Tollgate 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 a total of six quality statements from this key question. We have combined the scores for these areas with scores based on the rating from the last inspection, which was good. Our rating for this key question remains good.

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.

Results from the latest national GP patient survey showed that 92% of survey respondents felt involved as much as they wanted to be in their care and treatment decisions. The result was higher than the practice’s expected outcome of 90%. The patients we spoke with during the inspection told us they felt involved in their care and treatment and they were pleased with their experience of the practice and one patient had recommended the practice to others.

Leaders told us that patients could request to see their preferred GP. Staff offered patients the option of being seen in extended access clinics outside of regular opening hours, either on an evening or at weekends. The provider demonstrated patient involvement in their care and treatment, for example, in DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) decisions.

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.

The patients we spoke with told us they received information about other services when required.

Staff told us information was available to patients in their reception area and on the practice's website. They would highlight patients' records if they had any communication or accessibility needs, which staff gathered when a patient registered.

The practice was able to organise interpreter services for patients whose first language was not English. Patients could also access information about a variety of services through the practice’s leaflet and website, which were available in easy-to-read formats.

None of the patients we spoke with raised concerns about their ability to provide feedback or complain and all patients understood how to make a formal complaint.

Staff and leaders told us that patients' views were acted on to improve services and culture. Staff described how complaints were discussed in practice meetings, and areas of improvement were identified and shared.

The practice had a complaints policy and process. A member of the leadership team managed complaints, and the evidence we reviewed demonstrated that investigations were thorough and timely. Patients were informed of appropriate actions they could take if they were unsatisfied with the outcome of their complaint.

The practice monitored the GP Patient Survey and NHS Choices reviews. In addition, the practice conducted an enhanced access survey to understand patient appointment preferences.

Patients told us they could access clinical care when desired via different avenues. Results from the latest national GP patient survey showed the practice was in line with other local practices for the percentage of patients who responded positively to the overall experience of making an appointment and were satisfied with the appointment (or appointments) they were offered. The practice’s enhanced access survey showed that most respondents were positive about the practice’s opening hours.

Leaders told us they had listened to patient feedback about access and implemented new systems and ways of working to facilitate improvement. For example, the practice continued to offer extended access appointments at the practice to ensure their patients could be seen at a time that suited them locally.

Results from the National GP Patient Survey showed that the practice was in line with local practices for patients who responded positively to how easy it was to get through to someone at their GP practice on the phone. However, that figure was 30% compared to 50% for local practices in April 2023.

The practice’s appointment system required patients to complete an online request form, which a clinical team member would triage. Patients who could not complete the online form could contact the practice via telephone, and a receptionist would assist them. The reception staff had received care navigation training. Systems were in place to recall and invite patients to attend for childhood immunisations and cervical cancer screening.

The practice's opening times were 7 am to 6.30 pm, Tuesday through Friday. On Monday, it is open between 7 am and 7 pm. The practice advised patients to contact NHS 111 when the practice was closed.

The practice carried out an enhanced patient access survey in collaboration with other local practices within the primary care network (PCN). The practice results showed patients preferred morning appointments, which the practice had provided previously under the extended access programme. The practice negotiated with the PCN and the integrated care board, to continue to provide those hours for their patients.

People told us their overall experience of the practice was good, and they felt the service met the needs of the population. Results from the practices latest GP patient survey showed: The practice was in line with the local and national average for the percentage of people that felt their healthcare professional recognised or understood any mental health needs during their last general practice appointment. The practice was in line with the local and national average for the percentage of people that described their overall experience of the GP practice as good.

Staff told us they respected and appreciated people’s backgrounds and cultural values and received training in equality and diversity. The provider told us that patients requiring an appointment were usually seen within a few days.

Staff used system alerts on the clinical system to identify patients needing reasonable adjustments. Staff demonstrated an awareness of patients at risk of digital exclusion and took steps to support them.

The practice had equipment to support patients with a hearing impairment and information was available in different languages. The service sought the views of people by requesting feedback after patients had attended the practice for an appointment and by reviewing the results of the National GP Patient Survey.

The provider carried out monthly telephone audits which showed a significant drop in missed calls, (which represents patients that have given up on waiting on their call being answered) at the practice between October 2023 and August 2024, from over 2,673 to 678.

The provider invested in a learning disabilities training programme to develop staff members’ understanding of people with learning disabilities to improve their experience within the practice.

Staff told us they regularly attended multidisciplinary team meetings where they discussed patients who received end-of-life care.

Clinicians understood the requirements of legislation and guidance when considering consent and decision making. Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions were made in line with relevant legislation and were appropriate. We examined four detailed and comprehensive DNACPR records completed within the last 12 months. We saw that clinicians discussed the decision with the relevant parties and assessed the patient's mental capacity. An appropriate clinician had signed the decision forms.

The provider was working towards achieving the Gold Award for Green Impact for Health. Building on their Silver Award achievement last year and had introduced several new sustainability initiatives.