Goodcare Practice

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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 assessed all 7 of the quality statements from this key question: person-centred care; care provision, integration and continuity; providing information; listening to and involving people; equity in access; equity in experiences and outcomes; and, planning for the future. Our rating for this key question is good. We found the practice was providing a responsive service overall. Patients were encouraged to give feedback, which was acted on and used to deliver improvements. There were systems and processes for planning for the future. Patient feedback was mixed about accessing the service. The practice responded and made changes because of feedback from patients. Staff treated people equally and without discrimination. There was partnership working to make sure that care and treatment meets the diverse needs of communities.

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.

The service demonstrated a high level of person-centred care, with 94% of respondents from the national GP survey feeling that the healthcare professionals they interacted with had all the necessary information about them during their last general practice appointment. This performance is above both the local average of 91% and the national average of 92%.

The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs. This was highlighted in the ‘Shared Decision-Making Policy’ where it highlighted how shared decision making was an essential part of person-centred care and led to better and often more cost-effective outcomes.

Staff and leaders told us they were part of Northolt Primary Care Network (PCN). They also had PCN and ARR staff-led clinics including a first contact physiotherapist, a social prescriber, and clinics for primary care mental health nurses, to support patients. The practice also actively referred patients in Diabetic multi-disciplinary team (MDT) meetings. The aim of the MDT diabetes service is to improve quality of care and outcomes, reducing morbidity, dependency and mortality, and better patient experiences across all diabetes services within North West London. The staff involved with the diabetic MDT included, diabetes specialist nurses, Podiatrist, dietician, clinical pharmacists and GPs.

Leaders informed us they had set up special transport arrangements for patients outside of the ICB. The practice had organised a transport service they had a dedicated Transport officer who was responsible for coordinating with staff to arrange transport to/from the practice for patients who were vulnerable but not specially house bound and had difficulties getting to appointments. This service helped to reduce the number of house visits the practice made.

The staff from the local integrated care system stated they did not have any concerns about the service. The service was actively involved in their local primary care network, where they worked with other services to improve local health inequalities.

The practice was part of the Northolt Child Health Hub (CHH). The purpose of the CHH was to improve care pathways for children and their families, fewer appointments and more personalised care, improved parental confidence in local services and improved continuity of care cross-sector.

There were policies to ensure people received care and treatment from services that understand the diverse health and social care needs of their local communities. Continuity in people’s care and treatment was delivered in a way that met their assessed needs.

Patients could book appointments online, in person or by telephone, longer appointments were offered to those with more complex needs.

People in vulnerable circumstances were easily able to register with the service, including those with no fixed abode such as homeless people and Travellers.

The national GP patient survey found 94% of patients stated the health care professional had all the information they needed about them during their last general practice appointment (national 92%, local 91%), and 67% of patients stated the healthcare professional was fairly or very good at listening to them (national 87%, local 85%).

Positive patient feedback collected by the provider included a patient who noted that they had visited the GP surgery and had a very good experience. The staff had reminded the patient with a text message close to their appointment time which is one of the means the practice provides information to the patients.

We were told that changes were made to the website to make it more accessible to patients. This included a more user-friendly design with larger font and clearer signposting. They reworded ad hoc and repeat SMS messages that were sent and made waiting room signs more prominently positioned and clearer. They also put alerts on patients records that had accessibility needs.

There were processes for communicating with patients in their preferred language. This included having available documents such as the Complaints policy and the Internal patient survey in different languages. These included Polish, Punjabi, Swahili, and Urdu to reflect the local population of the practice. There were policies and procedures for staff to follow to ensure people had information that was tailored to individual needs. This included making reasonable adjustments for disabled people, interpreting and translation for people who don’t speak English as a first language.

The national GP Patient Survey found, 67% of respondents said the healthcare professional they saw or spoke to was good at listening to them during their last general practice appointment (local 85% and national average of 87%). The percentage of respondents who stated that during their last GP appointment they were involved as much as they wanted to be in decisions about their care and treatment was 81% (national average 91%, local 89%). As a result of this data, the practice set up their own internal annual patient survey to better understand the needs of their patients. The practice collaborated with the PPG to conduct a survey. This survey had 56 patients who responded, of which 94% reported they were either ‘Very satisfied’ or ‘Satisfied’.

Reacting to the advice from the PPG and the practices’ own internal analysis – due to nurse appointments being in high demand, the practice increased the supply of nurse appointment slots by employing a second nurse practitioner. Feeback from elderly patients led the practice to organise their September flu day on a Saturday to increase accessibility, which resulted in a higher-than-average turnout compared to previous years.

A complaints and compliments process was available on the practice website. Complaints was a standard agenda item that was discussed at practice meetings and learning as a result from a complaint. The new telephone system introduced in April 2024 was a direct result of listening to the concerns of the patients. Patient feedback led the practice to make changes to improve online and in-person user experience with information communication. An example of this was making the practice website have a more user-friendly design with larger font and clearer signposting.

The national GP patient survey found 55% of patients described their experience of contacting their GP as good (national 70%, local 67%). The survey found 72% of patients found the reception and administrative team helpful (national 81%, local 83%) and 34% of patients found it easy to contact the GP using their website.

As a result of patient feedback, the practice improved online and in-person user experience with information communication. They made their practice website have a more user-friendly design with larger font and clearer signposting. They made the waiting room signs more prominently positioned and clearer.

The practice installed a new telephone system in April 2024 which has demonstrated significant improvement as they were able to extract data, and as a result increased the number of staff answering the telephone call during the peak hours. The provider had processes in place to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers. A range of appointments were available to meet individual patient needs.

The practice collaborated with their PPG to conduct a survey of patient attendees following the national GP Survey. This survey was conducted by 3 PPG members, who asked 56 of the patients who attended how satisfied they were. 94% reported they were either ‘Very satisfied’ or ‘Satisfied’. The national GP patient survey found 55% of patient had a fairly to very good experience of contacting the service (national 70%, local 67%), 72% found the reception and administrative staff fairly to very helpful (national 83%, local 81%),, 34% found it easy to contact the GP practice using their website (national 48%, local 52%). 71% of patients knew what the next step would be after contacting the service (national 83%, local 82%), this increased to 87% within two days (national 93%, local 91%).

Leaders proactively sought ways to address any barriers to improving people’s experience and worked with local organisations, including within the voluntary sector, to address any local health inequalities. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes

Staff and leaders told us that the practice is a ‘Safe Surgery’, which means the practice is committed to tackle health inequalities faced by migrants in vulnerable circumstances accessing healthcare. An example of this was that the practice was registering patients without a fixed abode by using the practice’s own address.

The practice provided care for many patients who did not speak English as their first language. Translation services were available both at reception and inside consultation rooms and staff spoke a variety of different languages to support patients.

We could not collect evidence from patient feedback to score this evidence category. Our observation during the assessment raised no concerns. The evidence reviewed for the assessment showed no concerns about people’s experience regarding planning for the future.

Staff and leaders told us that there were regular MDT meetings and that any safety concerns were discussed amongst partnership. Staff and leaders also told us that the practice had a palliative care register.

We saw a copy of the consent policy. We reviewed five patients’ Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions and found they were made in line with relevant legislation and were appropriate. Most staff had completed mental capacity act training.