Billinge Medical Practice

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We assessed one quality statement in the well-led key question and found areas of good practice. The score for this area has been combined with scores based on the rating from the inspection in September 2023 which was inadequate. Though the assessment of this area indicated good practice since the inspection in September 2023, our rating for the key question remains inadequate. At this assessment we followed up the actions needed after our inspection in September 2023. During the assessment we reviewed records, spoke with staff, and undertook observations of the systems in operation. We found the following: • Improvements had been made to the management of significant events. • There was a process for the contents of meetings to be recorded to enable information sharing. • Tasks were appropriately managed to avoid a back-log and identify priorities. • Leaders had acted on patient feedback in the National GP Patient Survey 2023 concerning low satisfaction with the appointment system and access by telephone.

This service scored 32 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Leaders told us how they had acted on patient feedback to improve access. Staffing levels had been reviewed, changes made to the appointment system and more appointments were being offered. We reviewed patient feedback to assess how the changes made had impacted on patients experiences of the service. We met with representatives of the Patient Participation Group (PPG). They told us that there had been improvements to telephone access, experience of making an appointment and satisfaction with the appointments offered. They told us there was now access to phlebotomy at the practice and prescriptions were better managed. The PPG interviewed 34 patients in April 2024 and asked questions about access to services, improvements since January 2024 and whether they would recommend the service to family and friends. The results were very positive indicating 90.6% indicated that they felt that the practice had improved since January 2024, 90.3% said that they would recommend the practice and 100% said that they were not waiting long to be seen. Healthwatch visited the practice in January 2024 and spoke with 33 patients. Healthwatch concluded that overall, patients had reported a great improvement to the service provided. We reviewed feedback from patients on the NHS.uk website (formerly NHS Choices) since the inspection in September 2023 until April 2024. Positive feedback comments had been left by 27 patients out of 28 patients. Comments indicated patients considered there had been improvements to access and wait time for appointments. There were also comments about good care and treatment and polite and helpful reception staff. Friends and Family feedback from January to March 2024 showed that 201 responses had been received and 192 (96%) patients said the service was very good or good. Staff told us that there had been a number of positive changes at the service to improve the services provided and support staff in their roles.

Following the inspection in September 2023 the leaders had developed an action plan to demonstrate how they would address the improvements needed to information sharing, the management of tasks and significant events and to improve access. We reviewed the action plan alongside a review of records, discussion with staff and gathering patients views. We saw that leaders had updated the significant event procedure to ensure the process was clear. We saw that records of significant events were maintained. Records showed that any learning and actions had been shared with staff. We reviewed meeting minutes which showed a number of different meetings were taking place to share information across the staff groups. We reviewed records that indicated there were systems to review and share information with health and social care professionals about vulnerable patients. The records we reviewed were sufficiently detailed to enable clear information sharing. At the inspection in September 2023 we identified that there were a high number of outstanding tasks and insufficient non-clinical staff to manage tasks. At this assessment further non-clinical staff had been employed. The system to manage tasks had been revised to ensure there was better oversight and clearer responsibilities. Staff spoken with had access to standard operating procedures for guidance and had received training in the management of tasks. We reviewed the clinical, administrative and reception task system and found that there was not a back-log and staff understood the process to follow. Processes for monitoring access by telephone and to appointments were in place. This supported leaders to make the changes needed to enable patients to access the service in a timely manner.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.