Hendford Lodge 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 quality statements in the responsive key question.

At our last assessment, we rated this key question as requires improvement. At this assessment, the rating has changed to good. The service met people’s needs, and staff treated people equally and without discrimination.

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.

The service made sure people were at the centre of their care and treatment choices and they decided in partnership, how to respond to any relevant changes in people’s needs.

Our review of clinical records showed people were supported to understand their condition and were involved in planning for their care needs. They were also involved in decisions about their care.

Staff treated people as individuals and with respect. Staff got to know people during regular appointments and offered care and treatment with a person-centred approach. They also provided longer appointments for people with a learning disability or who had additional needs.

The service recognised the diverse needs of people registered with the practice.

The reception staff had an awareness of people who required additional assistance or who needed longer appointments to be made.Staff had allocated roles based on their specialised interests, experience, and training. This promoted coordinated care and continuity in areas like diabetes, asthma and COPD (a long-term lung condition) clinics. The service considered the importance of flexibility when delivering care and treatment.For example, the practice increased urgent appointments during the winter months, when demand for acute care was higher. As a quality improvement project, the practice set up an acute respiratory hub, in collaboration with the local Integrated Care Board, which served as a centralised clinic to manage patients with acute lung conditions to relieve pressure on general practices in the area and local hospitals. The practice worked collaboratively with the PCN to provide training for care home staff on inhaler techniques (the proper way to use a handheld device to breathe medicine into the lungs).

The practice provided information that was tailored to individual needs. Staff highlighted on the patients’ electronic record if they had any communication or accessibility needs.

Interpretation services were available for people who did not speak English as their first language. Patient information could be provided in different languages upon request. The practice worked closely with the PPG to review the language used in general communication with patients to improve accessibility. The practice incorporated a digital accessibility tool in their website to enhance accessibility and improve people’s experience. The practice had a designated phone line which operated daily for 2 hours to answer referral or private fee queries.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

Details on how to give feedback or complain were clearly displayed within the practice and on their website.People could raise concerns by speaking to the practice, in writing or by email. People who raised concerns were listened to and a response was provided. The practice actively engaged with PPG which reflected people’s views. There were regular bi-monthly PPG meetings to discuss evolving issues about the practice. The practice also communicated frequently with the PPG through other channels, such as by email and phone.

The practice had a policy and procedure to support and guide staff when dealing with complaints. There was a system to record and investigate complaints. When things went wrong, staff apologised and gave people support. There was evidence that complaints were used to drive continuous improvement. The practice held regular meetings to review complaints and share the lessons learned and actions taken with staff.

The service made sure that people could access the care, support and treatment they needed when they needed it.

People could access appointments online, over the phone and in person. However, some people told us they found contacting the practice difficult. The national GP Patient Survey (GPPS) (survey period: 01/01/2024 to 31/03/2024) identified phone contact as particularly challenging, with 18.1% of respondents saying it was easy to contact the practice by phone compared with a national average of 49.7%. The percentage of respondents to the GPPS who responded positively to the overall experience of contacting the practice was 49.2%, which was below the national average of 67.3%.

The practice was aware of patient feedback regarding access and had reviewed its systems and processes. The practice now adopted a ‘total triage’ approach, where patient information was initially triaged by a duty doctor. Based on clinical needs, patients were either offered an on-the-day or routine appointment or directed to the appropriate services. To improve phone access, the practice implemented a cloud-based phone system in April 2024. This increased call capacity and enabled the practice to monitor call data which was used to mobilise staff to answer calls at peak times. Patients welcomed the call-back option which markedly reduced the phone queue time. The practice published a newsletter to patients outlining the different types of appointment booking channels for urgent and routine care and highlighted peak times to avoid long wait times. Patients were encouraged to use the online eConsult system for routine issues to help keep phone lines open for those who needed them. The practice regularly reviewed the balance between routine and acute care appointments to meet people’s needs. The practice had recruited more GPs to increase GP capacity. Direct feedback from patients and comments from the PPG representative indicated that access to services had improved in recent months.

People’s feedback was positive regarding the quality of care. Staff treated patients equally and without discrimination.

All staff had completed training in equality and diversity and the practice had a policy in place. Staff told us they understood the local patient population and the difficulties they may encounter. For example, the practice provided leg ulcer clinic for people across south Somerset but many patients with leg ulcers could not travel far from home for appointments. The practice adjusted the clinic locations across south Somerset based on their patient list to provide services closer to their home. Another example involved a patient with a learning disability who refused to have blood drawn during their annual review at the clinic. To accommodate the patient, the practice arranged a home visit for blood taking which was successful.

The provider prioritised and allocated resources and opportunities as needed to tackle inequalities. Interpretation services were available for people who did not speak English as their first language. The practice had a carers champion and patients who were carers were listed on a carer register to receive additional support. The practice was flexible in its approach to supporting patients. For example, home visits could be arranged if required. The practice could offer appointments for routine issues at extended hours on some evenings on weekdays and some Saturdays depending on people’s needs.

Leaders proactively sought ways to address any barriers to improving people’s experience. The practice was an accredited veteran friendly practice. People who were a veteran (people who has served for at least one day in the British Armed Forces) were coded in their medical records for easy identification. The practice supported their physical and mental health and they could be referred to dedicated specialist healthcare services when required. To empower people with digital access to their health records, the practice invited patients in and guided them on how to use the NHS app.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff attended multi-disciplinary meetings to discuss patients receiving end-of-life or complex care. Clinical records were updated to reflect any actions or changes made to their care plans. Our review of clinical records showed people were supported to consider their wishes for their end-of-life care. Care plans documented a do not attempt cardiopulmonary resuscitation (DNACPR) decision when it had been made. Families and/or carers had been involved in these decisions when the person lacked the capacity to make them independently. This information was shared with other services, such as the out-of-hours services, when necessary.