Alum Rock Medical Centre

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We carried out an announced assessment of 5 quality statements (Kindness, compassion and dignity; Treating people as individuals; Independence, choice and control; Responding to people’s immediate needs and Workforce wellbeing and enablement). We found:

People were not always treated with kindness, empathy and compassion. They did not always feel listened to. Privacy and dignity was mostly respected.

Patient feedback was mixed and published satisfaction data showed that patient satisfaction was lower than local and national averages.

At the time of the assessment, the provider had not formed an action plan to improve patient satisfaction.

This service scored 55 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Data from the 2024 National GP patient survey showed that patient satisfaction was lower when compared with local and national averages. For example, of those people completing the survey:

• 72% found the reception and administrative team at this GP practice helpful (local average 76%, national average 83%).

• 54% described their experience of contacting their GP practice as good (local average 58%, national 67%).

• 55% described their overall experience of this GP practice as good (local average 67%, national 74%).

• 82% said the healthcare professional they saw or spoke to was good at treating them with care and concern during their last general practice appointment (local average 82%, national 85%).

In feedback we received, patients told us that non-clinical staff were not always helpful and if they didn’t know the answer to their query they did not make effort to ask a colleague. Furthermore, some clinical staff made patients feel anxious and upset and staff were described as rude and unprofessional and people did not always feel listened to.

There was 1 review on the NHS website. This was positive about reception staff and that the patient felt welcomed.

The practice had received 18 reviews on the Healthwatch website between October 2023 and September 2024, we found that feedback was mixed and included both positive and negative comments about staff.

Data from the practice’s in-house patient survey was more positive and showed: 39 out of 40 people found reception staff helpful. Thirty-five out of 40 people felt the healthcare professional they saw or spoke to was good at treating them with care and concern during their last general practice appointment.

Staff collected feedback from patients to help monitor patient satisfaction.

Leaders were aware of some of the comments relating to reception staff and told us staff had been provided with customer service training.

Chaperones were available if needed and privacy screens were used to help maintain dignity.

Leaders discussed complaints and learning in the practice meeting with all staff.

Staff told us patients would often give positive feedback to them at the end of their appointment indicating they were satisfied with the care and advice they had received. Staff valued this feedback.

We mostly observed staff speaking to patients in their native language. We were not able to comment on these interactions due to language barriers.

We saw that there was CCTV in reception, although there were signs outside the building, there were no notices inside the reception area to inform patients of this.

Data from the National GP patient survey showed that 87% of people that responded to the survey felt they were involved as much as they wanted to be in decisions about their care and treatment during their last GP appointment. This was similar to local and national averages.

The practice in-house survey showed that 38 out of 40 patients felt they were involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment.

We received negative comments from people, that they were given an appointment (face to face and/or telephone) with a healthcare assistant or physician associate when they were expecting an appointment with a GP and this appointment did not meet their clinical needs.

Another person had complained that the service would not offer home visits or telephone appointments when one was indicated. However, the person was told they had to attend the practice in person.

Staff shared examples with us where they had considered any relevant protected equality characteristics or people’s culture.

Staff used different communication aids and interpreters to enable patients to engage in their care, treatment and support to improve their experience and outcomes.

Our record reviews indicated that there was some evidence that patients’ individual needs and preferences were understood and these were reflected in their care, treatment and support.

There were processes in place that allowed staff to identify and record patients’ preferences on their patient record. However, from our record reviews, the practice could not demonstrate that this was always being done or that staff were aware of which adjustments may be needed.

For example. when we reviewed records of autistic people or people with a learning disability we did not find any evidence that reasonable adjustments had been considered for this group other than if they needed an interpreter.

We saw that 2 clinical staff had received training on how to support autistic people and people with a learning disability. Another clinical staff member had partly completed the training. However, non-clinical staff were yet to complete this training.

From patient feedback we reviewed we found that overall patients commented they were not always supported with care that met their needs or that they felt they were not always listened to.

Data from the 2024 National GP patient survey showed that of those people that completed the survey:

• 59% said they were offered a choice of time or day when they last tried to make a GP appointment. This was higher than local (48%) and national averages (53%).

• 57% said they have had enough support from local services or organisations in the last 12 months to help manage their long-term conditions or illnesses. This was lower than local (61%) and national averages (68%).

• 24% found it easy to contact this GP practice using their website. This was lower than local (38%) and national averages (48%).

The practice had carried out an in-house patient survey in August 2024. Forty people had responded to the survey, of those patients that responded 31 out of 40 reported they had been offered a choice of appointment when making their last appointment.

Staff told us patients could request to see their named or usual GP, staff accommodated this wherever possible and always for certain groups including palliative care patients.

Staff we spoke with told us that some patients would request an appointment with a male GP, however the salaried GPs were all female. While staff tried to accommodate this request, this was not always possible. The duty GPs were male and were at the practice every day, however they did not carry out routine consultations.

Staff told us they had identified 155 patients as carers. The social prescriber contacted carers to support them.

Extended hours appointments were available through a Primary Care Network (PCN) hub arrangement till 8pm Monday to Friday and 9am-5pm on a Saturday. We received conflicting information about who patients could book an appointment with. Staff told us appointments were with a nurse, pharmacist or physician associate, however information from the PCN indicated these appointments were with a nurse or GP.

Patients could contact the surgery in a range of ways including through telephone, the online consultation system, NHS app or in person.

We found that the nurse worked one day a week and only female GPs were available routinely for GP appointments, this limited the choice available to people.

From our record reviews, we found there was little evidence of reasonable adjustments in place (other than needing an interpreter) to support people to be independent and have control over their own care, treatment and wellbeing.

Patient feedback was mixed.

Feedback to CQC included complaints that people had not been assigned their appointment with the most appropriate clinician and consequently not received the care they needed from the practice.

Other feedback included that staff were rude and unhelpful or that home visits/telephone appointments where not offered when indicated.

When there were delays in their treatment or appointment, people were not kept updated.

The results from the practice’s in-house survey were more positive. We saw that 39 out of 40 people found reception staff helpful and 39 out 40 people felt their needs had been met.

Staff were not always alert to people’s needs because records had historically not been coded correctly for example with safeguarding information or if a medicine review had/had not taken place.

Staff told us interpreters were mostly pre-booked for patients.

Triage systems were in place to identify urgent care needs.

Reception staff were trained to signpost patients accordingly.

All staff we spoke with felt well supported to carry out their roles and responsibilities to the best of their ability and to develop their skills.

Staff had access to support and guidance as needed.

Staff felt able to raise concerns for example, concerns with the building or furniture that needed replacing however, they told us action was not always taken or was put on hold in view of future renovations that were planned.

There were opportunities to discuss complex cases and seek advice as needed, so that staff were not working in isolation.

Staff felt respected and valued by their colleagues.

There were processes in place to support ongoing professional development. Staff received yearly appraisals and had protected learning time to complete training.

Although staff told us they had received an induction, this was not always evident from their staff files.

While staff told us during the assessment they enjoyed working at the practice, the provider could not demonstrate how they formally sought staff views in order to make further improvements and monitor impact on staff satisfaction.

Staff immunisation information had not been collected for all staff where relevant and there were no risk assessments to demonstrate that risk had been assessed and relevant action taken to protect staff and patients.

The provider sent us evidence of 4 workstation assessments for non-clinical staff. Of these assessments, 2 had been completed after our site visit. We saw that 2 staff had identified issues with the workstations and equipment and 2 staff had reported suffering health issues as a result of using the computer at work. We did not see evidence of action being taken to support staff.