Manor Surgery

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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

The practice was very responsive to the needs of the local population. Patients could use the phone system, e-consults (online consultations with clinicians) and received information through text messages that supported them in accessing information. The provider had a flexible approach to staffing levels and adjusted them as required to ensure sufficient staffing and skills mix. The practice had recently taken on an additional branch and more patients who were previously registered at another practice. They proactively engaged with these patients to determine what their needs were and adjusted their services over time to enhance the experience of this population. For example, the number of clinicians at both sites was monitored closely and adjusted as needed based on the demand. There were 3 systems for patients to access care depending on their needs. These were routine triage where patients would be added to a list for clinical triage or allocated to urgent appointments if needed but could also receive advice from support staff where their needs did not require a clinical intervention. Phone triage, e-consults and text messages were used for communication. In addition, there was a proactive system and team made up of GPs, Nurses, Care Coordinators and Social Prescribers who worked alongside a patient’s usual GP. The team worked proactively to improve access to healthcare for the practices highest need patients and their families, and to those with a barrier to accessing health and social care independently through the usual route. This team supported patients and their families through both short-term health and social care crises, and longer-term frailty, chronic disease management and end of life care. The practice monitored data and feedback related to patients’ experiences when accessing care at the service. Where feedback demonstrated opportunities to improve, the practice responded with changes designed to continually improve access.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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.

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.

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

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.

Leaders had an extensive understanding of the local patient population and their needs. They monitored the appointment system daily and discussed access to services regularly, including daily discussions about the access and care requirements of patients with the highest needs. The leadership team demonstrated they were aware of the challenges in accessing services faced by some patients. For example, the patient record system was used to identify patients living with disabilities, sensory impairments, learning disabilities and those who may experience barriers to care. Longer appointments were offered where patients needed them. Home visits were also provided alongside other interventions as identified by the proactive care team.

The provider used real time data to monitor access and adjusted resources based on demand. Staff and patients were encouraged to provide feedback about the systems to make necessary adjustments. The access to care systems were designed around patients’ diverse needs and their experience. For example, recent adjustments were made to enhance patient experiences including providing female GP access, coil fitting services and dermoscopy. A language translation service was available for patients who did not use English as a first language and various communication tools were used to support patients for whom using digital communication or phones were not meeting their accessibility needs. The proactive care system operated on 3 levels dependent on patients’ needs and were adjusted over time, to each individual patient’s needs. For example, patients receiving end of life support or patients with exacerbations of their mental health conditions received greater proactive care and support input during specific times.

People using the service benefitted from a diverse appointment and access system to ensure their needs were met. The feedback consistently demonstrated high levels of satisfaction. National GP Patient survey results for the practice were above the local and England averages. For example, 63% of patients stated they found it easy to get through on the phone compared to 53% locally and 50% nationally, 67% were offered a choice of appointment last time they tried to access one compared to 59% locally and 59% nationally and 69% of patients described their overall experience of making an appointment as good compared to 55% locally and 54% nationally. We were contacted by 60 patients via the CQC Give Feedback on Care system. 59 of the responses were either positive or highly positive about experiences of accessing care. The comments included; “The wait was not long at all and the check-in system was easy to use. The GP appointment wasn't difficult to schedule either” “I emailed a query regarding a medical problem and they replied promptly with a face to face appointment. I only had to wait a few days for my appointment”, and “I recently attended an appointment at the Manor surgery with my relative. The whole process from calling up to being seen was very quick and efficient.” Another patient told us about their experience of accessing an urgent appointment, “I attend the Manor Surgery in Kennington. It is an exceptional example of patient centred GP care. I have found same day appointments for urgent issues to be readily accessible when I need them; administrative staff are friendly, helpful and proactive in facilitating this. GP staff are responsive and compassionate.” Other feedback included “The online consulting works really well for me. It says response within two days but every time I've used it they have responded within a couple of hours . Offering advice and what steps I need to take next . They also book you an appointment if they think it is needed”

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.

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.