The Firs Medical 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

Patient feedback was mostly positive about accessing the practice. The practice had developed a digital hub to improve patient access and had engaged with patients about the change. The practice had worked to ensure that all patients could access the care, support and treatment they needed when they need it. The leader were working towards tailoring care support and treatment to those who experience inequality in experience or outcomes.

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 national GP patient survey carried out from January to March 2024 had 90 responses, which demonstrated 80% of patients found health care professionals fairly or very good at treating them with care and concern and 95% of patients had defiantly or to some extent confidence and trust in the healthcare professional they saw or spoke to. Ninety one percent stated their needs were defiantly or to some extent met. The practice submitted their own unverified survey in July 2023 which had received 278 responses. This found 87% of healthcare professionals were very to fairly good at listening to them. CQC did not speak to patients on the days of the assessment.

The leaders explained they worked with multidisciplinary teams and other partners to enable co-ordinated patient care. The practice was working with the local primary care network to develop proactive anticipatory care multidisciplinary meetings, this would help patients to stay independent and healthy for as long as possible at home. The practice has been involved in forming its own multi-agency action group, which was made up of health partners, and the local authority. This had delivered GP pop up clinics, which provided access to social prescribers, GPs, pharmacists, dentists, nurses, and local vaccination teams together with over 20 other voluntary, community and social enterprises partners. In 2023 the practice was involved in developing diabetic workshops, this was part of a targeted quality improvement program, aimed at supporting patients with diabetes, one of the largest cohorts of long-term health conditions at the practice. The primary objective was to assist patients to better manage their diabetes through enhanced education and lifestyle modifications. This was led by the social prescriber and health and well being coach (in collaboration with diabetes specialists and representatives from Diabetes UK.

The staff explained, in January 2024 the practice invited patients by text who had not engaged with the practice during the last six months to a GP pop up clinic where they offered free massages, physiotherapy, a dental check, a haircut, a free health check, and covid vaccines. Staff told us the practice ran searches to identify their very vulnerable patients who were at high risk from poor health or isolation. The practice carried out welfare checks on these patients. The practice had social prescribers who have open days to tell people about services and support available locally. The practice ran a flu campaign in partnership with a local mosque.

Leaders explained they met regularly with multi-agency staff to discuss and improve outcomes for people with complex needs. The practice was working with the local primary care network to develop proactive anticipatory care multidisciplinary meetings, this would help patients to stay independent and healthy for as long as possible at home. The staff from local integrated care system stated they did not have any concerns about the practice. The practice was actively involved in their local primary network, where they worked with other practices to improve the local health inequalities.

The practice reviewed long-term condition monitoring at their safety and quality meetings. The practice attended both anticipatory and current multidisciplinary meetings regular to review and improve patient care. Patients could book appointments online, through the digital hub or by telephone, longer appointments were offered to those with more complex needs. People in vulnerable circumstances were easily able to register with the practice, including those with no fixed abode such as homeless people and Travellers. Patients could be referred to the PCN appointed Mental Health nurse, who worked one day a week at the practice. The practice carried out the Safer Surgeries project in collaboration with Doctors of the World. This was a project that aimed to improve access to healthcare for migrants in vulnerable circumstances, particularly around registration.

The national GP patient survey carried out from January to March 2024 had 90 responses. This found 93% of patients stated the health care profession to some extent or definite had the information they needed about them, and 85% of patients stated the healthcare professional was fairly or very good at listening to them. The practice submitted their own unverified survey in July 2023 which had received 278 responses. This found 87% of healthcare professionals were very to fairly good at listening to them. CQC did not speak to patients on the days of the assessment.

The leaders and staff explained how they ensured information was available to as wide an audience as possible. The leaders explained they recruited staff who were multilingual and from the local community.

The practice complied with the Accessible Information Standard and staff had completed training. There were arrangements in place for people who need translation services. The practice website was available to as wide an audience as possible, and included accessible online tools such as translation and the ability to change colours, font and the use of a screen reader. Staff had access to the data protection and accessible information policies online.

The national GP patient survey carried out from January to March 2024 had 90 responses. This found 85% of patients stated the healthcare professional was fairly or very good at listening to them. The practice submitted their own unverified survey in July 2023 which had received 278 responses. This found 87% of healthcare professionals were very to fairly good at listening to them. We were provided with patient feedback from local Healthwatch they had gathered from social media and the provider website from July 2023 to April 2024, found 37 positive and 10 negative comments. CQC did not speak to patients on the days of the assessment.

The practice had carried out an independent staff survey in June 2024, 15 out of 29 staff responded, all agreed their manager encouraged them to raise issues without fear of getting into trouble. Leaders told us that complaints were reviewed responded to and shared with colleagues. Any improvements were made in response to the complaints.

The practice had received 31 complaints in the previous 12 months. We examined 3 complaints and found all had been managed satisfactorily and in a timely manner. Information about how to complain was readily available. There was evidence that complaints were used to drive continuous improvement. The practice categorise complaints received as administration which were responded to by the practice manager or clinical which were responded to by the clinical leads. The practice acknowledged complaints within 3 days. We saw from meeting minutes that complaints were a standing agenda in clinical team meetings.

