Lupset Health Centre

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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 carried out an announced assessment of one quality statement, equity of access, under the key question Responsive. We found that the practice had reviewed areas of previous below average performance and put in place measures, such as the introduction of a new telephony system to improve access. We saw the practice supported patients via Care Navigation to access services which were more appropriate to their needs. Services were designed to make appointments accessible and timely for people including those most likely to have difficulty accessing care. For example, patients with a learning disability, or those which were patients with the Special Allocations Scheme were offered longer appointments. The provider prioritised, allocated resources and developed opportunities as needed to tackle inequalities and achieve equity of access. Where negative feedback was received, or opportunities to improve were identified, the practice responded with plans being developed and implemented, and changes designed to improve access, patients’ experiences, and satisfaction levels. As evidence of this we saw that the practice had developed a plan to optimise access which required them to evaluate current demand and capacity and put in place improvements. Actions taken included those related to telephony and the allocation of additional staff to answer telephones at peak periods. Analysis of patient preferences saw the practice introduce a hybrid model of care which consisted mainly of telephone consultations and face to face appointments which were interchangeable dependent on clinical need and patient preference.

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.

In the 2023 National GP Patient Survey, the practice’s results for satisfaction for the ability of patients to contact the practice by telephone, and their experiences of their appointments were consistently below national and local averages. The practice adapted services for patients who had additional needs. For example, patients with a learning disability were offered longer appointments. Results from the NHS Friends and Family Test (FFT) were reviewed, and we found them to be generally positive. From September 2023 to February 2024 the practice had received 1,670 responses. Of these 1,520 rated the practice as either very good or good, and only 71 rated the practice as either very poor or poor. A recent survey undertaken by the PPG showed that of 93 responses 55% of patients said their experience of being a patient at the practice was either excellent or very good, 30% neither good nor poor, and 15% rating their experience as poor. We saw the practice had responded to patient feedback of their experiences. For example, they had reduced numbers of people in the telephone queue to 50, re-established email reminders to patients for appointments following an IT problem, and ensured that clinicians inform administration staff if they are running late with appointments so patients can be kept informed.

Managers and leaders, we spoke with demonstrated they were aware of the challenges to patient access, and had acted to improve services. For example, in response to low patient satisfaction in respect to contacting the practice via telephone and appointments the practice had implemented a number of improvements which included the installation of a new telephony system with improved functionality. As well as offering patient call back, the system allowed the practice to gather more accurate performance information which they have used to further focus capacity on need. Data from the practice has shown that average waiting times for calls to be answered by the practice since the introduction of the new telephony system was 8 minutes. The practice told us that they felt call answering times were longer due to the impact of Care Navigation and the need to spend more time talking to callers to fully assess their needs so they could be signposted or referred on to the most appropriate service. Other provision to improve access to services for patients included an acute on call team which operated in the afternoon 2-6pm, and dealt with around 30 patients per session, and dedicated ward rounds delivered to patients within local care homes. The practice promoted the use of their website and online consultation service to improve access and had available online appointments. We saw evidence from the practice which showed that numbers of appointments had increased from 7,202 appointments in January 2023 to 7,634 appointments in January 2024.

Patients could book appointments by telephone, online, and in person by visiting the practice. Information regarding access was displayed in the practice and online. Appointments were available face to face, by telephone, online or as a home or care home visit. Urgent and same day appointments, and pre-bookable in advance appointments were offered by the practice. We were told by the practice that appointment type offered was dependent on patient need and preference. An acute on call team of GPs and Registrars was available to add capacity in the afternoons. Patients were also able to obtain extended hours appointments on weekday evenings and at weekends and bank holidays through GP Care Wakefield. The practice had arrangements in place for prioritising patients. Staff were trained and supported to book appointments with members of the practice clinical team, or to signpost patients to other appropriate services. By working with other practices in their Primary Care Network patients also accessed services delivered by other clinical staff including pharmacists and pharmacy technicians, mental health practitioners, and physiotherapists. In the previous 6 months patients from the practice had accessed 3,855 appointments with these allied staff. The introduction of the new telephony system had improved telephone access to the practice. We saw that average call answering times were stable at around 8 minutes, and saw that numbers of dropped calls to the practice since the improvements had reduced from 5,114 in October 2023 to 1,661 in February 2024. The practice had introduced processes to reduce the incidences of patients who failed to attend appointments, this included practice staff making calls to personally remind patients closer to appointments for specialised clinics to prevent non-attendance. Electronic links were also sent to patients for follow-ups which allowed patients to book in directly online with with a clinician.

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.