Billinge Medical Practice

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• 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 from this key question. Our rating for this key question has improved from inadequate to good. At this assessment we found that there had been a number of improvements to ensure people could access care and treatment in a timely way. This included changes to staffing, the appointment system and the monitoring of access. Improvements had also been made to the systems to act on patients’ views and evaluate that the action taken was effective. People received person-centred care. People, those who supported them, and staff could easily access information and advice. This supported them in managing and understanding their care and treatment. There was partnership working to make sure that care and treatment met the diverse needs of communities. There was a system to manage complaints in a way that demonstrated duty of candour and in accordance with regulatory requirements. There were systems and processes for planning for the future.

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.

There was no specific feedback from people who used the service about Person-centred care.

People’s records reflected their physical, mental, emotional and social needs; including those related to protected characteristics under the Equality Act. People could receive the most appropriate care and treatment for them, as the service made reasonable adjustments where necessary.

Staff and leaders told us that people’s care and treatment was delivered in a way that met their assessed needs. Leaders knew the needs of their patient population and delivered services or took action to deliver services that met these needs. For example, since the last inspection a phlebotomy service had been re-instated to reduce the need for people to have to travel to have a blood test. The service had a Pride in Practice Award for the work undertaken to improve the experience of LGBTQ+ people accessing primary care services. The service was also a veteran friendly practice as it recognised the importance of supporting the care and treatment of people who had served in the armed forces. Staff told us how they worked with other health and social care services to ensure there was continuity in people’s care and treatment.

Partners had no specific feedback on care provision, integration and continuity.

There were processes to monitor and meet the health care needs of the local patient population. Systems were in place to ensure people received coordinated care and treatment. All staff had undertaken Equality and Diversity training, and the needs and preferences of people were taken into account when delivering care and treatment.

There was no specific feedback from people who used the service about providing information.

Staff and leaders ensured people’s individual needs to have information in an accessible way were identified, recorded, highlighted and shared. People who used the service, their family and carers (where appropriate) were provided with information that was safe and secure.

There were systems in place to tailor information to individual needs. Reasonable adjustments were made for people, for example, disabled people and people who did not speak English as a first language. People who had difficulty using digital services were also supported with accessible information. The provider had up to date policies to support information governance which included General Data Protection Regulation (GDPR) and all staff had completed information governance training.

Feedback from the Patient Participation Group (PPG) indicated that people knew how to provide feedback and ideas or raise a complaint about the service. Feedback from the PPG indicated that changes had been made to the service as a result of listening to people’s feedback. The National GP Survey carried out from January 2024 – March 2024 indicated 82% of people were involved as much as they wanted to be in decisions about their care and treatment. The survey undertaken by the PPG In July 2024, which had feedback from five times as many patients as the National Patient Survey indicated 93% of patients were involved as much as they wanted to be in decisions about their care and treatment.

Staff and leaders were familiar with the processes for people to provide feedback or complaints about their care and treatment. Feedback could be made through the complaints process, suggestion box, on-line, through surveys and the PPG. Staff and leaders provided examples of how improvements had been made to the services as a result of listening to feedback from people who used the service.

Information about how to complain was readily available. We reviewed a sample of 3 complaints. These had been responded to appropriately and in a timely manner. When a complaint took longer to resolve people were kept informed as to the reason for this. Duty of candour was evident in responses to complaints. There was a process for learning from complaints and any actions needed to be shared across the whole staff team. There was evidence that complaints were used to drive continuous improvement.

People could access care, treatment and support when they needed to in a way that worked for them. The National GP Patient Survey was carried out shortly after the current provider began operating the service. Following a number of changes to staffing and access to appointments the Patient Participation Group (PPG) carried out a further survey in July 2024. Findings showed:- 52% of respondents to the National GP Survey reported a good overall experience of contacting the practice compared to 92% of respondents to the PPG survey. 20% of respondents to the National GP Survey reported an easy experience of contacting the service by phone compared to 84% of respondents to the PPG survey. 61% of respondents to the National GP Survey reported that they waited about the right amount of time for their last appointment compared to 88% of respondents to the PPG survey. NHS Family and friends test feedback showed that from January to August 2024 84% of 2,133 respondents would recommend the practice.

Leaders told us how they had acted on patient feedback to improve access. Staffing numbers and roles had been reviewed, more staff employed, improvements made to the appointment system and telephone system. A service development plan was in place that indicated the changes made and further plans to improve people’s access. For example, a new website was in the process of being developed. Staff told us that there had been a number of positive changes to the service to improve patient access. They said that patients were happier with the service they received and that made coming to work enjoyable for them.

The practice offered appointments Monday 8am to 8pm and Tuesday to Friday 8am to 6:30pm. Appointments were 15 minutes in length. Longer appointments were available for people who needed them. People could make an appointment by calling the practice, attending in person, or online via the NHS app or through an electronic triage tool. Appointments were face to face, telephone, video consultation or as a home visit. Patients were able to choose whether they saw a clinician in person. Routine nurse and doctor appointments could be made in advance. There were arrangements to prioritise patients to ensure urgent needs were met on the same day. On the day of the inspection, we noted that timely routine appointments were available with a range of clinicians. There were clear arrangements for what people should do if they needed care and treatment when the practice was closed. There were systems and processes to audit access to ensure this met people’s needs. These audits supported improvements or changes to be made where required. The provider had processes in place to gather patient feedback about access, to act on the findings and evaluate the changes made. The PPG had begun to produce a newsletter for patients. This included useful information for people about how the service was operating. For example, staffing, appointments and how the practice had responded to patient feedback.

There was no specific feedback from people who used the service about equity in experience and outcomes.

Leaders proactively sought ways to address any barriers to people’s experience and worked with local organisations, including within the voluntary sector, to address any local health inequalities. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes.

The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers. Staff used appropriate systems to capture and review feedback from people using the service, including those who did not speak English or have access to the internet or digital devices. The provider had regard to the needs of people with different protected characteristics and made reasonable adjustments to support equity in experience and outcomes.

Records viewed showed that when people expressed their wishes about their future care such as cardiopulmonary resuscitation, this was documented and reviewed.

Staff and leaders told us how they made sure when people wanted to express their wishes about cardiopulmonary resuscitation (CPR), they were supported to do so. Leaders made sure external services were involved or updated when needed.

There were systems and processes to ensure people who may be approaching the end of their life were identified (including those with protected characteristics under the Equality Act and people whose circumstances may make them vulnerable). There was a process to share this information with other services and staff.