Great Barr 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

At the last inspection we found that the practice did not always organise and deliver services to meet patients’ needs, patients could not always access appointments in a timely way. And complaints were not used to drive continuous improvement. At this inspection we found patient feedback continued to highlight difficulties in accessing services and this was also reflected in the results of the GP National Patient Survey for access. The practice had a duty doctor available to provide advice and to deal with urgent requests, but staff reported a shortage of appointments impacted on availability.

The practice had implemented a lead for complaints, however we were unable to gain assurances that complaints were being used to drive improvement.

There were 5 reviews from NHS UK since our last inspection who found some reception staff unhelpful and difficulty in accessing appointments.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Feedback from the National GP Patient Survey about the overall experience of using the service was negative with a score of 48% in comparison to the national average of 78%. We spoke with people during the on site assessment who told us that they struggled to get an appointment, but were generally happy with the service provided once they saw a clinician. An inhouse survey had been completed in November 2024 and the practice had received 415 responses which showed improvements in servide user feedback on accessing services. An plan of action was being implemented following the results which included ongoing monitoring of appointments. However, feedback from patients continued to demonstrate concerns on accessing services due to appointment availablility.

We found during the clinical review of people's records that improvements were required to ensure people were aware of their health conditions and the appropriate care and treatment was provided to assist them in managing their health conditions.

Staff had been trained in equality and diversity, safeguarding and mental capacity. The practice had implemented a patient participation group recently and were currently recruiting people to join the group. An inhouse survey had also been completed during the month of November. At the time of the assessment, the practice had not finished the survey or reviewed the actions required to improve patient satisfaction.

The practice had posters on display in the waiting area and reception providing information on different groups and helplines for people to access support.

We were unable to gain assurances that staff and leaders worked within the primary care network (PCN) and other agencies to ensure that people’s care and treatment was delivered in a way that met their needs and were responsive. For example, the practice was supported by a social prescriber to provide support to people, however feedback from staff showed a lack of understanding of what the social prescriber was focusing on.

We were unable to gain assurances that regular meetings with community services were held.

The primary care network had a range of services available that the practice could refer into if required.

Minutes of meetings shared showed no evidence that multi disciplinary meetings were being held with the community services to discuss and manage the needs of people with complex medical issues. Safeguarding meetings were held at the practice, however the minutes provided showed no evidence of discussions with health visitors when safeguarding concerns had been highlighted.

The practice had updated their website to make it more accessible. The website included useful information on health awareness and promotion. Information and resources were available for people to support them to understand how to access services. For example, there were arrangements in place for people who need translation services or who may be digitally excluded.

The practice had made improvements to the website and had plans to make further improvements to provide people with information. E-consult was currently being planned to provide people with the option to contact a clinician without having to book an appointment via the telephone.

The summarising of records continued to require strengthening. Some improvements had been made, however staff told us that there were not enough staff trained in this area and they recognised that more staff needed to be updated on how to do this role. The leadership team told us they were having difficulties in accessing training in this area.

There were systems in place to support people who face communication barriers to access treatment, however there was no hearing loop to help people who had hearing difficulties. We found there was no system in place for summarising clinical records and we were unable to gain assurances that this was being addressed. Records were held in line with guidance and requirements.

We found the practice complied with the Accessible Information Standard and that information about people that collected and shared was in line with data protection legislation requirements.

Feedback from the GP National Patient Survey results demonstrated that 76% of people say the healthcare professional they saw or spoke to was good at listening to them during their last general practice appointment and 93% were involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment.

We found there was a system for recording complaints and we were told they were discussed at practice meetings to share learning. We reviewed a sample of 6 sets of minutes of meetings and found complaints was an agenda item on one set of minutes, however there was no reference to complaints or learning included in the minutes.

The practice told us they collated feedback via the Friends and Family test to make improvements to the service and an inhouse patient survey was currently taking place during the month of November to gather further patient feedback following the results of the GP National Patient Survey.

The practice had a complaints policy in place and regular practice meetings were now being held, however we found that complaints and significant events were not always discussed to share learning and make improvements. On reviewing the clinical system we found tasks to the leadership team with requests to respond to outstanding complaints from people who were waiting for a reply.

Information about how to complain was readily available and patients could make a complaint in person, or via the practice website.

The practice told us they obtained feedback from various sources such as the GP patient survey, friends and family feedback, complaints and via informal feedback from people. The practice had a duty doctor available to provide urgent on the day appointments if required, however people we spoke with on the day of the assessment told us of the difficulties they faced in obtaining an appointment.

