Lisson Grove and Woolwell Medical Centres

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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 2 quality statements from this key question. We have combined the score for this area with scores based on the rating from the last inspection, which was good. Our rating for this key question remains good. Service provision did not meet the needs of the whole population and people experienced difficulties accessing the services. Staff have responded with care and professionally when people had managed to secure an appointment.

This service scored 68 (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.

Feedback provided by people using the service, both to the provider as well as to the CQC was mostly positive when people had managed to secure an appointment with a doctor. However people also said that the service needs to do more to listen to them, get them involved in their own care and improve it's communication with patients. People at times had experienced a lack of response from the service when they had made a complaint.

Staff told us patients complaints were discussed in team meetings and that as a result of patient feedback, the practice had made changes to the phone system so patients were told their position in the queue and reception staff used the wording “thank you for waiting” when answering the phone. Leaders used different methods to keep aware of people's feedback. This included social media and an internal survey. However they yet to use these feedbacks in a strategic way for planning and making on-going improvement to the service.

The provider has yet to establish governance processes for patients involvement in the way services were planned and provided. This would have involved a patient led PPG who work in partnership with the provider to bring about positive changes and improvement on an going basis. The practice had a complaint policy and processes for internal and external use. Staff when asked, knew where the policy is located and how to access it. Staff told us complaints were shared in staff meetings for learning purposes. We found that in a number of cases the practice had not followed its own processes, where patients had not received a response to their complaint or had experienced long delays in receiving a response.

People told us they experienced difficulties in accessing the services . This included long waits for appointments, reduced continuity in care, long waits on calls, delays in response calls from the practice and not having received a call when expected. Some working people, parents and people with no or limited knowledge of using a computer found the services additionally difficult to access. Some people who were discharged from hospital, said that they had experienced delays in follow up treatments by the practice. People said that once they have seen a doctor or nursing staff, their experience has been positive. Some described staff as generally courteous and helpful. Some described their interaction and communication with individual staff members as not having been positive and said the service should do more to listen and involve patients in their care.

Leaders told us that they were aware of difficulties with access for patients, saying this has been due to the limited resources, an increase in the number of patients from 9000 to 13,545 in the recent years, together with difficulty in maintaining a sustainable workforce to meet patients’ demands. Managers and staff told us about the new triage system, SystemConnect Total Triage, was to be introduced on 22 April 2024, which would change the way patients’ demand for appointments was filtered and dealt with. The impact of the new system on patient access and satisfaction is yet not clear as it is not fully embedded and its introduction did not appear to be linked to any documented consultation with patients or study and analysis of patient experience.

The current process for accessing appointment was not meeting people's needs. The service was in the process of introducing a new triage system on 22 April 2024, to change the way patients’ demand for appointments was managed. The effects of the new system on patient access and satisfaction is yet to be monitored for making improvements to patient access as they continue to use it for accessing and providing feedback to the service. The service lacked strategic patient led processes for planning and implementing on-going improvements to the service. The practice had access to Language Empire for patients with languages other than English and a tablet was available for reception staff to use Google Translate when needed. Downstairs consulting room were used for patients with difficulty with mobility.

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.