Bousfield 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 reviewed 2 quality statement in the Responsive key question, providing information and listening to and involving people and equity and access. The scores for the other quality statements are based on the previous rating for this key question. The practice was proactive in ensuring patients had access to appointments to gain advice from the clinicians. They recognised some patients experienced delays in getting through to the practice to access appointments and action had been taken to improve this. Although data from the National GP Patient Survey published July 2023 showed some lower performance in terms of patient’s experience of access, the practice had undertaken their own patient survey and shared the results of the Family and Friends test to show more positive results. The practice provided evidence to show they were reviewing, monitoring, and making changes to further improve patient experiences in relation to access.

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 this quality statement for this assessment. The score for this quality statement is based on the previous inspection carried out in September 2023.

We did not look at this quality statement for this assessment. The score for this quality statement is based on the previous inspection carried out in September 2023.

We did not look at this quality statement for this assessment. The score for this quality statement is based on the previous inspection carried out in September 2023.

We did not look at this quality statement for this assessment. The score for this quality statement is based on the previous inspection carried out in September 2023.

We did not look at this quality statement for this assessment. The score for this quality statement is based on the previous inspection carried out in September 2023.

Patients fed back to us that new information about how to access appointments and how to make contact with the practice had been recently developed and shared with patients.

Practice information was available for patients in a number of written formats and all staff were aware of this. Some of this information was displayed in the reception area.

The practice understood the needs of its local population and had developed services in response to those needs. At our last inspection we saw that information could be made available in large print, however, there was no easy read information available for people who may need it. This had improved at this assessment and there was now a wider range of information available to support patients who had a range of communication needs. The practice understood the needs of its local population and had developed services in response to those needs. for this assessment the provider had shared a summary of how the practice aims to meet the needs of individual patient groups. This included access to translation services if needed by patients and processes were in place for staff to access this. The provider was aware of the requirements to meet the ‘Accessible Information Standards’. The patient record system was used to alert staff to any particular communication needs of the patient so that staff could then communicate effectively with the patient. Information could be made available in alternative languages and formats including easy read materials.

We reviewed the GP patient survey, published in July 2024. Results indicated that 87% of patients said the healthcare professional they saw or spoke to was good at listening to them during their last general practice appointment. This was in line with England and local averages. Results indicated 85% were involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment. This was an improvement from the previous year’s survey results. The practice reviewed all patients’ comments for the NHS Friends and family Test (FFT). The results across January to May 2024 were positive and comments made indicated patients experienced staff who were good at listening and involving them. The provider undertook a patient survey in September 2023 and the results for the question, did your GP listen to you, were positive. The PPG reported that patients felt their complaints were being listened to and dealt with promptly. There was no feedback from patients either on-line via our GFOC (give feedback on care).

Staff we spoke with knew how to respond to patients that wanted to give feedback about their care. They knew what information should be given to support them with this, and who patients and families might speak with for an initial response from the practice manager. Staff were aware that complaints would be investigated and discussed at staff meeting so learning could take place. All complaints were reviewed by the service provider. Staff told us that patient complaints and feedback in general was important and an opportunity to improve services they provided.

At our last inspection we identified the systems in place for managing complaints required improvements. Since then, the provider had reviewed the complaints policy and changed the organisational management structures so that complaints were dealt with at a local level. The practice manager had responsibility to receive formal and informal complaints, undertake an investigation and respond to the patient who had made the complaint. We looked at the complaints information and found 3 verbal complaints and 1 written complaint, which had recently been received by the practice. The management of the complaints was satisfactory and there was evidence they had been discussed with staff so that learning could take place. We found that information about how to complain was readily available. Complaints were reviewed at clinical and non-clinical staff meetings. The practice had a newly formed Patient Participation Group (PPG), and patient views were acted on to improve services and culture. For example, patients told the PPG member when seeking feedback, about the uncomfortable chairs in the waiting room if you had to wait for a long time and had disabilities, during the assessment the provider confirmed a number of new chairs had been ordered. The practice received lower than England and local average scores for patient satisfaction in the national patient survey for questions relating to access issues. The provider monitored this feedback and presented an action plan showing the work that was being done to improve patient experience in these areas. The practice reviewed Friends and Family results to identify ways in which services and patient experience could be improved. They collated positive feedback and comments from patients to share with staff during meetings. In September 2023 the provider undertook a practice survey to gain patient feedback and an action plan was put into place to respond to this.

