Austen Road Surgery

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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 reviewed 2 quality statement in the Responsive key question – Equity in experiences and outcomes and Equity in access. The scores for the other quality statements are based on the previous rating for this key question. The practice understood the needs of its population and tailored services in response to those needs. For example, extended opening hours, online services, and advanced booking of appointments. The practice made reasonable adjustments when patients found it hard to access services. Patients were able to book appointments in a number of ways. Patients could attend the practice and book at the reception desk, via telephone, via email to a generic account or by completing a form on the website. There were early morning appointments with a nurse and a GP as well as late appointments on a Monday. The results of the most recent GP Patient Survey showed the practice performance was above the national averages for all 4 of the indicators measured. The most significant was the ease of getting through to the GP practice.

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.

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.

The practice was responsive to the needs of older or vulnerable patients and offered home visits and urgent appointments for those with enhanced needs and complex medical issues. Parents or guardians calling with concerns about a young child were offered a same day appointment when necessary. The practice held a register of patients living in vulnerable circumstances including those with a learning disability. People in vulnerable circumstances were easily able to register with the practice, including those with no fixed abode such as homeless people and Travellers. The practice had changed their telephone system so that patients could be called back rather than waiting in a queue. The practice offered 15 minutes appointments to all patients. The practice had completed an audit to review how many patients had digital access to their medical records. They recognised they had low numbers and so established a process to promote the benefits of patients using digital approaches. Results of audits showed a continued improvement. The first audit in April 2023 showed only 9 patients registered and the last audit completed in December 2023 showed an increase to 1860 patients with digital access. The practice had attended a number of digital journey workshops and was reviewing ways to help reduce the number of appointments made by patients who attended the practice on a regular basis. The practice had recognised the importance of continuity of care for complex patients who may be well known to a particular Doctor and therefore may be less appropriate to be seen by another Doctor.

Staff we spoke with told us patients had access to care and treatment when they needed to and in a way that worked for the patient. They felt there was a good range of appointments offered, and various methods for booking. This meant patients could choose their preferred method for booking and the type of appointment right for them. For example, by having early morning appointments meant those who commuted for work were able to access care and treatment at a time more suitable. Those patients who preferred not to use digital methods were able to phone the practice or attend in person to book their appointments. Staff interviews showed a clear understanding of potential barriers to care including patients with a hearing or visual impairment or for homeless patients. In response the practice provided access to interpreters and had a hearing loop. Adjustments for homeless patients included using the practice as their postal address or contacting them via email.

Results from the national patient survey showed positive results. Patient feedback from the national patient survey showed that 81% of patients were positive to the overall experience of making an appointment. The national average was 54%. The national patient survey showed 82% of patients responded positively to how easy it was to get through to someone at their GP practice on the phone. The national average was 49%. The national patient survey showed 64% of patients were very satisfied or fairly satisfied with their GP practice appointment times. The national average was 53%. The national patient survey showed 76% of patients responded they were satisfied with the appointment (or appointments) they were offered. The national average was 72%.

We interviewed staff members including health care assistants (HCA), Nurses, reception staff, and administrators, as well as the practice manager and GPs. Staff showed a clear understanding of potential barriers to care including patients with a hearing or visual impairment or patients who were homeless. We found there was an inclusive approach to patient care. The practice in 2022 was able to take over an additional part of the building. This meant they were able to increase the size of their accommodation and created a practice managers office, an administrator’s office, a staff common room and an additional consultation room. Staff told us the new consultation room was offered to other services to see patients. For example, General Practice integrated Mental Health Service (GPiMHS) which is an emotional and wellbeing service for adult patients over 18 and Community mental health teams (CMHTs) who provide multi-disciplinary assessment, treatment and care of individuals with severe and enduring mental health problems. The practice had recently started to host the Smoking cessation team for a weekly stop smoking clinic. Twice a week a Drug and Addiction service used the practice to see patients across practices in the Guildford area. The support workers have developed a good network with the clinicians and could help staff with any concerns or queries. It was also useful for those patients who do not want to visit their own surgeries for fear of being seen by someone they know. Staff felt that being able to offer additional services in an environment that patients felt safe in was beneficial.

The practice had systems in place to ensure patients and staff feedback was received. We saw there were comment cards for patients to complete in the waiting area if they wished and staff had a comment box within the staff room. The practice had also completed a staff survey. Patients could also leave comments via the practice website or by writing to the practice. The practice investigated and reviewed complaints and comments by patients, including those left on digital platforms. The practice provided a number of different support mechanisms for patients where needed. Patient records were detailed and gave a good overview of patient's requirements. This included appointments in a downstairs room, interpretation services, or additional time needed. There were processes in place to allow a GP to refer a patient to the health care coordinator (HCC) who would then networks with social prescribing (social prescribing is an approach that connects people to activities, groups, and services in their community to meet the practical, social and emotional needs that affect their health and wellbeing) or other third-party agents who may be able to assess any additional needs of the patient. There were monthly meetings with the lead frailty GP, Community Matron and HCC to discuss any ongoing patients or any new patients who have a need for additional support.

We had feedback from 2 members of the Patient Participation Group. Both were very positive towards the practice in regard to the practice wanting to learn and was proactively asking for feedback. The results of the national patient survey was positive in all areas and above the national average. A patient had commented they cycled to the practice and had nowhere to leave their bike securely. In response the practice had installed cycle rings to chain bikes to.

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.