GPS Healthcare - Tanworth Lane

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• 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 1 quality statement from this key question (Equity in access). We have combined the score for this area with scores based on the rating from the last inspection, which was good. We found leaders used people’s feedback and other evidence to improve access for people. However, patient satisfaction in the 2024 GP Patient Survey showed poor results for access. The provider had an access improvement plan and many of the actions had been implemented, such as a centralised triage function and use of online appointment requests. Recent feedback from patients on the NHS website showed overall positive feedback for new systems for triage and online appointment booking. Since our assessment we have seen evidence that the provider is aware that further improvement in access is required. They have continued to monitor the impact of their improvement plan on the number of appointments available, telephone waiting times and patient satisfaction. For example, evidence we saw showed that the number of available GP appointments increased from 7,980 in June 2024 to 11,480 in October 2024.

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.

People reported difficulties in accessing appointments at the provider’s practices. The 2024 GP Patient Survey showed that patient satisfaction with how easy respondents found it to access the practices by phone was very poor at 19% compared to the national average at 50%. Respondents also gave low satisfaction rates for access via the website and NHS app. This data was for 1 April 2023 to 31 March 2024. Feedback from some people to CQC was negative about accessing the practices and difficulty getting an appointment. The provider collected feedback from patients after appointments using the friends and family test. Between June 2023 and May 2024, 1,615 patients had responded to the survey. The provider had identified that patient satisfaction was particularly poor in appointment availability and phone queue times. The NHS website reviews of the provider in July 2024 were mainly positive about access. Of 74 reviews, 51 were positive (69%). Comments were mainly that the new online booking system was quick and effective. There were 23 negative reviews (31%) which were mainly about difficulty making an appointment. The provider had responded to many of the comments and stated it had taken the feedback on board. The provider had responded to the results of the 2024 GP Patient Survey and had an access improvement plan. There had been several changes to the phone and online access, reception staffing and triage systems and since our assessment the provider had conducted a patient survey (in November 2024) which showed modest improvements in patient satisfaction with phone, web and NHS App access.

Staff understood the needs of their population and had developed responsive services as a result. Patients could make appointments by telephone, online and in person. The provider offered face to face or telephone appointments, on the day and pre-bookable with a range of clinicians. Patients had access to interpretation services. All sites were accessible to patients with mobility needs. Staff told us that people in vulnerable circumstances were able to register with the provider, including those with no fixed abode. Leaders were aware of the challenges to patient access and had made changes to improve it. The introduction of a total triage system meant appointments could be requested digitally and were prioritised based on clinical need. Following the introduction of this system, telephone queue waiting times had halved from 55 minutes to 27 minutes. However, the provider acknowledged that telephone waiting times were still not satisfactory and that further work remained to be done regarding access. Evidence we have viewed since our assessment shows further reduction in the average telephone queue waiting time to 13 minutes. This verified that the provider was engaged in ongoing monitoring of their performance and the impact of the changes made so far. The provider had undertaken a promotional campaign to educate patients about the new systems including “digital days” and “queue busters” where staff were available to show patients alternative access channels. Where appropriate, to reduce the need for patients to contact the provider again, clinicians could book follow up appointments when needed. To improve the availability and range of appointments, the provider offered appointments with paramedics, pharmacists and social prescribers. Since our assessment, the provider has undertaken an outreach event at a local hotel housing a community of asylum seekers to reduce health inequalities by increasing access to primary care services and improving patient engagement.

The facilities and premises were appropriate for the services delivered. Reasonable adjustments were made so that people in vulnerable circumstances could access services. Although the provider had systems in place to monitor telephone and appointment access through a central triage facility, patients still found it hard to access appointments in a timely way. The processes the provider had implemented had not yet significantly improved patient satisfaction with access. Leaders discussed information relating to access and patient satisfaction in meetings. The provider had ongoing plans to broaden the online booking system to include access to the same service by phone by reception team members completing the online consultation form. The provider recognised the need for ongoing monitoring and quality improvement to embed the new systems and ensure progress regarding access to the service. They have provided evidence since our assessment that this work is being done. For example, they have undertaken a piece of work to understand capacity, demand and the unmet need (that is the number of appointments requested but not provided) which will help them to determine what further developments are required. The provider obtained feedback from a range of sources, including the GP patient survey, friends and family survey, PPG and complaints. Leaders had used this feedback to help them design the new access systems and to understand how patients were responding to the changes. Leaders told us they were improving the induction training process for reception staff to ensure consistency in appointment booking.

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.