Ferryhill & Chilton 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

People receive 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 which was delivered in a way that meets their assessed needs and for delivering and coordinating services (considering the needs and preferences of different people, including those with protected characteristics under the Equality Act and those at most risk of a poorer experience of care). People who use the service, their family and carers (where appropriate) were provided with information that was accessible, safe and secure and supported their rights and choices. Leaders acknowledged patients had experienced difficulties in accessing the service since the pandemic. Improvements had been implemented, including implementing a new phone system, but the practice had not yet been able to gather evidence to demonstrate this had improved the experience for patients. People were supported to make informed choices about their care and plan their future care while they have the capacity to do so.

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.

National GP Patient Survey data (2024) about patients experience of person-centred care showed results were just below local and England averages. * 87% of patients surveyed reported they felt their needs were met during their last GP appointment, compared to the 91% average locally and 90% across England. * 62% of patients surveyed reported they had enough support from local services or organisations in the last 12 months to help manage their long-term condition or illness. This was compared to 72% locally and 68% across England. We reviewed the feedback received by the practice (through complaints, compliments, NHS friends and family results) as well as information shared with CQC by people who used the service. Although generally the feedback did not relate to this quality statement, there were a small number of patients who raised concerns about the difficulty in getting to see a GP (instead they had been offered a consultation with a different health care professional) and feeling they were not always listened to. However, other patients praised the experiences they had with different healthcare professionals, such as nurse practitioners.

Leaders told us they had implemented systems to ensure people’s records fully reflected their physical, mental, emotional and social needs; including those related to protected characteristics under the Equality Act. People could receive the most appropriate care and treatment for them, as the service made reasonable adjustments where necessary. There were arrangements in place to ensure people understand their condition, care and treatment options (including any associated risks and benefits) and any advice provided. There were systems and processes to support this. Leaders told us they had experienced an extremely challenging period with several key personnel retiring or otherwise leaving the practice. They recognised this had impacted on continuity of care and patients experience at the practice. However, they also felt this had created an opportunity to make changes and improve the way the service operated. Several improvement projects had been implemented over the last year, and although anecdotal evidence demonstrated they were positively impacting patient experience it was too soon for them to be able to evidence this fully. They had improved the processes for reviewing the health of patients with long term conditions. This included inviting patients in for a wholistic review on their birth months of all their health conditions. The practice had also undertaken more NHS Health checks and Health Checks for people with learning disabilities compared to last year.

Staff and leaders told us people’s care and treatment were delivered in a way that meets their assessed needs from services that were co-ordinated and responsive. Leaders told us the relationship with the Primary Care Network was very productive and there was supportive partnership working. They had worked together on several improvement initiatives, for example to analyse data to improve access for patients. There were several schemes and services provided across the PCN that supported patients of the practice, including a home visiting service, cancer care support worker, podiatry, first contact physiotherapy, pharmacist support and mental health specialist. There was also a pop-up service offered to the local Gypsy and Travellers communities. The practice had arrangements in place to check the robustness of shared care agreements with providers of private healthcare to ensure any agreements put in place were safe and effective for patients and to refuse any that could place patients at risk. The practice provided a one-page summary when a patient registered of when to access each local service, to help them make decisions about where their needs could best be met. For example, when to get advice from a community pharmacy and when to attend A&E.

Member of the patient participation group told us they had a mixed experience in how the practice worked with them to improve the quality of care and service for patients. Some were disappointed the membership of the group was not representative of the patient population and that numbers attending the group had tailed off. Others told us they liked that there was good representation from practice staff and that a GP partner attended. The practice told us in response to this feedback that they recognised they needed to refresh the approach to the patient group to increase the representation and impact this group had. We did not receive any concerns from the Integrated Care Board about this service in relation to care provision, integration and continuity. The local Healthwatch shared they had a significant level of patients contacting them with concerns about access to the service, including when trying to contact the practice by phone and being able to see a GP.

There were clear policies and procedures to ensure: people receive 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 which was delivered in a way that meets their assessed needs and for delivering and co-ordinating services (considering the needs and preferences of different people, including those with protected characteristics under the Equality Act and those at most risk of a poorer experience of care).