On the day of the assessment we found the telephone monitoring system showed people were waiting 30 minutes or more for a call to be answered. The practice had increased the number of staff answering calls. The 2024 National GP Patient Survey data showed a 5% increase in comparison to the 2023 results, however there continued to be a significant negative variation with the practice having scored 18.1% in comparison to the national average of 49.7%

During the month of November the practice ran an inhouse survey to gather patient feedback on access. A total of 415 service users responded and the practice saw increased satisfaction scores in appointment availablility and overall experience of the practice. An action plan was being implemented in December 2024 which included ongoing monitoring of appointment availablity.



The practice used a sign-posting triage system where reception staff would ask the person for enough information to make a decision regarding which clinician was appropriate for them to see. People were given the option of a face to face or telephone appointment. Requests for an emergency appointment were allocated to the duty doctor for them to make a clinical review. Feedback from staff demonstrated people in vulnerable circumstances were able to register with the practice, including those with no fixed abode.

Leaders were aware of the challenges to access and following the results of the National GP Survey had reviewed the responses and implemented an action plan to improve access. This included the implementation of e-consult which was planned to be commenced in the near future. The practice had also carried out an inhouse survey for the month of November 2024 to gather more feedback. At the time of the on site assessment, a total of 227 replies had been received. The practice planned to continue with the inhouse survey through the month of November to gather more feedback from patients.

Staff told us that during holidays and sickness they struggled to cope with the demand for appointments. On the day of the on site assessment staff reported a shortage of appointments for the amount of requests that were being received.

People could book appointments by telephone and online. On the day of the onsite assessment we found people who had visited the practice to book an appointment were told this was not available now and appointments had to be booked via the telephone. We discussed this with the leadership team who told us that people could book if they visited the practice, so we were unable to gain assurances of what process was in place. Appointments were available face to face, by telephone, or as a home visit. Same day appointments were available.

Appointments with a GP were available throughout the week. When the practice was closed people were able to contact 111. The practice offered appointments from a variety of additional clinical staff for example nurses, health care assistant and pharmacist. Pre-booked appointments were available on weekday evenings and at the weekend through an arrangement with other local GP practices.

The practice had arrangements in place for prioritising people. Staff were trained to book appointments with members of the practice clinical team or signpost patients to other appropriate services and were supported by a duty doctor.

The practice had not responded to all feedback by people who used the service within the last 6 months. People could leave feedback via NHS UK, the practice website and the Friends and Family test (FFT). The practice had received 6 reviews since June 2024 on NHS UK, however the practice had not responded to any comments.

We spoke with the leadership team on the day of inspection, who told us that the practice were addressing workforce challenges including the recruitment of more clinical and management staff. On the day of the assessment we found changes had been made to the clinical team with a clinical pharmacist having joined the practice to support the existing team and a new practice manager was due to start in January 2025.

We were provided with an action plan in response to the 2024 GP National Patient Survey results which showed significant negative feedback to access and the overall experience of the GP practice. This was also supported by the feedback we received on the day from patients at the practice.

To further support the action plan the practice had implemented an inhouse survey to gather more feedback which was going to be analysed during December 2024. The action plan currently in place highlighted further training to be completed to enhance customer service skills, review triage processes to ensure patients are seen by the appropriate clinician.

The provider complied with legal equality and human rights requirements, including avoiding discrimination, having regard to the needs of people with different protected characteristics and making reasonable adjustments to support equity in experience and outcomes, including meeting the Accessible Information Standard.

The results of the GP National Patient Survey showed 80% of people that the healthcare professional they saw or spoke to was good at treating them with care and concern during their last general practice appointment and 92% stated that during their last appointment they had confidence and trust in the healthcare professional they saw or spoke to.

Leaders understood the requirements of legislation when considering consent and decision making and had access to policies to support them. We were told that the practice held multidisciplinary meetings with other agencies to share and discuss information relating to care and treatment, for example, those on the practice palliative care register.

There were systems in place to ensure staff kept up to date in training relating to the Mental Capacity Act and Deprivation of Liberty Safeguards. We found that all staff had completed the required training.

There were registers held for those people who were vulnerable who were on the palliative care register or at the end of their life. We found that clinicians understood the requirements of legislation and guidance when considering consent and decision making and saw that consent was documented.