Ling House 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

We assessed all quality statements from this key question. Our rating for this key question is Good. Leaders understood the challenges to patient access and constantly reviewed their access model and appointment availability to ensure that patients were able to make an appointment with the most appropriate member of their team. The practice actively sought patient feedback and responded to complaints in a timely manner in order to drive improvement.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

As part of the assessment process, we reviewed patient feedback from the National GP Patient Survey, the NHS Friends and Family Test (FFT) and an internal survey. In addition, we asked the provider to share details of our Give Feedback on Care process with patients. Patients providing feedback for this assessment had no specific views or concerns in this area.

Discussion with leaders showed that they understood the needs of their local population and had developed the service in response to those needs. They demonstrated a good understanding of the practice’s demographics, challenges they faced and systems in place which placed patients at the centre of care. Referral systems ensured patients received consistent, coordinated, person-centred care when they moved between services. Staff told us that they involved patients in their care and treatment. They told us they did this by having discussions, offering choice, and by providing patients with the support they needed to understand, for example by offering support with any communication needs. They felt they put patients at the centre of their care and treatment.

Staff and leaders spoke positively about the patient population they served. They recognised their population was situated in an area of high deprivation. They were able to describe processes to ensure patients received coordinated care, for example through effective multi-disciplinary team working where needed. Staff described reasonable adjustments that could be made to support patients in receiving care and the ability to offer choices where possible.

We spoke with the NHS West Yorkshire Integrated Care Board ahead of this assessment. From the feedback we received from them there was no indication of concern in this area. The practice was able to provide examples of systems in place to demonstrate effective working with multi-disciplinary teams and the practice's primary care network (PCN).

There were systems and processes in place to ensure people’s care and treatment was delivered in a way that met their assessed needs. The practice held registers of different patient groups, including those with a learning disability and carers. Evidence reviewed demonstrated the provider undertook analysis of the local population and worked with other local services to support patients in the most appropriate way.

As part of the assessment process, we reviewed patient feedback from the National GP Patient Survey, the NHS Friends and Family Test (FFT) and an internal survey. In addition, we asked the provider to share details of our Give Feedback on Care process with patients. Patients providing feedback for this assessment had no specific views or concerns in this area.

Staff and leaders assured us efforts were made to keep practice information up to date. The practice complied with the Accessible Information Standard. Patients could request information in more accessible ways, such as in large print. Individual communication needs were noted on a patient’s clinical record. Staff told us there were several bilingual staff within the practice and that this supported communication with patients. Staff told us they supported patients with using online services, which included a volunteer at the practice who helped patients use the electronic patient check in system to avoid queuing at the reception desk.

The practice website was accessible and had the functionality to translate to other languages, change colour, contrast level and font size. It included up-to-date information, for example, opening times, out of hours information, patient registration, clinics and services, health information and support, complaints and suggestions, and how to access medical records. Reasonable adjustments were made at the practice to support communication, including a hearing loop and use of interpreters. We saw that the electronic patient check in system was available in multiple languages in line with the practice demographic. The practice sent out text messages in other languages aligned to the patient demographic, for example, to follow-up on breast and bowel screening. A quarterly practice newsletter was also created to share information with patients. We saw the summer newsletter was available on their website. Posters were displayed in the reception and the waiting room to provide patients with information on the practice and the different services available to them.

As part of the assessment process, we reviewed patient feedback from the National GP Patient Survey, the NHS Friends and Family Test (FFT) and an internal survey. In addition, we asked the provider to share details of our Give Feedback on Care process with patients. Patients providing feedback for this assessment had no specific views or concerns in this area.

Staff told us the different ways that patients could share feedback and ideas and raise complaints. This included the NHS Friends and Family Test (FFT), in-house patient surveys, the complaints process and through compliments. Staff we spoke with understood the complaints process and how to assist patients with any complaints or concerns they may have. Staff told us how learning from complaints was used as an opportunity for improvement.

There was a robust complaints process in place, including a complaints lead, a policy and a patient leaflet. Information was also accessible on the practice website. Complaints were actioned in an appropriate and timely manner, discussed in meetings, and learning shared with all staff. Where appropriate, patients were provided with an apology and signposted to the Parliamentary and Health Service Ombudsman (PHSO). The practice kept a log of written and verbal complaints to ensure all opportunities to learn from feedback was captured.

