Alston Medical Practice

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. At our last assessment, we rated this key question as Outstanding. At this assessment, the rating has stayed the same

This service scored 90 (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 was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. The practice demonstrated that they were continually striving to improve services for patients. Leadership within the practice demonstrated a knowledge of the local population, they were aware that due to how rural the practice was, the patient population were at higher risk of isolation and loneliness.

The practice was seen as a central hub for the local community; using additional space in the adjoining community hospital (no longer used clinically) to set up a social day unit for those experiencing isolation or loneliness. The unit, which is run solely by the practice with the support of volunteers from the patient population, opened in October 2022. Having initially opened for 1 session it now runs 3 sessions a week. The group grew from 8 attendees to 24 regular attendees within the first year. With the increase in popularity, specific groups have grown, with a men’s group, women’s group, bereavement group and mothers'/baby group. We reviewed evidence which demonstrated positive outcomes for mothers, who prior to this group would have had to travel long distances to seek breast feeding support.

In addition to the social aspect of the hub; there was a proactive ‘clinical and social risk-identification’ aspect to it. Leaders told us they wanted to provide a ‘holistic, responsive service’. Feedback from attendees noted that ‘it kept them going’ and that it was ‘their lifeline’. We also reviewed evidence which highlighted the importance of the bereavement group in supporting family members in times of grief. Two of the volunteers at unit had joined after visiting following a bereavement.

The practice had also been able to use this additional space to effectively administer covid-19 vaccinations during the pandemic and continued to offer vaccination clinics during the winter period. The extra rooms also enabled the practice to offer private rooms if needed for autistic people or those with mental health needs, more appointments and could offer care which patients previously would have needed to attend secondary care to obtain. For example, physiotherapy.

The practice was a strong advocate for people’s human rights to dignity and respect; there was a zero-tolerance policy to any form of bullying to staff and patients, and we heard of examples where it had been implemented by leaders. Staff knew leaders would advocate strongly for them in these circumstances. Difficult conversations would be had with patients and appropriate outcomes reached.

Arrangements were in place to promote patients’ privacy. National GP Patient Survey data reflected people felt listened to (93% positive response compared to 87% nationally) and were treated with kindness (93% positive response compared to 86% nationally). During the assessment we received 80 positive feedback cases from patients that reflected the responses in the National GP Patient Survey; they highlighted the practices professionalism, kindness of staff, caring and team ethos and being a valued part of the community. Example of feedback we saw included; 'they are always helpful...', 'friendly and polite [staff]', and '...doctor was attentive and listened well.'

There was a process to ensure young adults had control over their own privacy and the amount of parental involvement in managing their care and support. Staff sought to ensure even in the most delicate of circumstances they would be able to receive appropriate medical care, increasing patient satisfaction and confidence.

The service treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The service took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The practice provide support to vulnerable patient groups, such as veterans. Staff were able to show us how they worked with external agencies and the practice was proudly a Safe surgery, offering services to people in the community even if they didn’t have all the standard documentation for identification. This meant people’s nationality or immigration status did not affect their right to register with the practice. Leaders told us this was done to ensure inclusivity for the local population; ‘everyone in the community deserves quality healthcare’, regardless of whether they had identification or proof of address. This was in line with the practice’s homeless persons policy.

Patients’ personal, cultural, social, religious and equality characteristics needs were understood and met. Patient communication needs were met to enable them to be fully involved in their care. For example, staff had set up a bespoke clinic for patients who lived in local sheltered accommodation so that they could come together with their carer, to help them feel suitably supported and calm. This was done on a yearly basis and the practice received positive feedback on this being set up.

Leaders continuously reviewed feedback and amended care where needed, for example introducing extended access appointment slots for patients who worked during the practice’s standard opening times.

