Martonside Medical Centre

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

We assessed all the quality statements from this key question. Our rating for this key question remains good. We found staff treated people equally and without discrimination. The provider complied with legal equality and human rights requirements. The practice had taken steps to improve access for patients, but there were further improvements planned.

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.

Patient feedback through the National GP Patient survey results in 2024 showed patients felt their needs were met during their appointments (89% of responded positively compared to 91% across the Integrated Care System (ICS) and 90% in England). The patients we spoke with in advance of the site visit also gave positive feedback about the way the service met their needs.

Leaders told us they had implemented systems to ensure people’s records fully reflected their physical, mental, emotional and social needs; including those related to protected characteristics under the Equality Act. People could receive the most appropriate care and treatment for them, as the service made reasonable adjustments where necessary. There were arrangements in place to ensure people understand their condition, care and treatment options (including any associated risks and benefits) and any advice provided. There were systems and processes to support this.

We found feedback about care provision, integration and continuity of care was mixed. The general feedback we had received from patients was generally positive about care provision. However, of note in the National GP Patient Survey 2024, only 7% of patients who responded, said they usually got to see or speak to their preferred healthcare professional. This compared to 42% average across the ICS and 40% across England. The practice told us that they were aware of concerns from patients about continuity of care and being able to see their preferred clinician. They told us there had been a lot of changes in the GPs in the practice, due to retirement and general turnover. They felt that patients had not yet had the opportunity to get to know the new GPs and develop preferences. They felt this would change over time. Staff and leaders told us people’s care and treatment were delivered in a way that meets their assessed needs from services that were co-ordinated and responsive.

Leaders told us the relationship with the Primary Care Network was very productive and there was supportive partnership working. They had worked together on several improvement initiatives, for example, nurse led ward rounds for local care homes. There were several schemes and services provided across the Primary Care Network (PCN) that supported patients of the practice, including, cancer care support worker, first contact physiotherapy and pharmacist support. The practice had arrangements in place to check the robustness of shared care agreements with providers of private healthcare to ensure any agreements put in place were safe and effective for patients and to refuse any that could place patients at risk. There was a positive relationship with the local care home, which supported good continuity of care.

There were clear policies and procedures to ensure people received care and treatment from services that understood the diverse health and social care needs of their local communities. This included consideration of the needs and preferences of different people, including those with protected characteristics under the Equality Act and those at most risk of a poorer experience of care. Processes supported the co-ordination of services with other health and care providers and good continuity of care.

Patient feedback through the National GP Patient survey results in 2024 showed patients felt involved in decisions about their care and treatment and that healthcare professionals had the information they needed during their last general practice appointment. We reviewed the feedback received by the practice (through complaints, compliments, NHS friends and family results) as well as information shared with CQC by people who used the service.

Staff and leaders provided us with evidence that showed people could get information and advice that was accurate, up-to-date and provided in a way that they can understand, and which met their communication needs. People who use the service, their family and carers (where appropriate) were provided with information that was accessible, safe and secure and supported their rights and choices.

There were policies and procedures for staff to follow to ensure people had information that was tailored to individual needs. This included making reasonable adjustments for Disabled people, interpreting and translation for people who don’t speak English as a first language and for Deaf people who use British Sign Language. People who had used digital services were also supported with accessible information. There were systems to ensure information about people that was collected and shared, met data protection legislation requirements. Following feedback during the site visit, the practice contacted their web provider and arranged for it so their website could be automatically translated into multiple languages. The practice gave us examples of how they had implemented individual reasonable adjustments to meet the communication needs of patients. However, they had not audited this to make sure their arrangements were comprehensive and were suitable for their practice population overall.

National GP Patient Survey data (2024) about experiences of being listened to and involved in decisions about their care, treatment and support were similar to local and England averages. For example: 79% responded they knew what the next steps would be after contacting their GP (ICS average was 84%, England average was 83%).; 99% responded they knew what the next steps would be within 2 days of contacting their GP practice. (ICS average was 94%, England average was 93%).; 79% responded the healthcare professional they saw or spoke with was good at listening to them during their last general practice appointment. (ICS average was 89%, England average was 87%).; 91% responded they were involved as much as they wanted to be in decisions about their care and treatment during their last general practice appointment. (ICS average was 92%, England average was 91%). We reviewed the feedback received by the practice (through complaints, compliments, NHS friends and family results) as well as information shared with CQC by people who used the service. The practice had carried out an extensive patient survey in November 2024. There were 911 responses over the 10-day survey period. This equated to 11.5% of the practice population. This validated the concern that patients found it difficult to get through to the practice by phone. Of those who responded 58% somewhat or extremely difficult to get through via the telephone. However, 89.7% thought call queuing and 92.8% thought unlimited lines would be somewhat or very helpful. The practice in-person patient participation group had lapsed since the pandemic. However, the practice had recently recruited over 500 patients to join a virtual practice participation group as a mechanism for gathering feedback and involving patients in improvement initiatives.

