• Doctor
  • GP practice

Dr Baxter and Partners

Overall: Good read more about inspection ratings

Robert Lucas Drive, Hitchin Road, Shefford, Bedfordshire, SG17 5FS (01462) 818620

Provided and run by:
Dr Baxter and Partners

Report from 10 January 2024 assessment

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Responsive

Requires improvement

Updated 1 February 2024

When we inspected in 2019, we rated the practice as requires improvement for providing responsive services because National GP Patient Survey results were lower than local and national averages and some patients told us that there was difficulty in making appointments or accessing the practice via the telephone. On 10 January 2024 we carried out an announced assessment of the equity of access part of the responsive key question. We noted that patient satisfaction (as measured by the 2023 National GP Patient Survey) with getting through to the practice by phone and with the overall experience of making an appointment remained below average, and some patients told of difficulties. The practice had used feedback and other information to try to optimise patient access. Since the last inspection, the practice had made some significant changes to how patients could contact the practice, which had improved the service and gave the practice much better data about what patients needed. These improvements were made after the last National GP Patient Survey results and were not yet consistently reflected in feedback about the patient experience. The practice continued to monitor and make improvements.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Person-centred Care

Score: 2

We did not look at Person-centred Care during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Care provision, Integration and continuity

Score: 2

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Providing Information

Score: 2

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Listening to and involving people

Score: 2

We did not look at Listening to and involving people during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Equity in access

Score: 3

In the 2023 National GP Patient Survey, the practice’s data for access was mixed. Patient satisfaction with their GP practice appointment times and satisfaction with the appointment offered were in line with average. Patient satisfaction with getting through to the practice by phone and with the overall experience of making an appointment were below average. The most significant outlier was the ease of getting through to the GP practice where practice performance was 18% compared to the national average of 49.6%. Patient feedback gathered by the practice was more positive, including feedback gathered after some recent improvements, but this cannot be compared directly to the National GP Patient Survey. For example, 85 patients completed the Friends and Family Test in December 2023. 81% said that their experience was good or very good, and 13 patients mentioned the online request form positively. When asked what needed to improve, 7 patients suggested that appointment access and 1 patient said phone waiting times. We had feedback from 4 patients who made negative comments about the service, including about the time to get through by phone.

Leaders and staff demonstrated they were aware of the challenges to patient access and had acted to improve it. The practice created an action plan in response to the annual National GP Patient Survey results. We heard about some changes made including: the introduction of a form on the practice website for patients to use to request an appointment or completion of an admin task and work to improve patient knowledge of other ways to receive treatment, including from local pharmacies, and of the different clinical staff in the practice. We were told how these changes were assessed to make sure patients were not disadvantaged and how the impact of the changes was being monitored. Staff told us that the data from the online request form had given the practice very valuable data as to differences in the type of care patients were looking for when they contacted the practice on different days of the week, and that this information was used to make changes to the services provided. 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, online, and in person by visiting the practice. Patients could ask for administrative requests to be completed by filling in a form on the practice website. Appointments were available face to face, by telephone, or as a home visit. Same day appointments were available and patients could also book routine appointments in advance. The practice was open 8am to 6.30pm Monday to Friday. Pre-booked appointments were available on weekday evenings and at the weekend through an arrangement with other local GP practices. When the practice was closed, patients were advised to contact NHS 111. We saw evidence that following changes made by the practice, patients were contacting NHS 111 less and were generally only using NHS 111 when the practice was closed. The practice had arrangements in place for prioritising patients. Staff were trained to book appointments with members of the practice clinical team or signpost patients to other appropriate services and were supported to this by documented protocols and access to a duty doctor. Appointments were available with GPs, nurse practitioners, practice nurses, healthcare assistants, pharmacists, and a paramedic. There was also a social prescriber and a health and well-being coach. Appointments were adjusted to take into account demand from patients around school holidays and bank holidays and the time of year (with, for example more appointments with staff able to treat minor illnesses in winter). We saw evidence that the changes made by the practice (including the online request form) had reduced the numbers calling the practice and reduced the length of time patients waited for their calls to be answered.

Equity in experiences and outcomes

Score: 2

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Planning for the future

Score: 2

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.