Dr B. Bekas

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

At the previous inspection we rated responsive as requires improvement because: patients reported difficulty getting through to the practice by telephone and accessing a GP appointment during the day. There was a lack of information available to patients via the telephone system and there was no online information available on how to make a complaint. There was no recording, oversight and learning from complaints and therefore investigation into complaints were not used to drive improvement and shared with staff. At this inspection we saw improvements in some of these areas, including an improvement to the percentage of respondents to the GP Patient Survey 2024 who responded positively to how easy it was to contact their GP practice on the phone. However, we were unable to gain assurances that staff and leaders worked consistently with external agencies to ensure people’s care and treatment was delivered in a way that were responsive to patients’ needs.

This service scored 39 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Patient feedback through the GP patient survey 2024 showed that 82% of respondents to the survey stated that during their last appointment, the healthcare professional was very good or fairly good at treating them with care and concern compared to a national average of 85%.

Staff were unable to tell us how they regularly involved patients in making shared decisions about their care and treatment plans. At the previous inspection there was no active patient participation group (PPG). At this inspection leaders told us that the PPG was now active and met regularly. We found no evidence to demonstrate the outcome of the national patient survey had been reviewed and used this to make improvements.

Leaders told us that there was engagement with some agencies such as health visitors and the midwife to review safeguarding concerns, although we did not see evidence of this. The practice told us they attended primary care network meetings; however, we saw evidence that attendance was not consistent. Evidence was provided to demonstrate that palliative care patients were reviewed within the practice.

We were unable to gain assurances that staff and leaders worked consistently with external agencies to ensure that people’s care and treatment was responsive. For example, the practice was supported by a paramedic employed by the PCN to deliver clinical appointments. However, on the day of the site visit, the member of staff was available to see patients, but there were no appointments scheduled.

We were provided with evidence to demonstrate that there were meetings with the practice team. However, there was no evidence that staff employed by the PCN had attended these meetings. Staff told us that safeguarding meetings were held at the practice, however there was no evidence of this.

The practice had developed a website since the previous inspection but some patients we spoke to told us that they were not aware of it. The recently developed website included useful information on health awareness and promotion. Information and resources were available for patients to support them to understand how to access services. For example, there were arrangements in place for people who need translation services or who may be digitally excluded.

Leaders told us that the new website was up and running but there was work to be done to improve the content and also to enable patient interaction.

We found the practice had some processes which complied with the Accessible Information Standard, (AIS). For example, the practice was aware of their patient demographic and were able to support them to access health services, but they were unaware of the total scope of the AIS and their legal requirements to comply with it.

Since the previous inspection, the practice had worked to develop an active patient participation group, (PPG). We spoke with one member of the PPG who told us that their personal experience of the whole practice staff team was very positive. Although the practice had a system for complaints, we found that where people had sent the practice a written complaint, they did not always receive a written reply, which was not inline with the practice policy.

The practice told us they collated feedback via the Friends and Family test to make improvements to the service, although they were unable to provide and analysis of the data or any changes made as a result of the feedback.

The practice had a complaints policy in place. However, we found the systems to monitor complaints and use patient comments to improve the quality of care was not embedded to ensure improvements were demonstrated. We found there was a system for recording complaints, however there was no evidence to demonstrate that they were regularly reviewed and discussed in practice meetings to share learning. The practice had received 16 complaints in the period April 2023 to August 2024. On reviewing these complaints, we found evidence that staff had not followed the practice policy and procedure to address them.

The practice had processes in place to respond to the needs of their population. For example, a paramedic and pharmacist support. There had been 6 reviews on the NHS website in the previous 12 months. Of these, 5 were rated 5* and 1 was rated 1*, where 5 is the highest score and 1 is the lowest. Comments included, “The reception staff were so kind and helpful”, “This is how good GPs used to be, where the appointment is about the patient, not a 'ten-minute slot' regardless of your needs being met”, “I actually 'had a voice” and “I couldn't be happier with this surgery.” The National GP Patient Survey results for the period 01/01/2024 to 31/03/2024 indicated that 72.4% of respondents to the survey responded positively to how easy it was to contact their GP practice on the phone, compared to the national average of 49.7%.The National GP Patient Survey results for the period 01/01/2024 to 31/03/2024 indicated that 78.8% of respondents to survey responded positively to the overall experience of contacting their GP practice compared to the national average of 67.3%.

Leaders demonstrated they were aware of the challenges to patient access and a new telephone system had been installed to improve access. However, we identified concerns that this improvement would not be sufficient to address the shortfalls in the appointment availability within the practice. We were told of examples, where clinical staff in various roles said they were asked to provide appointments and on occasions, patients were allocated to them, but they were unable to provide care as the patients’ needs were complex and outside of their competencies. We saw evidence that GP face to face appointments were only provided by the practice for 6 set hours a week. Extended access appointments (evenings and weekends) were available at other local practices. We were told that a high number of staff had left in the previous 12 months and while some had been replaced, they were still undergoing training, and this was impacting on the delivery of services.

The practice offered appointments by telephone and in person by visiting the practice. At the time of inspection, there was no facility to book appointments online. The practice offered a range of appointment types to suit different needs, however this process required strengthening.

There were some systems in place to support patients who face communication barriers to access treatment, including those who might be digitally excluded. For example, interpreter services were available for patients whose first language was not English. People could leave feedback via the NHS website, the practice website, the Friends and Family test (FFT), or in person.

The practice had implemented the Friends and Family test (FFT) and the practice told us that the majority of patients rated the practice as good or very good. We did not see any evidence of this. The practice told us that they had developed a patient survey, but at the time of inspection this was in progress and no results were available. People could also provide feedback via the PPG, but there were no examples of this being received or acted upon.

We saw examples where the practice had met the needs of some vulnerable patient groups and removed barriers for improved patient experience. People with learning disabilities and poor mental health experienced additional care through annual reviews, however we found processes needed improving to ensure these were being routinely carried out. Not all people had received treatment in line with the guidance, including some people with a learning disability, some people with diabetes and some people with asthma.

Staff we spoke with told us that people were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. However, we saw no evidence of this.

There were systems in place for staff to keep up to date with training, but on reviewing these we found there were gaps for some staff in their training and updates. There were registers held for those patients who were vulnerable, on the palliative care register or at the end of their life, but these were not always maintained or updated. This meant that some patients did not receive the correct monitoring and treatment for their conditions.