The national GP patient survey carried out from January to March 2024 had 90 responses. This found 76% of patient had a fairly to very good experience of contacting the practice, 76% found the reception staff fairly to very helpful and 77% found contact through the website fairly to very easy. 90% of patients know what he next step would be after contacting the practice, this increased to 95% within two days. However, 48% of patients found it fairly easy to very easy to contact the practice by phone. The practice submitted their own unverified survey in July 2023 which had received 278 responses. This found 63% described their experience of making an appointment from fairly to very good, and 74% of patients found it fairly to very good to make contact by phone. In addition, 86% of patients found the receptionist fairly to very good, 62% were fairly to very satisfied with the appointment times and 52% were satisfied with the choice of appointments offered. We were provided with patient feedback from local Healthwatch they had gathered from social media and the provider website from July 2023 to April 2024, found 37 positive and 10 negative comments. The positive comments covered the booking system, the quality of the practice, and reception staff. The negative comments were regarding practice administration and medicines. CQC did not speak to patients on the days of the assessment.

The practice had implemented a new GP-led total triage model supported by AI-powered triage software, delivered through an innovative digital hub and centralised call centre. The hub had GP’s co-located in a multidisciplinary team hub setting, supported by GP assistants, care navigators, pharmacists and paramedics who triaged and signposted all requests for support at the first point of contact through a single point of access virtual front door. Staff were supported by a clinical and non-clinical triage guide. The provider explained this had reduced the number of missed calls, enhanced patient access and maintained service quality. After six months the average call queue time and missed calls were reduced, calls answered went from 70% to 92% and there was 100% response to online consultations within 3 hours. Prior to the introduction of the digital service, the practice had held patient engagement meetings. The staff provided examples of how they had engaged with patients and their families who were unable to use the phone or digital platforms to offer them care or treatment. The leaders said that the new digital system had caused their patients accident and emergency and NHS 111 use to decrease, and patient attendance was the lowest in the local area.

The practice was open from 8am to 6.30pm Monday to Friday and extended hours appointments were available in the evenings and weekends. The practice had implemented a new GP-led total triage model supported by AI-powered triage software, delivered through an innovative digital hub and centralised call centre. The digital hub was open from 7.30am. The staff had a service level agreement of a response within 3 hours which was monitored through a dashboard system. The practice had a quality improvement plan which included reviewing any barriers to accessing appointments. Appointments could be booked on the same day and in advance through the online patient access application. The practice had introduced a triage protocol to help staff identify patients who needed to be seen urgently or face to face. All requests for home visits were reviewed and responded to by the triage GP. The practice had a silent surgery concept meaning the phones do not ring but the dashboard clearly showed who was in the call queue and how long they had waited. The staff ran mock mystery calls to monitor how practice staff dealt with patients calls, and staff calls were audited to ensure compliance with customer service. The practice had drafted reports about the quality improvements in two areas telephone access and innovative digital hub.

The national GP patient survey carried out from January to March 2024 had 90 responses. This found 76% of patient had a fairly to very good experience of contacting the practice, 76% found the reception staff fairly to very helpful and 77% found contact through the website fairly to very easy. 90% of patients know what the next step would be after contacting the practice, this increased to 95% within two days. The practice submitted their own unverified survey in July 2023 which had received 278 responses. This found 63% described their experience of making an appointment from fairly to very good. In addition, 86% of patients found the receptionist fairly to very good, 62% were fairly to very satisfied with the appointment times and 52% were satisfied with the choice of appointments offered. We were provided with patient feedback from local Healthwatch they had gathered from social media and the provider website from July 2023 to April 2024, found 37 positive and 10 negative comments. The positive comments covered the booking system, the quality of the practice, and reception staff. The negative comments were regarding practice administration and medicines. CQC did not speak to patients on the days of the assessment.

The practice carried out the Safer Surgeries project in collaboration with Doctors of the World. This was a project that aimed to improve access to healthcare for migrants in vulnerable circumstances, particularly around registration. The staff told us that patients they did ask for an address when patients want to register. If they had no fixed abode, they provided the practice address and register the patient. The practice was planning to carry out a quality improvement project in September 2024 because they had identified from patient feedback that patients are not able to see the doctors they want to see. This involved providing the names of the GPs on the online access form and asking the patient whether there was a particular GP they wanted to see so that staff could book the patient an appointment with that GP.

The practice had tried to recruit staff from the specific local communities to enable equity of access. The practice had a health and well being coach and social prescribers. The practice had a GP pop up clinic where they offered free massages, physiotherapy, a dental check, a haircut, a free health check, and COVID vaccines to patients who had not contacted the practice in the last six months. The practice monitored the quality of access and made improvements in response to findings.

The national GP patient survey carried out from January to March 2024 had 90 responses. This found 95% of patients stated they were to some extent or definitely involved as much as they wanted to be in decisions about their care and treatment. CQC did not speak to patients on the days of the assessment.

The leaders explained how they had planned for the patients care, through the anticipatory and multidisciplinary team meetings, and through the involvement in the local health inequalities group.

We reviewed five patients Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions and found they were made in line with relevant legislation and were appropriate. The practice held a three-monthly palliative care meeting to review patients’ needs and had a system in place to ensure their needs were met. The practice had carried out a review of all deaths in the last 12 months.