware of the challenges to patient access and had acted to improve it. The introduction of an online triage system in June 2024 for patients requesting appointments or support had been well received and was working well to reduce pressures on the telephone system. Services were altered accordingly to meet demand. We heard how the practice provided opportunities and support for different groups of patient population to overcome health inequalities, including adjustments to the registration and to how patients could communicate the practice. We heard about ways that the practice was working with other local stakeholders to improve access to primary care.

Patients could book appointments by telephone (with support from staff), online, and in person by visiting the practice. Appointments were available face to face, by telephone, or as a home visit. In response to the results of the 2023 National GP Patient Survey and as part of the General Practice Improvement Intensive programme the practice made significant improvements to the practice’s appointment system, which included the introduction of an online triage system in June 2024. Although the system was yet to be audited, leaders advised early indications based upon patient feedback and telephony data were positive. All requests for care were triaged by a GP with dedicated administrative support. Processes were developed in line with the demands of the practice’s patient population who were situated in an area with high levels of deprivation. Systems were in place to call and recall patients to attend for childhood immunisations and cervical cancer screening. The practice had arrangements for prioritising patients. Staff were trained in care navigation which enabled them to signpost to other services and had documented information to support them with this, for example: Pharmacy first (an NHS scheme where patients are able to consult with a community pharmacist for specific minor ailments) or first contact clinicians through their Primary Care Network (PCN) such as pharmacist, mental health practitioner and social prescriber. The practice opening times were 8am to 6.30pm Monday to Friday. In addition, extended access appointments were available through the PCN from 6.30pm to 8pm Monday to Friday and on Saturday and Sunday from 9am to 1pm. When the practice was closed, patients were advised to contact NHS 111. Those calling the practice were automatically re-directed to the out of hours provider.

People told us they felt empowered by staff to give their views and felt the practice supported their rights to equality and their human rights. People told us they felt any cases of discrimination or inequality would be listened to and acted on to improve care. None of the patients we spoke with raised concerns relating to equity in experiences or outcomes.

Leaders told us how they took a proactive approach to support those that may struggle to access appointments. Alerts were used on the clinical system to identify those who may need reasonable adjustments so that they could be accommodated. Staff demonstrated an awareness of patients who may be at risk of digital exclusion and took steps to support them. The practice worked as part of a Primary Care Network (PCN). PCNs are groups of GP practices collaborating with community, mental health, social care, pharmacy, hospital, and voluntary services in their areas to provide local services.

The practice complied with legal equality and human rights requirements by avoiding discrimination, having regard to the needs of people with different protected characteristics, and making reasonable adjustments to support equity in experience and outcomes. The practice was an IRIS accredited service. IRIS is a specialist domestic violence (DVA) training, support and referral programme for General Practices. The practice was also a recognised Safe Surgery. A Safe Surgery is a GP practice which commits to taking steps to tackle the barriers faced by migrants accessing healthcare. People’s care, treatment and support promoted equality, removed barriers or delays and protected people’s rights. The practice had systems to obtain and review patient feedback. This information was used to review patient experience and address any instances of discrimination. The practice had information available in alternative formats and equipment to support patients who had a hearing impairment. The practice had taken steps to promote patient confidentiality.

We could not collect evidence from patient feedback to score this evidence category. Our observations raised no concerns. The evidence we reviewed did not show any concerns about people’s experience regarding planning for the future.

Staff and leaders had an awareness of systems to support patients requiring end of life care. They advised there was a register of patients and that multi-disciplinary meetings were held with relevant healthcare professionals to ensure the best possible care was available.

Clinicians understood the requirements of legislation and guidance when considering consent and decision making. Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions were made in line with relevant legislation and were appropriate. As part of our assessment, we reviewed 5 DNACPR decisions made within the last 12 months. We undertook a random review of records and saw that they were all detailed and comprehensive. We identified that decision forms had been retained and signed by an appropriate clinician. Care notes outlined how the decision had been discussed with patients, and how an assessment of the patient’s mental capacity had been undertaken.