We reviewed the feedback received by the practice (through complaints, compliments, NHS friends and family results) as well as information shared with CQC by people who used the service. Although generally the feedback did not relate to this quality statement, we did receive a concern that automatically generated NHS letters did not reflect the persons communication needs. For example, hospital appointment letters or invites for health screening not being sent in large font. The practice told us they would take away this feedback to consider how they could address this issue, even though it did not relate to letters generated directly by the practice.

Staff and leaders provided us with evidence that showed people could get information and advice that was accurate, up-to-date and provided in a way that they can understand, and which met their communication needs. People who use the service, their family and carers (where appropriate) were provided with information that was accessible, safe and secure and supported their rights and choices. Leaders told us they had supported staff to learn British Sign Language to increase support for Deaf patients.

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 and for Deaf people who use British Sign Language. People who had used digital services were also supported with accessible information. There were systems to ensure information about people that was collected and shared, met data protection legislation requirements. The practice website could be automatically translated into several languages. However, the practice had not considered if the language options available covered those most frequently spoken by their patients. The practice gave us example of how they had implemented individual reasonable adjustments to meet the communication needs of patients. However, they had not audited this to make sure their arrangements were comprehensive and were suitable for their practice population overall.

National GP Patient Survey data (2024) about experiences of being listened to and involved in decisions about their care, treatment and support were just below local and England averages. * 88% of patients surveyed reported they were involved as much as they wanted to be in decisions about their care and treatment during their last GP appointment. This compared to 92% locally and 91% across England. * 83% of patients surveyed reported the healthcare professional they saw had all the information they needed about them at their last appointment. This compared to 92% locally and across England. We reviewed the feedback received by the practice (through complaints, compliments, NHS friends and family results) as well as information shared with CQC by people who used the service. Generally, the feedback did not relate to this quality statement. We spoke with 6 members of patient participation group. They told us although meetings had taken place, there had been a drop off in attendance over the last few meetings. They said the practice worked with them to gather their feedback; however, it wasn’t always clear what actions had been taken to address concerns. Members told us they appreciated there was a good representation from practice staff to these meetings.

Leaders told us they had reviewed their approach to identifying and acting upon complaints and concerns. They had moved away from an approach of asking complainants to put their concerns in as formal written complaints. The practice instead implemented a complaints process which captured all concerns raised by patients, whether that was verbally or in writing. This increased the amount of feedback the practice was able to investigate and learn from. It also allowed the practice to receive feedback on concerns from patients who would be unlikely or unable to submit written complaints. There was information on the practice website giving patients information about how to complain. People knew how to give feedback about their experiences of care and support including how to raise any concerns or issues. They could do so in a range of accessible ways. People were kept informed about how their feedback was acted on. Where improvements were required as a result, people had the opportunity to be involved in decisions made in relation to next steps in their care and treatment or during future experiences of the service.

There were systems and processes to ensure people felt that their complaint or concern would be investigated thoroughly, and they would receive a response in good time. Records viewed showed complaints were dealt with in an open and transparent way, with no repercussions for people who raised them.

National GP Patient Survey data (2024) about experiences of accessing the services provided by the practice were mostly below local and England averages. A couple of the indicators were particularly low: * 20% of respondents reported they found it easy to through to the GP practice by phone, compared to 52% locally and 50% England average. * 24% of respondents reported they found it easy to contact the GP practice using the NHS app. This compared to 50% average locally and 45% across England. * 24% of respondents told us they usually get to see or speak with their preferred healthcare professional when they would like to. This compared to 42% average locally and 40% across England. These results reflected the other feedback we had seen from patients, including the feedback received by the practice (through complaints, compliments, NHS friends and family results) as well as information shared with CQC by people who used the service. This also reflected the feedback received by the local Healthwatch. Some members of the patient participation group told us that there had been ongoing concerns with access to the GP practice and being able to get an appointment, however, they had seen some signs of improvement over the last few months. The NHS Friends and Family test for May, June and July 2024 showed that on average 68% of patients rated the practice as very good or good over the 3 months.

