Thornbury Medical Practice

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

Overall, we found that the practice provided a responsive service. Feedback we received from patients about the service was positive. The practice actively sought patient feedback and responded to complaints in a timely manner in order to drive improvement. The provider had taken action to improve access and to make services accessible for people most likely to have difficulty accessing care. Leaders understood the challenges to patient access and had made improvements in response to this. Overall, we found that the practice provided a responsive service. Feedback we received from patients about the service was positive. The practice actively sought patient feedback and responded to complaints in a timely manner in order to drive improvement. The provider had taken action to improve access and to make services accessible for people most likely to have difficulty accessing care. Leaders understood the challenges to patient access and had made improvements in response to this.

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.

Patients we spoke to told us their individual needs were taken into account, and that healthcare professionals listened to them and helped them to understand their condition, care, and treatment options. For example, they told us they could request to see a male or female GP and were given longer appointment times if they needed it.

The practice put patients at the centre of their care and treatment. They offered reasonable adjustments, for example the use of interpreters, so that patients’ needs were met and that they received the most appropriate care and treatment. The practice told us that they involved patients in planning and making shared decisions about their care and treatment.

Leaders took steps to understand the diverse health and care needs of their patient population. An in-house patient survey had recently been carried out and this was designed to be accessible to patients in terms of length of the survey and potential digital barriers. The practice held monthly multidisciplinary meetings with external stakeholders and services, for example district nurses, and this helped to ensure that care was co-ordinated and joined-up.

We received positive feedback from the NHS West Yorkshire Integrated Care Board (ICB) regarding steps the practice had taken to engage with them following the previous inspection.

Patients had a named GP to support continuity of care, although they could choose to see a GP of their choice where possible. Where referrals were made to external services, these were monitored and followed up appropriately. There was an integrated approach to patient care and services worked well together. Some services, for example a drug and alcohol support service, were delivered at the practice.

Patients told us that they were provided with enough information to understand their care and treatment, including different options available to them. They told us they were able to access the information they needed at the practice and on the practice website.

The practice complied with the Accessible Information Standard. Leaflets were available in the reception area and posters were displayed to provide patients with information on the practice and the different services available to them. The practice told us there were several bilingual staff within the practice and that this supported communication with patients. They also told us that patients could request information in more accessible ways, such as in large print, and that individual communication needs were noted on the patient’s records. Staff told us they supported patients with using online services. Staff completed mandatory information governance training to ensure that information collected and shared by staff met data protection legislation requirements.

The practice website contained accessible and up-to-date information on, for example, opening times, patient registration, clinics and services, complaints, and prescription ordering. Reasonable adjustments were made at the practice to support communication, including a hearing loop and use of interpreters. Practice newsletters were also created to share information with patients. The practice held weekly coffee mornings for patients and used these as an opportunity to share information about the practice and the services available. In addition, they often invited external agencies to support patients in various ways, such as providing advice on jobs, benefits and healthy living.

There was an active Patient Participation Group (PPG) in place and members of the PPG told us that the practice listened to and acted on their feedback and were trying to improve services. For example, they said that feedback on the difficulties patients had with booking appointments had led to improvements, including a telephone call-back system, and this had increased patient satisfaction.

The practice told us about 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, patient coffee mornings, and the complaints process. Staff we spoke to 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. For example, a complaint about an incorrect appointment booking by reception staff led to additional training for all reception staff members in how to use the appointments booking system appropriately.

There was a robust complaints process in place, including a complaints lead, a policy and a leaflet which was available in the reception area of the practice. 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. Weekly coffee mornings at the practice were used as an opportunity to listen to patients and gather feedback.

The practice’s results for the National GP Patient Survey 2023 indicated that patient experience of access was generally in line with national averages. In order to obtain larger participation and to capture a more meaningful view of patients’ experience, the practice carried out an in-house patient survey in May 2024. A total of 2292 surveys were sent out electronically and to patients attending the coffee mornings. 308 patients (13%) responded. Overall, results indicated that patients were generally satisfied with access at the practice, including appointment times, types of appointments offered, and the new cloud-based telephony system.

A capacity and access plan had been created with the practice’s Primary Care Network (PCN) in May 2023, with the aim of increasing capacity within the practice and enhancing access for patients. Actions included creating an in-house patient survey, undertaking a capacity and demand audit, national care navigator training for staff, and website improvements. At the time of the assessment some actions had been completed and others were in progress. Some staff had also taken part in a face-to-face session with members of other practices within the PCN, where they shared access improvement ideas.

The practice opening times are Monday to Friday from 8am until 6pm. Appointment types include telephone and face to face. Appointments can be booked on the day or in advance, by telephone, online, or at the practice. Routine appointments can be booked up to 4 weeks in advance with the GP’s, and 3 months in advance with the nursing team. The practice offered home visits and urgent appointments for patients where appropriate. Enhanced access appointments are available to patients on evenings and weekends at various practices across Bradford and can be booked on the day or in advance. The enhanced access service is run by Bradford Care Alliance. Out of hours services are provided by Local Care Direct Limited.

We saw no indication of any concern in this area.

Examples of how the practice have engaged with harder to reach groups include working alongside drug, alcohol, and smoking services, whereby these services run sessions at the practice 1 day a week. The practice also arranged for a pop-up van to come on site to deliver vaccinations, as well as health checks. Coffee mornings were held at the practice to engage with patients by, for example, reducing isolation, promoting services, and providing support with using online services. We saw examples of where the practice had invited members of external organisations to these meetings to offer advice and support to patients on social issues. The practice had 47 patients aged 14 and over on their learning disability register, and 49 patients on their carers register.

Home visits were carried out for housebound and vulnerable patients. Reasonable adjustments were made, including use of interpreters and longer appointments. Staff received equality and diversity training. There were registers in place to identify patients who may need extra support, such as carers and patients with learning disabilities. Health checks were routinely offered to patients. Support with using online services was offered to those patients who needed it.

We saw no indication of any concern in this area.

Staff supported patients to make informed decisions about their future, including at the end of their life. The practice had 19 patients on their end-of-life care register. Palliative care patients were reviewed in monthly multi-disciplinary meetings. Staff told us how they worked with patients, and their carers, to support them to understand their options regarding Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) decisions.

Processes were in place to support patients to make informed decisions about their future, and to review patients at the end of their lives. DNACPR and ReSPECT forms were completed in line with guidance and with the input of patients, and when necessary, their carers.