Old Fletton Surgery

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

As part of a planned programme we carried out an announced assessment of 1 quality statement, Equity of Access. The scores for this area have been combined with scores based on the key question rating from the last inspection, which was good. Though this assessment indicated some areas of concern since the last inspection, the rating for this key question and our overall rating remains good. We recognise the pressure that practices are currently working under and the efforts staff are making to maintain levels of access for their patients. At the same time, our strategy makes a commitment to deliver regulation driven by people’s needs and experiences of care. We saw the practice was attempting to improve access. In February 2023, the practice changed to a system where all appointment requests were reviewed and patients either directed to other local services who could help or were made an appointment with a doctor or other clinician at the practice. The practice was about to receive a new telephone system. We heard how the practice provided opportunities and support for different groups of patients to overcome health inequalities, including adjustments to registration and to how patients could communicate with the practice. Patient satisfaction as measured by the National GP Patient Survey was not statistically significantly different from average, but was somewhat below average for some indicators and had been falling since 2021. We were contacted by 257 patients for this assessment. The majority (67%) of feedback we received was positive. However, we also heard about difficulties with access to care from patients who contacted us. The practice had no effective method to seek feedback from patients about their experience. The practice had not carried out any survey/patient feedback exercise to assess the impact of the changes on patient experience and had no patient participation group. The practice carried out limited monitoring of access.

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.

We did not look at Person-centred Care during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Listening to and involving people during this assessment. The score for this quality statement is based on the previous rating for Responsive.

Patient satisfaction as measured by the 2023 National GP Patient Survey was not statistically significantly different from average, but was somewhat below average for some indicators. The lowest was about phone access: 39.9% responded positively about how easy it was to get through to the practice by phone (England 49.6%). The highest was for appointment offered: 77% said that they were satisfied with this (SICBL 66.4%, England 72.0%). Satisfaction as measured by the National GP Patient Survey had been falling since 2021. We were contacted by 257 patients for this assessment. The majority (67%) of the feedback we received was positive. However, we also heard about difficulties with access to care from patients who contacted us. Repeated themes amongst those dissatisfied included: the time to get through to the practice by phone, difficulties with the app to request an appointment, appointment availability, and that staff were not as helpful as expected. Patients also told us that they had been told that they could not make an appointment by visiting the practice, had been told to call back on repeated occasions to try to get an appointment, did not receive face to face appointments when they wished to have one, or were called back at times they had said they would not be available. The practice premises allowed good access to those with mobility needs, and the practice provided support for different groups to overcome health inequalities. The practice used the Friends and Family Test, in paper form and on the website, and received approximately 4 responses per month, which were mostly positive. The practice logged and responded to verbal complaints. It was down to the judgement of staff speaking to patients to decide if a comment should be logged.

Staff and leaders were aware of challenges to patient access and had acted to try to improve it, but there was very limited monitoring to check if the actions had been successful. The practice had moved to a system where all requests for with GP or with minor illness nurse appointments were triaged. The latest National GP Patient Survey results were published in July 2023. The practice had reviewed the results and created a formal action plan. The practice was about to receive a new phone system. Staff and leaders told us that the plan was to carry out a patient survey once this was in place. We heard about ways that the practice was working with other local stakeholders to improve access to primary care. Staff and leaders told us that the practice tried to accommodate requests to call within/outside certain times and would inform patients if their request could not be reviewed that day. We asked about feedback that patients were told that they could not book an appointment by visiting the practice and that patients were told to ring back on another day. Staff and leaders said that they were surprised by this, but had seen some similar comments online (along with lots of positive feedback). There had been no formal or verbal complaints about these matters. Staff and leaders told us that the practice used to see any patient who visited the practice and that older patients were very conscious of the difference.

Patients were asked to use the online service to request an appointment with a GP or minor illness nurse. This offered self-help advice and information about other services that could help, as well as the option to request an appointment. Patients who called the practice by phone were asked questions to collect information for triage. We heard mixed feedback about whether patients could request an appointment by visiting the practice. Patients could ask for administrative requests to be completed by filling in a form on the practice website. Appointment requests were reviewed within 2 days. The practice had arrangements in place for prioritising patients, with a duty GP available. Where patients could be better supported by other local services, patients were advised as how to access these. Pre-booked appointments were also available on weekday evenings and at the weekend through an arrangement with other local GP practices. Patients could request a face to face appointment, and this was considered by a GP. Some patients were coded to always have face to face appointments (for example, because of their communication needs). The practice had tried to improve patient experience of calling the practice by adding extra lines and extra staffing, and was about to receive a new phone system, with new features for patients and to enable monitoring of patient experience. The practice had not carried out any survey/patient feedback or audit/demand monitoring exercise to assess the impact on patient experience of the changes to access they had made so far and had no patient participation group at the time of this assessment. The practice was open 8am – 6pm Monday to Friday. Outside of these times patients were advised to contact NHS 111 or visit the local urgent treatment centre. Appointments were available with a range of healthcare professionals.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.