Leaders acknowledged patients had experienced difficulties in accessing the service since the pandemic. They told us a high turnover of staff, a lack of focus on customer service and an inadequate telephone system had led to a poorer service for patients. However, they felt within the last 6 to 8 months they had started to address this and made significant improvements. Actions included staff recruitment, a focus on customer service training and multiskilling the reception team as well as a new phone system. The practice had worked with the Primary Care Network (PCN) to analyse the peaks and troughs of patient contact to the practice. We received 17 CQC staff questionnaires back. Most staff told us they had experienced increased satisfaction with their role in the practice, since the new practice manager had started. Some told us they now enjoyed much more coming into work. However, others told us that the practice were still in the transition to new ways of working and there were some cultural staff issues that were still being addressed. The practice recognised that their old phone system could no longer meet the needs of the practice population and allow the practice to carry out their work effectively. In March 2024, they implemented an improved telephone infrastructure. The practice told us this had been a game changer for them and had helped them significantly improve the experience for patients contacting the practice. Leaders told us they planned to carry out a patient survey to check on the success of the improvements they had made but were waiting for enough time to pass for patients to have experienced the improvements. We found leaders had a good awareness of the improvements they needed to make and had made good progress with addressing these. People were given support to overcome barriers to ensure equal access. Services were designed to make them accessible and timely for people who were most likely to have difficulty accessing care.

The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers. Staff used appropriate systems to capture and review feedback from people using the service, including those who did not speak English or have access to the internet. There were systems and processes to ensure the provider used people’s feedback and other evidence, to actively seek to improve access for people more likely to experience barriers or delays in accessing their care. People had equal access to care, treatment and support because the practice complied with the legal equality and human rights requirements; including avoiding discrimination, considering the needs of people with different protected characteristics and making reasonable adjustments. The provider had improved the processes for auditing of access, which included capacity and demand of appointments, numbers of appointments offered, those accepted or declined and those which were offered and not attended. These audits supported improvements or changes to be made. However, the quality improvement processes around access had yet to show that significant progress had been made in increasing customer satisfaction levels.

People were encouraged to share their experiences of the services. We reviewed the results from the NHS Friends and Family test for May, June and July 2024. This showed that on average 68% of patients rated the practice as very good or good over the 3 months. They had also reviewed and improved their website installing accessibility features of altered size and text to speech to assist people with a visually impairment. Staff were able to text people directly from their clinical system aiding timely and appropriate communication. We saw patients had been offered the opportunity to speak directly with members of the management team to discuss their individual concerns and try and resolve them.

Staff told us, they listened and responded to peoples experience of the service and made changes to try to ensure they had equity in their experiences, such as denoting clinical notes to alert staff to individual’s needs. There was also a named care coordinator appointed to support people with learning disabilities and/or for people who received support from a carer. 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.

There were established systems in place to capture people’s experiences of the service by providing informal feedback or recording a complaint. The practice team considered all feedback including the findings of the national GP survey. They acknowledged they had experienced challenges in ensuring good access and had implemented improvements to address this. However, they had not yet collected or analysed patient feedback to see if their approach had been successful. The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers. Staff used appropriate systems to capture and review feedback from people using the service, including those who did not speak English or have access to the internet or digital devices.

We reviewed the feedback received by the practice (through complaints, compliments, NHS friends and family results) as well as information shared with CQC by people who used the service. Generally, the feedback did not relate to this quality statement.

People were supported to make informed choices about their care and plan their future care while they have the capacity to do so. Decisions and choices made by people were documented and reviewed as required. When any treatment was changed or withdrawn, professionals communicated and managed this openly and sensitively. Leaders described the arrangements for ensuring when people expressed their wishes about cardiopulmonary resuscitation, they were supported to do so and were able to change their mind if they wished. These were arrangements in place to ensure these plans were appropriately reviewed. When people’s future care preferences were for greater independence and fewer care interventions that were likely to benefit them, professionals worked together to support them to achieve their goals.

There were systems and processes to ensure people who may be approaching the end of their life were identified (including those with protected characteristics under the Equality Act and people whose circumstances may make them vulnerable). This information was shared with other services and staff.