Leaders told us they had a well-established process for identifying and acting upon complaints and concerns. This included written and verbal complaints. This maximised the amount of feedback the practice was able to investigate and learn from. It also allowed the practice to receive feedback on concerns from patients who would be unlikely or unable to submit written complaints. There was information on the practice website giving patients information about how to complain. The practice told us they had used the results of their November 2024 patient survey to inform their next steps in the improvement of access. This included the planned installation of a new telephony system, with improved call handling facilities, such as call back and unlimited queuing. People knew how to give feedback about their experiences of care and support including how to raise any concerns or issues. They could do so in a range of accessible ways. People were kept informed about how their feedback was acted on. Where improvements were required as a result, people had the opportunity to be involved in decisions made in relation to next steps in their care and treatment or during future experiences of the service.

There were systems and processes to ensure people felt that their complaint or concern would be investigated thoroughly, and they would receive a response in good time. Records viewed showed complaints were dealt with in an open and transparent way, with no repercussions for people who raised them.

Patient feedback through the National GP Patient survey results in 2024 was mixed on how patients perceived equity in access, but results were generally lower than the ICS and England averages. Overall, 59% described their overall experience of the GP practice as good, compared to 77% across the ICS and 74% across England. Similarly, 49.7% described their experience of contacting their GP practice as good, compared to 69% across the ICS and 67% across England. The practice carried out their own patient survey in November 2024, which found 62.8% of patients rated their experience as very or fairly good. The patients we spoke with in advance of the site visit did not raise any concerns with us about access.

Leaders told us they had made progress with actions to address previous feedback about difficulties with access and poor patient satisfaction levels. They had, increased the proportion of female clinician time to meet the needs of the practice population; increased the availability of face-to-face appointments and given patients more freedom to specify which type of appointment they preferred; increased the appointment times from 10 minutes to 15 minutes; increased GP capacity for emergency consultations by changing the duty system; changed the process for e-consultations to provide a consistent approach; and, agreed to redirect finances from the Primary Care Network budget to employ a practice specific pharmacy technician and a part-time GP. This had increased staffing capacity within the practice. The practice recognised there were still difficulties in patients attempting to contact the practice by phone. They had made arrangement for a new phone system, due for implementation in early 2025, which would improve functionality, such as automatic call backs and unlimited queuing. We found leaders had a good awareness of the improvements they needed to make and had made good progress with addressing these. People were given support to overcome barriers to ensure equal access. Services were designed to make them accessible and timely for people who were most likely to have difficulty accessing care. We found evidence of significant positive patient feedback to demonstrate the changes had been popular with patients.

The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers. Staff used appropriate systems to capture and review feedback from people using the service, including those who did not speak English or have access to the internet. There were systems and processes to ensure the provider used people’s feedback and other evidence, to actively seek to improve access for people more likely to experience barriers or delays in accessing their care. People had equal access to care, treatment and support because the practice complied with the legal equality and human rights requirements, including avoiding discrimination, considering the needs of people with different protected characteristics and making reasonable adjustments.

Feedback provided by people using the service, both to the provider as well as to CQC, was positive. Staff treated people equally and without discrimination.

Leaders proactively sought ways to address any barriers to improving people’s experience and worked with local organisations, including within the voluntary sector, to address any local health inequalities. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes.

The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers. Staff used appropriate systems to capture and review feedback from people using the service, including those who did not speak English or have access to the internet.

We reviewed the feedback received by the practice (through complaints, compliments, NHS friends and family results) as well as information shared with CQC by people who used the service. Generally, the feedback did not relate to this quality statement.

People were supported to make informed choices about their care and plan their future care while they have the capacity to do so. Decisions and choices made by people were documented and reviewed as required. When any treatment was changed or withdrawn, professionals communicated and managed this openly and sensitively. Leaders described the arrangements for ensuring when people expressed their wishes about cardiopulmonary resuscitation, they were supported to do so and were able to change their mind if they wished. These were arrangements in place to ensure these plans were appropriately reviewed. When people’s future care preferences were for greater independence and fewer care interventions that were likely to benefit them, professionals worked together to support them to achieve their goals.

There were systems and processes to ensure people who may be approaching the end of their life were identified (including those with protected characteristics under the Equality Act and people whose circumstances may make them vulnerable). This information was shared with other services and staff.