We reviewed the GP patient survey, published in July 2023. There were some indicator results that had improved since last year. This included saying the healthcare professional they saw or spoke to was good at listening to them during their last general practice appointment, saying the healthcare professional they saw or spoke to was good at treating them with care and concern during their last general practice appointment. Results showed that while there had been an increase for the practice for patients finding it easy to get through on the phone, this was still below the England and local averages. Other indicators for access were mostly below the England and local averages. The results for patients describing their experience of contacting their GP practice as good, was below the England and local averages along with, being offered a choice of time or day, choice of location and waiting the right amount of time at the appointment. Patients indicated that patients said the healthcare professional they saw or spoke to was good at listening to them during their last general practice appointment. This was an improvement for the practice based on the previous year’s results. Results indicated an improvement in the confidence and trust in the healthcare professional they saw or spoke to during their last general practice appointment. Being involved with decisions about care and treatment had also improved. Results were lower than the England and local averages for how patients felt their needs were met during their last general practice appointment. Overall, the practice had improved results for patients saying their overall experience of this GP practice was good. This aligned with the views of the PPG. There was no feedback from patients either on-line via our GFOC (give feedback on care).

Leaders demonstrated they were aware of the challenges to patient access and acted to improve this. They implemented initiatives and action plans in response to patient survey results and patient feedback relating to access. We were shown action plans the provider had set up and these were being monitored by the leadership team. Leaders prepared a statement for this assessment showing how the needs of the full practice population were being met. This included vulnerable patients, older patients, and those from diverse and minority patient groups. For example, an advanced mental health nurse practitioner was available to support patients with mental health needs. Patients with poor mental health, including dementia, were referred to appropriate services. We heard about practice changes they had made, including changes to telephone systems, appointment availability, types of appointments and call handling systems. The practice developed and promoted the use of their website, digital technology and online consultation service to improve access. The practice was working with other local stakeholders to improve access to primary care, such as extended access services on a Monday evening and Saturday daytime. We were told that the number of available clinician appointments offered each day, met requirements of the GP contract.

Patients could book appointments by telephone, online, through an App. and in person at the practice. Information regarding access was displayed in the practice, on social media and online. Appointments were available face to face, by telephone, online, by the App or as a home visit. Same day and pre bookable appointments were available. Weekday evenings and at the weekend appointments were available through an extended access arrangement with other local GP practices in the network. The practice had arrangements in place for prioritising patients. Staff were trained and supported by documented triage protocols to book appointments with members of the practice clinical team or signpost patients to other appropriate services. The practice offered appointments from a variety of clinical staff for example doctors, advanced nurse practitioners, practice nurse, healthcare assistants. They also offered appointments with advanced role clinicians through the PCN such as physician associates, physiotherapists, pharmacists and a social prescriber. Information on how to access care out of normal GP hours was available on the telephone message system, online and at the practice. The practice demonstrated how feedback from patients was continually monitored. We were shown and talked about feedback that was gathered, reviewed and acted upon. We saw improvements were made as a result. The practice reviewed Friends and Family results to identify ways in which services and patient experience could be improved. They collated positive feedback and comments from patients to share with staff during meetings. In September 2023 the provider undertook a practice survey to gain patient feedback and an action plan was put into place to respond to this.

We did not look at this quality statement for this assessment. The score for this quality statement is based on the previous inspection carried out in September 2023.

We did not look at this quality statement for this assessment. The score for this quality statement is based on the previous inspection carried out in September 2023.

We did not look at this quality statement for this assessment. The score for this quality statement is based on the previous inspection carried out in September 2023.

We did not look at this quality statement for this assessment. The score for this quality statement is based on the previous inspection carried out in September 2023.

We did not look at this quality statement for this assessment. The score for this quality statement is based on the previous inspection carried out in September 2023.

We did not look at this quality statement for this assessment. The score for this quality statement is based on the previous inspection carried out in September 2023.