Belmont 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

The Responsive key question has been rated as Good. All quality statements for this key question were included in this assessment: Person-centred care; Care provision, integration and continuity; Providing information; Listening to and involving people; Equity in access; Equity in experience and outcomes; and 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.

Feedback from the National GP Patient Survey results demonstrated that 83% of patients described their experience of contacting their GP practice as ‘Good’ and 92% felt their needs were met during their last general practice appointment. The practice undertook monthly Friends and Family Test surveys to assess patients’ experience of the service. The latest survey results for the Friends and Family Test demonstrated that 94% of patients were likely or extremely likely to recommend the practice to friends and family if they needed similar care or treatment. We reviewed patient comments from this survey and found practice staff were repeatedly described as very helpful and friendly. At the time of this assessment, the practice was in the process of working with the Primary Care Network (PCN) to set up a joint Patient Participation Group (PPG) with local practices to facilitate gathering further patient feedback to improve service delivery. As part of this assessment, we asked the practice to share details of our Give Feedback on Care process with patients. Feedback we received from patients was positive. Patients told us they felt listened to and that staff were caring and efficient. Feedback from the National GP patient survey results demonstrated that 92% of patients said the healthcare professional they saw or spoke to was good at listening to them during their last general practice appointment. In addition, 92% were involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment.

Since our last inspection, the practice had undertaken a number of initiatives to improve patient experience. This included participating in the national General Practice Improvement Programme (GPIP) which provides tailored support to general practice to make changes and improvements. As part of this workstream, the practice had successfully developed and implemented a nurse practitioner triage model for on the day patient appointment requests. Care navigation crib sheets were developed with the GPs to aid the reception team to help ensure when patients contacted the practice, they were guided to the right service to receive the right care for them. In addition, the reception team worked closely with the clinical duty team which facilitated any clinical advice required to book appointments appropriately for patients and signpost them effectively.

Staff understood the diverse health and social care needs of their local community and patient population. Care and treatment was delivered in a way to meet those needs and the practice worked in a co-ordinated way with external services. For example, staff told us the practice worked well with local pharmacies as part of the Pharmacy First service; and the Primary Care Network’s Social Prescribing and Health and Wellbeing teams.

Partners reported that the practice management team were very experienced, responsive and supported people to receive care and treatment that was person-centred and met their needs.

Information about patients care and treatment needs was available to share between services as required. The practice was part of the Herefordshire One Record initiative which enabled the sharing of patient records between GPs and other healthcare professionals in the county when needed to improve patient care. The practice had clear referral policies and procedures in place to ensure patient care is joined-up, flexible and supports patient choice and continuity.

We asked the practice to share details of our Give Feedback on Care process with patients as part of this assessment. We received positive feedback from patients although no feedback related specifically to this area. The National GP Patient Survey however found 92% of patients felt the healthcare professional they saw had all the information they needed about them during their last general practice appointment.

Staff and leaders provided us with evidence that showed patients could get information and advice that was accurate, up-to-date and provided in a way that they can understand and which met their communication needs. Patient Service Advisors were available to help patients who found using any of the practice systems challenging. Staff explained they had increased advertising the NHS digital application and informing patients of the benefits of this and access to their medical records. For patients that do not have the technical skill set or confidence to use digital services, the practice had commenced online inclusivity help through the social prescribing team and ‘Digital Champions.’

There were policies and procedures for staff to follow to ensure patients had information that was tailored to individual needs. This included making reasonable adjustments for disabled people, interpreting and translation for people who don’t speak English as a first language and for Deaf people who use British Sign Language. Patients who have difficulty using digital services were also supported with accessible information. There were systems to ensure information about patients that was collected and shared met data protection legislation requirement.

Feedback from the National GP patient survey results demonstrated that 92% of patients said the healthcare professional they saw or spoke to was good at listening to them during their last general practice appointment. In addition, 92% were involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment.

Leaders told us that complaints were regularly reviewed and discussed in practice meetings to share learning. The practice had received 8 complaints in the last 12 months and there was evidence that appropriate action was taken and patients were responded to in a timely fashion.

The practice had a complaints policy. We saw complaints were used to improve the quality of care. There were regular practice meetings where complaints were discussed to share learning and make improvements. Information about how to complain was readily available and patients could make a complaint in person, by telephone, via email or letter.

Patient feedback as a result of the National GP Patient Survey was generally positive with regards to access to the practice. 59% of patients found it easy to get through to the GP practice by phone which was in line with the national average of 50%. 56% of patients found it easy to contact the GP practice using the practice website which was in line with the national average of 48%. 59% of patients felt they waited about the right amount of time for their last general practice appointment which was in line with the national average of 66%. However, 28% of patients said they usually got to see or speak to their preferred healthcare professional when they would like to, which was below the national average of 40%. Staff explained they were working to increase patient education regarding the types of appointments which are clinically appropriate to be undertaken by an Advanced Nurse Practitioner rather than a GP.

Leaders and staff demonstrated they were aware of the challenges to patient access and had acted to improve it. In June 2023 the practice enrolled on the General Practice Improvement Programme (GPIP) and spent 6 months working on reviewing and managing the practice capacity and demand. Since our last inspection, the practice had installed a new telephone system; had utilised the ‘Accurx’ software messaging service; and made changes to the appointment triage system. The practice had also made changes to the staffing structure and had recruited 2 additional Advanced Nurse Practitioners resulting in a team of 4 nurses. As a result of the practice capacity and demand review, leaders told us changes were made with the staffing numbers of the reception team so that between the hours of 8am and 10am, there were always 3 members of staff on duty to meet the increased patient access demand during these times. In addition, to further manage the increased demand during this time and improve access, the practice had been working to inform patients via waiting room notifications, website updates and any patient encounter, that routine enquires should be made after 10am. On an ongoing monthly basis, staff reviewed the telephone and appointment statistics, and information from the Integrated Care Board with regards to the Accurx use, to monitor access performance.

Patients could book appointments by telephone, online, and in person by visiting the practice. All reception staff had received training in Care Navigation to help to ensure all appointments were booked with the most appropriate service. Patients were asked to give some brief details about their concern to allow their request to be triaged. Where patients could be better supported by other local services, patients were advised as how to access these. 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 – 6:30pm Monday to Friday. Extended hour appointments and additional appointments could be made for patients as part of Taurus Healthcare and the Herefordshire GP Federation. The practice had processes in place to ensure auditing of access was maintained which included capacity and demand of appointments, numbers of appointments offered, those accepted or declined and also those which were offered and not attended. These audits supported improvements or changes to be made where required.

Feedback provided by patients using the service, both to the practice as well as to CQC, was positive. Staff treated patients equally and without discrimination.

Staff proactively sought ways to address any barriers to improving people’s experience and worked with local organisations 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. All staff had received equality and diversity training.

The practice had processes to ensure people could register, 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 as a first language or have access to the internet.

We did not receive any patient feedback which directly related to planning for the future however, patient feedback we received showed patients felt listened to and cared for. Results of the National GP Patient Survey showed 69% of patients felt they had enough support from local services or organisations in the last 12 months to help manage their long-term conditions or illnesses which was in line with national averages.

Patients were supported to make informed choices about their care and plan their future care. This included patient wishes about cardiopulmonary resuscitation. Decisions and choices made by patients were documented and reviewed as required. The practice had undertaken a quality improvement project to ensure all patients regularly update their Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) forms, including decisions about cardiopulmonary resuscitation, by renewing them annually. Staff explained regular updates helped to maintain accurate patient preferences and enhance patient-centred care.

The practice had systems and processes in place to ensure patients 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). This information was shared with other services and staff.