Patient feedback from the National GP Patient Survey (2024) was below local and national averages in relation to access. We saw that from 125 responses, only 9% of patients found it easy to get through by phone (Local Average 47%; National Average 50%). Following the outcomes of the National GP Patient Survey the practice had undertaken their own internal survey in July 2024. A total of 1000 people responded, and they found that 23% found it easy to get through on the phone, which remained below the local and national average. Some feedback received through the Give Feedback on Care form on the Care Quality Commission’s website was positive and noted that improvements had been made to the appointments system.

Leaders and staff demonstrated they were aware of the challenges to patient access and had acted to improve it. They had engaged in the General Practice Improvement Programme (GPIP) and told us they had focused on understanding and managing demand and capacity, improving the telephony journey for patients, improving online contact journey for patients, enhancing triage and care navigation and better managing practice workload. The practice demonstrated how they had processed mapped the patient access journey and used this to adapt the access model and appointment availability to ensure that patients were able to make an appointment with the most appropriate member of their team in a timely manner.

The practice was open from 8am to 6pm Monday to Friday. Extended access was provided on Tuesday from 6.30pm to 8pm. Patients could also access pre-bookable evening and weekend appointments at various practices across Airedale, Wharfedale and Craven. Patients calling the practice outside practice core hours were automatically transferred to the NHS 111 service, who would triage the call and pass the details to Local Care Direct, who provided out of hours care. Appointment types included telephone and face-to-face. Appointments could be booked on the day or in advance, by telephone, online, or at the practice The practice offered home visits and urgent appointments for patients where appropriate. Staff were trained in care navigation which enabled them to signpost to other services and had documented information to support them with this. The practice had spent a considerable amount of time and resource to understand the challenges of patient access and make adjustments to their access model. They planned to implement a total triage system from October 2024. Total triage is a system where every patient contacting the practice provides some information on the reason for their contact. All requests are then reviewed by the practice’s triaging team. Patients would then be offered an appointment within an appropriate timeframe, with the most appropriate clinician and through the most appropriate method (face-to-face, telephone or online). At the time of the assessment the practice was in a period of staff training and patient engagement. Following the launch of total triage, patients would contact the practice via their website and complete an online questionnaire. Patients with technology access restrictions would be able to telephone the surgery and staff would help them with the process or attend to the surgery where help would be provided. The practice told us they would review the total triage model at regular intervals to assess its impact on access.

As part of the assessment process, we reviewed patient feedback from the National GP Patient Survey, the NHS Friends and Family Test (FFT) and an internal survey. In addition, we asked the provider to share details of our Give Feedback on Care process with patients. Patients providing feedback for this assessment had no specific views or concerns in this area.

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 local health inequalities. Leaders told us about the ways in which they supported national initiatives to engage with and educate patients. Staff we spoke with understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. They told us they could access communication assistance, including British Sign Language (BSL) and interpreters for those patients who needed it. Leaders told us they were currently working towards being a ‘veteran friendly’ practice which was a national scheme to improve medical care and treatment for former members of the armed services. The practice had nominated a veterans' lead.

The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people. Home visits were carried out for housebound and vulnerable patients. There was a face-to-face weekly ward round for a nearby home for patients. Reasonable adjustments were made, including longer appointments, for those who required them. Staff had received equality and diversity training. Support with using online services was offered to those patients who needed it.

As part of the assessment process, we reviewed patient feedback from the National GP Patient Survey, the NHS Friends and Family Test (FFT) and an internal survey. In addition, we asked the provider to share details of our Give Feedback on Care process with patients. Patients providing feedback for this assessment had no specific views or concerns in this area.

People were supported to make informed choices about their care and plan their future care while they had the capacity to do so. Decisions and choices made by people were documented and reviewed as required. Palliative care patients were reviewed in multi-disciplinary team meetings.

Processes were in place to support patients to make informed decisions about their future, and to review patients at the end of their lives. Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) and Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) forms were completed in line with guidance and with the input of patients, and when necessary, their carers.