Cressex Health Centre

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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

The practice used patients’ feedback to actively improve access for patients. Services were reviewed, designed and improved to make them accessible and timely recognising people who were most likely to have difficulty accessing care. The practice identified and allocated resources as required to reduce inequalities and support equity of access. The practice had a flexible approach to staffing level and adjusted them as required to ensure sufficient staffing and skills mix at both the main practice and the branch practice. Practice leaders continued to monitor and improve access through regular reviews of actions taken to manage the needs of the population groups. The practice monitored data and feedback related to patient’s experiences when accessing care. This included a rapid 13% growth in the number of patients registered at the practice. Where opportunities to improve had been identified, the practice responded with changes designed to improve access and, patients’ experiences and satisfaction levels.

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.

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.

Feedback from staff members demonstrated that they had a good understanding of the patient population, awareness of the local and national primary care challenges and had acted to improve patient access. Staff explained how they provided opportunities and support for different groups of the patient population aiming to overcome health inequalities. They for example introduced adjustments to the registration process and how patients could communicate with the practice. We were told that all reception team were trained in care navigation and were able to signpost patients to the most appropriate clinician or service. Staff told us if a member of staff was concerned about a patient this was flagged to the duty doctor who provided clinical oversight and support to the reception team. The practice team spoke of a cohesive relationship between all members of the primary care network (PCN) and the Integrated Care Board (ICB) which helped to deliver high quality sustainable care, with a view to improve patient care and access, and invested in new ways of providing primary care across High Wycombe.

Patients could book appointments by telephone, online, through a mobile app and in person by visiting the practice. Staff were trained and supported by documented processes and protocols to book appointments with members of the practice clinical team or signpost patients to other appropriate services. Appointments were available at both the main practice and the branch practice with a variety of health care professionals including GPs, nurses and a Physician’s Associate. The practice had increased the opening hours of the branch practice to support the rapid increase in patients registered at the practice. This was an increase of 20 additional hours. Data showed the practice population of ‘working age people’ was significantly higher than the national average. As a result, the practice provided daily ‘pre-office/commuter’ appointments between 7am and 8am. The practice had access to a variety of data and performance dashboards. They continually reviewed data and ran reports to enable them to monitor staff resources and patient flow. The practice used a SMS text service to remind patients of the date and location of their appointment, to reduce the number of patients who did not attend. In December 2022, the practice launched an unique and innovative pilot programme in association with a local Cancer Alliance, known as the ‘Rapid Access, Assessment and Referral Programme’. They continued this programme aimed to address the perception of delays within primary care and access to a GP referral for suspected cancer. The programme included a daily provision for up to 6 patient presentations with suspected cancer diagnosis. All patients were triaged by GP and seen either on the same day, or on the next day by the clinical team. All staff involved in this programme were proud of their achievements and how they optimised the cancer diagnosis pathway.

The practice's most recent results in the 2023 national GP patient survey specifically the indicators relating to access were positive. All 4 access indicator scores were comparable to local and national averages. For example, 49% of respondents responded positively to the overall experience of making an appointment. This was comparable to the local average of 47% and the national average of 54%. In the last 12 months, the Care Quality Commission have received 3 items of feedback with 2 of the 3 items being positive, including reference to high satisfaction regarding access. Where practice provided GP services to a local residential care home they praised the practice, the designated GP, the access, the continuity of care and the twice weekly ward rounds. The practice encouraged and monitored patient feedback that was collected via the NHS Friends and Family Test. This is a national feedback tool used within NHS services and asks if people would recommend the service. In December 2023, January 2024 and February 2024, 98% of respondents said they would recommend (extremely likely or likely) the practice to friends or family. Patient feedback was shared and celebrated on the practice website. We saw 7 different items of feedback which had been recorded in January and February 2024. The feedback was positive and included positive references to access and same day GP access appointments.

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.