Hanham Surgery Also known as Hanham Health

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 carried out an announced assessment of 1 quality statement, equity in access. We found the GP Patient Survey results were below local and national averages and although the provider had taken action to respond to the GP Patient Survey and implement changes, they had not carried out their own patient feedback to evaluate changes. Services were designed to make them accessible and timely for people who were most likely to have difficulty accessing care. The practice had worked with other local GP practices to improve access for patients with a learning disability and/or serious mental illness. Patient feedback indicated patients did not always have a good experience with accessing the practice. No breaches of regulation were identified.

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.

The practice website provided information for patients regarding how to book appointments. The range of options included by telephone, by visiting the practice, by NHS app and online. The practice supported patients with communication needs such as access to an interpretation service to support patients whom English language was not their first language and signposted to easy-read documents. We reviewed patient feedback via Give Feedback on Care on the CQC website and from the practice's patient participation group (PPG). Feedback was mixed and provided both positive and negative experiences. Some patients reported issues with access at the practice, in particular, patients that rely on phone contact. However, patients also gave positive feedback stating they felt listened to and received good care. We reviewed the 2023 National GP Patient Survey results and found data showed 17% of people responded positively about how easy it is to get through to the practice by phone. This is significantly lower than the national average of 50% and indicates a decline in performance from the previous year’s results. Although the practice was aware of the poor survey results and had taken some action such as implementing a new online booking and triage system, they had not carried out their own survey into patients' experience of access at the practice.

The leaders told us they understood the needs of its local population and had developed services in response to those needs. Patients could request a named clinician when booking an appointment to promote continuity of care to ensure a clear understanding of the patient needs and to improve patient outcomes. This was not always possible due to staff availability but clinicians would review the request and where possible and necessary, meet this request. The leaders explained they provided opportunities and support for different groups of patient population to overcome health inequalities. For example, delegated clinicians would carry out video ward rounds and visits in person to local care homes to assess patients' needs on a regular basis. Feedback we received from these care homes was positive. Leaders told us they had a bi-weekly meeting to discuss issues and have increased appointment capacity on every Monday and on Fridays before a bank holiday. Leaders told us they were aware of the challenges to patient access and had acted to improve access however, they could not fully demonstrate people’s current experience. Patients had not been asked for feedback on their experiences of phone and online access and the practice had not carried out audits to evaluate changes they had implemented.

The practice had arrangements in place for prioritising patients and staff had guidance to follow. The practice had up to date policies and procedures in regard to patient access. Some routine appointments could be booked by reception staff but for any clinical input or on-the-day appointments, a triage process operated by clinicians was in place. A new online appointment system was implemented in August 2023. Patient feedback on this new online system had not been sought therefore, the impact of the new system on patients had not been evaluated. For example, we received feedback indicating older patients were struggling to use the online booking system. The practice told us they did not have a modernised telephony system but a new system was going to be installed imminently. The last audit carried out on the practice's phone system was in November 2022. The practice was aware of the limitations of the phone system and had introduced an online appointment system to improve access for patients however they had not requested feedback from patients to demonstrate the impact of this system for patients requiring phone access. Feedback from patients we received indicated new systems were poorly publicised. The practice showed us a message shown on waiting room call screens in January 2024 advertising the new phone system was due to be implemented in April 2024 but there has been no further communication with patients. The provider submitted their NHS Friends and Family Test results which showed the majority of patients stated they had a good or very good experience. However, the practice could not demonstrate they had reviewed the responses where patients had indicated poor or very poor experiences to identify themes and gaps in learning. Some improvements need to be made to meet the quality of care described in the quality statement.

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.