Bay Medical Group

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

We assessed all quality statements in this key question. At our last inspection the practice was rated requires improvement in responsive. This was because people were not able to easily get through to the practice by telephone, people were not able to access appointments in a timely way, the practice complaints process was not fully effective at identifying risks and learning and taking appropriate action to prevent recurrence of issues. During this assessment, we found that improvements had been made. Our rating for this key question is good overall. However, improvements were required to ensure all complaints were investigated and an appropriate response issued.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People received the most appropriate care and treatment for them. The service made reasonable adjustments where necessary.

Staff and leaders gave examples of people receiving the most appropriate care and treatment for them as the service made reasonable adjustments where necessary.

Bay Medical Group had nearly 55,000 patients and operated over 5 sites. Staff had a good understanding of the demographics of the whole area and each site and offered flexible appointments, including drop-in appointments, to provide care to meet the needs of people.

Partners had no specific feedback on this area.

People’s care and treatment was delivered in a way that met their assessed needs. The practice worked with services in a coordinated and responsive way.

People received information and advice that was accurate, up to date and provided in a way that they could understand.

Staff and leaders ensured people’s individual needs to have information in an accessible way were identified, recorded, highlighted and shared. Staff had completed General Data Protection Regulation (GDPR) training.

The practice had up to date information governance and data protection policies. The practice was registered with the Information Commissioner's Office.

People were enabled to feedback about their care in ways that worked for them, and they knew how it was acted on. The practice had an active patient voice group who met regularly, either face to face or on-line.

Staff told us that the complaints procedure had been more formalised since our previous inspection. The lead met with 2 GPs each month so they could be involved at an early stage if needed. The complaints team told us they sometimes raised a significant event following a complaint being received. However, these were dealt with separately from the main significant event process and were handled by the complaints team. Complaints were sometimes discussed in meetings.

The practice supplied us with their complaints’ policy, which had been reviewed by the complaints’ manager. This contained information for patients and was not a policy for staff to follow. The practice also supplied a document titled ‘Complaints, Comments & Suggestions – Staff Guidance’. This had also been reviewed by the complaints’ manager. This did not contain detailed information about how complaints should be handled or how they were used for learning. Written and verbal complaints were recorded. We looked at 4 completed complaints in detail. We found issues with 3 of these. The 1st person made a complaint about a clinician. This had not been investigated by a 3rd party; the clinician concerned had written to the person, but the letter contained inappropriate comments. The 2nd person had made a written complaint. It had been resolved by a telephone call, but documentation was very brief, and it was not clear what action had been taken. The 3rd person had also made a complaint in writing. It had been discussed with GPs but the person had not been contacted. We discussed this with the complaints’ manager. They told us they had not been able to get hold of the person to discuss the issues, so no response had been made. However, contact had only been attempted by telephone and not in writing. This complaint was not included in the complaints spreadsheet the practice supplied to us. Complaints had been discussed in the Quality, Safety and Governance Group meeting in July 2024, but they were not discussed in the previous 2 meetings in April and June 2024. Learning from complaints was not evidenced.

People could access care, treatment and support when they needed to and in a way that worked for them. This promoted equality, removed barriers or delays and protected their rights. The National GP Patient Survey results for being able to contact the practice by telephone were below the national and local average. However, a new system for appointments had been introduced in January 2024. Feedback was mixed but people commented that they felt access had improved. The practice’s survey on the system showed positive responses, although we received some negative feedback about the availability of appointments.

Staff and leaders explained how the Central Assessment Team (CAT) now triaged all requests for appointments. The system benefited from clinicians working together as a team. Requests were graded according to their urgency, and people were sent a text message, so they knew when to expect an appointment or telephone consultation. Staff told us telephone lines were less busy than before the new system started.

People could make an appointment by completing an on-line form, by telephone, or by attending a practice. If they attended or telephoned, a staff member completed the on-line form for them, and the request went through the same triage process. Urgent and routine requests were dealt with, and people who required an on the day appointment received one. The CAT team consisted of GPs, advanced clinical practitioners, mental health workers and first contact practitioners. The practice was in the process of adding a dietician to the team. The process was constantly monitored to ensure requests for appointments were actioned within given timescales. The monitoring meant that clinicians could be freed up to hold a surgery if it was appropriate to do so.

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

Staff and leaders 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. 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. The provider had made videos to explain some procedures, such as cervical screening and electrocardiograms, to patients. The nurses who would carry out the procedures were in the videos, and these were shown on the provider’s YouTube channel and on the screens in waiting areas. The practice had an Enhanced Health Check project supporting people living in specific streets in the area where it had been identified there was a low healthy life expectancy. The project used a holistic approach looking at health and social concerns. Results were documented and were positive. They included people having cancer screening, changing their medicines, accessing mental health support or being referred to community groups.

People were supported to plan ahead for important changes in their lives.

Staff made sure that when people wanted to express their wishes about cardiopulmonary resuscitation (CPR), they were supported to do so and were able to change their mind if they wished. Leaders made sure external services were involved or updated when needed.

The practice had processes in place to help people plan ahead for important changes in their lives. We saw evidence that staff acted without discrimination when supporting people and their families to make decisions.