Gravesend 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

People were involved in decisions about their care. The service provided information people could understand. The service took complaints and concerns seriously and responded to them appropriately to improve the quality of care. The service organised and delivered services to meet patients’ needs. It took account of patient needs and preferences. People were able to access care and treatment from the service within an appropriate timescale for their needs.

At our last assessment, we rated this key question as good. At this assessment, the rating remains the same.

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 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. Where appropriate, staff included carers and dependants were involved in the planning and making shared decisions about the persons care and treatment.

National GP Patient Survey data showed 90.7% of respondents stated that at their last appointment, they were involved as much as they wanted to be in decisions about their care and treatment.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. Staff and leaders spoke positively about the patient population and acknowledged that the practice was in an area of high deprivation. They described processes in place to ensure patients received coordinated care, including multidisciplinary team working when needed. Staff also discussed reasonable adjustments to support patients in accessing care and the ability to offer choices where possible.

The practice signposted patients to other services to support their well-being and social issues. The practice maintained registers of different patient groups, including those with a learning disability, those with mental health concerns and those requiring palliative care to help ensure regular monitoring and support condition management.

There was a home visiting service available through the primary care network.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Interpreting and translation services were used for patients whose first language was not English and for patients who used British Sign Language. Patient information leaflets and notices were available in the patient waiting area which told patients how to access support groups and organisations. Patients who had difficulty with reading, writing or using digital services were supported with accessible information. There were processes in place to support patients with learning disabilities, allowing them to bring a carer or family member to their appointments. Systems ensured that patient’s individual needs for accessible information were identified and recorded.

The patient waiting area offered a wide range of information for patients and carers.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

We saw complaints were managed in line with the practice’s policy. Learning from complaints was evident and staff were able to identify changes made as a result of patient feedback, including complaints.

The service made sure that people could access the care, support and treatment they needed when they needed it.

National GP Patient Survey data showed 75.5% of respondents said the healthcare professional they saw at their last appointment was good at listening to them, 74.5% of respondents said the healthcare professional treated them with care and concern and 85.8% of respondents said they had confidence and trust in the healthcare professional they saw or spoke with. Further, 64.5% of respondents responded positively to the overall experience of the practice.

In response to the NHS Friends and Family Test, the provider had identified changes to improve access to the service. For example, the practice extended appointment times to 15 minutes to better accommodate individual patient needs and introduced a self-check in system, reducing waiting times for patients.

Staff and leaders listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Leaders proactively sought ways to address any barriers to improving people’s experience, for example providing extra evening clinics for screening tests.

Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes.

There were established processes in place to assess patient experiences and their outcomes. Systems were in place to ensure trained staff followed up and reviewed clinical referrals and results.

The national GP patient survey showed that 50% of respondents said they were offered a choice of time or day when they tried to make an appointment. In response, staff discussed this in a meeting and emphasised a flexible approach to booking appointments.

CQC received 10 records of feedback through CQC’s “Give Feedback on Care” form in the last 12 months. Positive feedback highlighted quick access to appointments, high-quality and compassionate care, and efficient, supportive staff. Patients valued the friendly reception team and attentive GPs, with minimal wait times. However, some concerns were raised regarding feeling dismissed, difficulties in obtaining referrals, delays in fulfilling repeat prescription requests, administrative delays, and a disagreement with a clinical decision.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff and leaders had an awareness of systems to support patients requiring end of life care. There was a register of patients and that multi-disciplinary meetings were held with relevant healthcare professionals.

Our records review showed people were supported to consider their wishes for their end-of-life care, including cardiopulmonary resuscitation. This information was shared with other services when necessary. Clinicians understood the requirements of legislation and guidance when considering consent and decision making. Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions were made in line with relevant legislation and were appropriate.