Hill Top 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 is Good. We found staff treated people equally and without discrimination. The provider complied with legal equality and human rights requirements.

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.

Patients had access to appointments provided by a range of a multi-skillset of clinicians including GPs, practice nurse and healthcare support workers a social prescriber and pharmacist. Patients requesting an appointment were asked to provide a brief description of their presenting symptoms to ensure they were booked to see the most appropriate clinician for their presenting condition.

Staff told us they used decision aids, such as leaflets, videos, or online tools, to help patients understand their options and make informed choices. They said they took account of the patients' health literacy needs and provided education and resources to improve the patient's understanding of their condition and treatment options for their empowerment and education. Leaders told us a multidisciplinary team approach was adopted to ensure that all relevant healthcare professionals were involved in the care planning process to provide a comprehensive approach to the patient's care. The practice used patient feedback to identify areas for improvement and make necessary adjustments to care planning processes.

Practice staff were able to refer patients to their social prescriber, who was able to sign post and support patients with the understanding of the social, economic, and environmental factors that impact patients' health and well-being. Staff told us they worked to build relationships with community organisations, social services agencies, religious institutions, and local government entities, whenever possible to improve patient care in the forms of multidisciplinary teams.

We received no specific feedback from partners regarding care provision, integration and continuity.

The practice had completed resource mapping to identify community organisations, support groups, social services, and programs available to address these needs. Health exchange in Sandwell and Birmingham provided a service to help with addressing care needs.

We received no specific feedback from patients regarding the provision of information.

Staff we spoke with told of their awareness of an action taken to meet NHS England’s Accessible information standards. They confirmed they had completed information governance training which included General Data Protection Regulation (GDPR). Leaders demonstrated they understood the needs of their local population and had developed services in response to those needs. The importance of flexibility, informed choice and continuity of care was reflected in the services provided. Appointments included a mixture of telephone, face-to-face and home visits which were noted on the practice website.

The practice staff had awareness and actions were taken to meet NHS England’s Accessible information standards. There were arrangements in place for people who need translation services. There were systems in place to support patients who face communication barriers to access Treatment, including those who might be digitally excluded.

Patient feedback results were described and discussed with the reasonably new practice Patient Participation Group (PPG); this included any practice improvement action plans. Leaders had listened to people’s experiences and as a result of patient feedback had commissioned a new telephony system with callback facility to improve patient experience of contacting the practice via phone.

Staff described the various systems in place for how patients could raise suggestions, comments, compliments, feedback and complaints. Outcomes of complaints were shared practice wide, including any mitigations of risks for learning.

The practice had various systems in place for how patients could raise suggestions, comments, compliments, feedback and complaints. The practice had a designated complaint lead. Information about how to complain was readily available. There was evidence that complaints were used to drive continuous improvement. An example included the practice purchase of a new telephony system.

Feedback provided by people using the service, both to the provider as well as to CQC, was mainly positive. Staff treated people equally and without discrimination. However, the NHS UK website had 2 more negative star ratings which related to not being provided with information prior to making an appointment to which the practice had responded.

Leaders told us they had since revamped their telephone system to enable queue numbers and optional call back. They reported they had received positive feedback from patients and were confident this would be reflected in their results in the next national GP patient survey. 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 received no specific feedback from patients regarding equity in experience and outcomes.

Staff described the systems used to capture and review feedback from people using the service, including those who did not speak English or have access to the internet to promote equity in experience and outcomes. Staff told us parents or guardians calling with concerns about a child were offered a same day appointment when necessary.

The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers. The practice adjusted the delivery of its services to meet the needs of patients with a learning disability. The practice had used benchmarks regarding patient equity of experience at the practice, such as quality outcome frameworks, clinical audits and feedback from ICB and PCNs. There were improvements made in some areas such as cervical smear and childhood immunisation uptake. An example of change was in their proactive approach to booking both mother and child for a review. Cervical screening had improved within the Quality Outcome Framework data, from 70% to 83% in the age groups 25-49, and to 84% ages 50-64. The uptake of the childhood immunisations from ages 1-5 years of the booster vaccine improved from 11% to 76%.

We received no specific feedback from patients regarding their experiences of planning for the future.

Clinicians we spoke with demonstrated a clear understanding of the requirements of legislation and guidance when considering consent and decision making. GPs demonstrated awareness of ReSPECT and Treatment Escalation Plans (TEP). These tools offer patients the opportunity to plan their future care and support. This included medical treatment and resuscitation options, while they have the capacity to do so.

We saw that consent was documented. Clinicians supported patients to make decisions. Where appropriate, they assessed and recorded a patient’s mental capacity to make a decision. Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) decisions were made in line with relevant legislation and were appropriate. We reviewed 5 Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) forms. We found that where a DNACPR decision had been recorded, this identified, were possible, the patient’s views had been sought and respected, and information had been shared with relevant agencies. However, we identified some gaps in the noting of assessments for 2 patients without mental capacity and multi-agency discussions in those with hospital DNACPRs. The summary of relevant information lacked detail and review dates were not detailed. The practice advised us review dates were noted on patient records but these had not been referenced on the ReSPECT forms. Following our feedback the practice updated their standard operating procedure (SOP) to reflect the required documentation for decisions made.