St Mark's 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

We carried out an announced assessment of one quality statement, equity of access, under the key question Responsive and found: The leaders used peoples feedback and other evidence to improve access for people. Services were designed to make them accessible and timely for people including those most likely to have difficulty accessing care. The provider prioritised, allocated resources and developed opportunities as needed to meet patient’s needs and achieve equity of access. The National GP Survey Data showed that improvements were needed to patient satisfaction with accessing the service by telephone, appointment times, experience of making an appointment and satisfaction with the appointment offered. The practice had taken steps to address this.

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.

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.

Patients were encouraged to request appointments via an electronic form. Appointments could also be made in-person, by telephone or on-line. Patients were triaged to ensure the appropriate clinician and appointment type to meet the patients’ needs, prioritise any urgency and utilise appropriate resources. Appointments could be face to face, over the telephone, video or home visit. Appointments were offered the same day or could be booked in advance. A dedicated GP and paramedic provided a daily home visiting service. The leaders told us that the improvements to the appointment system had improved patient access as they were now offering more consultations and responding more appropriately to patients’ needs. There were monitoring arrangements for the process for booking appointments and the telephone system to ensure they were effective. Systems were also in place to monitor demand and capacity to help determine the required number of appointments and staffing levels. Information regarding access was displayed at the practice, online and by telephone message. Arrangements were in place for addressing communication barriers with regards to information. Assistance with using the electronic appointment forms was provided to patients over the phone or face to face. A new service had been introduced to complete an electronic consultation form by telephone. Staff were trained to book appointments with the practice clinical team or signpost patients to other appropriate services. The practice offered appointments with a variety of clinical and non-clinical staff for example GPs, health care assistants, advanced nurse practitioners, pharmacists, practice nurses and social prescribers. Clinicians also specialised in areas such as dermatology, women’s health and mental health. The practice was open from 8.30am to 6.30pm during weekdays. Further access was available to patients evenings and weekends as part of a service provided by Southport and Formby Health.

The National GP Patient Survey data demonstrated that patient satisfaction with the appointment they were offered was 67%, which was below the national average of 72%. Patient satisfaction with appointment times was 42% which was below the national average of 53%. Patient satisfaction with making an appointment was 39% which was below the national average of 54%. Satisfaction with getting through to the practice by telephone was 16% which was significantly below the national average of 50%. Results from the NHS Friends and Family Test (FFT) were reviewed. This showed that from December 2023 to February 2024 there were a total of 975 responses received and 776 (80%) rated the practice as very good or good. A survey by an external service was carried out in 2022 which indicated 78% of all ratings, including access were very good or good. A further survey had been undertaken in 2023 and although the results were not available initial indications were that further improvements had been made. Twelve patients had left feedback through Healthwatch. Where this related to access responses were mixed with 4 patients having a positive experience and four patients making negative comments. CQC received no feedback from patients during this assessment. The provider encouraged patients to feedback to the service in a variety of ways. They showed us a number of positive comments made by patients about the service in the last three months. Where any aspects of survey results were lower than expected the practice analysed these and made changes to improve. The provider worked with the Patient Participation Group (PPG) to seek feedback on a range of issues including access. Adaptations were made for patients whose first language was not English and for patients who had information and communication needs related to a disability, impairment or sensory loss. The practice was accessible to patients with reduced mobility.

The leaders understood the challenges they had regarding patient access. They had taken action in response to the National GP Patient Survey. For example, they had made improvements to the appointment system and were now offering more appointments than the previous 12 months. A new telephone system had been introduced which had improved access and could be monitored to identify where improvements were needed. Data showed that more calls were now being answered. Further improvements included an increase in staff numbers and staff roles, longer appointments and staff training. A new website was planned to improve accessibility. Adjustments were made to the service to support patients with any communication barriers or additional needs they may have. For example, support for patients unable to complete a digital form, longer appointments, large print, interpreting services and home visits. Arrangements were in place to support patients who were more likely to have a poorer experience of care such as homeless patients. Alerts were on patient records to identify vulnerability or any additional needs. The provider had also introduced other services to support vulnerable patients, for example they had employed a nurse to specifically support patients with a learning disability. They were also working with a local charity to provide a GP service to homeless patients. Patients also had access to an acute visiting service operated by the PCN. Improvements to the premises had been made to support the needs of patients. It was clear that improving access and patient experience was a priority. Leaders reviewed data and feedback and changes were made to ensure improvements would have a positive impact for their patients.

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.