The practice ran an extended clinic for learning disability patients to complete annual health checks; this was run for a small group of patients; with patients knowing what to expect and targeted outcomes in a relaxed atmosphere. Patients had a full health check and any necessary vaccinations from a consistent staff member therefore ensuring continuity of care and better patient interaction. Of the patients eligible, 92% have had this health check undertaken in the last year.

The practice also ran, alongside the social day unit, a parent and child group. Parents, carers and grandparents could meet in a social setting with their young ones, and support could be offered both formally and informally from each other or from the practices’ health and wellbeing co-ordinator. They also ran a baby massage session to support bonding and infant wellbeing. The group currently runs 3 days a week and since it began 53 parents and children and 65 adults in total had been supported. This is another example of the practice actively addressing the potential for social isolation and housebound people due to the small, isolated population. For housebound people the social day unit has transport that can bring those people for activities.

Feedback received about the parent and child group stated; “this is a great group to meet new people…watched our kids grow and have so much fun…they have plenty of things for the children to do….We all sharestory'sand help each other with our own experiences with food, sleep and other things that we might struggle with that our children struggle with and it's lovely that we all help each other."

The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Staff helped patients and their carers to access advocacy and community-based services.

The ‘social day unit’ run by the practice offered a range of activities for those who attended; everything from chair yoga and fit4all to crafts and games. These activities were run by trained volunteers. Lunch was provided, organised by practice staff. On the day of our assessment, we saw that it was woman’s day at the unit and a range of activities were planned with a special lunch prepared to be served in the boardroom. Staff and attendees, we spoke with highlighted how much they enjoyed and appreciated the unit being run.

The practice co-ordinated weekly Integrated Community Ageing Team (ICAT) home visits. This demonstrated proactive care planning and supported keeping patients independent and giving them a choice in their care beyond standard GP appointments. Discussions were held during these visits (alongside blood tests, checks and other holistic assessments) with patients and their families regarding plans, next of kin (NOK) contact details, DNACPR and preferred place of care. Frailty assessments, ICAT visits and GP reviews resulted in 90 patients holding an active care plan. Searches on records were run monthly by the practice to ensure everything was up to date. All plans were reviewed at least annually.

The service was exceptional in how they listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. For example, setting up a bespoke clinic for patients with long term health conditions, who would come into the practice later in the day with their carers. This helped to reduce any undue stress or anxiety.

The practice was adept at emphasising to patients the benefits of undertaking NHS health checks – through social media and posters on display throughout the practice. As a result, 82 NHS health checks had been completed in the last year (41 male, 41 female), with outcomes including 17 patients with raised cholesterol (5 started on statins, all given lifestyle advice, annual review booked), 1 new pre-diabetic identified, 2 new Type 2 diabetics identified (now on annual follow-ups), 5 patients with raised blood pressure (1 new hypertension diagnosis).

Staff went to great lengths to make sure that people’s needs, views, wishes and comfort were their utmost priority. Leaders at the practice actively looked to recruit PPG members, constantly seeking patient feedback. The practice had good evidence of acting from patient feedback via the Friends and Family test – accessible online or via written feedback. We saw in the month of March 2026 52 separate feedback statements from patients and their families. An example of where feedback had led to changes included the request for readily available water in the waiting room for patients.

There was a system for appointment triage that ensured people with immediate needs had access to services. Staff we spoke with knew the process for referral to emergency support, including mental health crisis teams. We reviewed quarterly appointment figures and the clinical staff rota which showed planning by leaders saw a 20% ‘cushion’ of available appointments with clinicians, giving greater flexibly and quality of care to patients. Practice leaders were proactive at reviewing appointment availability against patient requests.

The practice policy was 15-minute appointments as standard. Staff were all trained in signs of sepsis. Staff knew where to access emergency equipment.

Many practice patients lived in isolated rural areas, with little access to either public transport or their own means to access the practice. Staff and leaders had systems in place to ensure that despite this, patients immediate needs were responded to.

We were told of several examples where staff went out of their way to support patients, including visiting on their way to and from work, which meant people did not have to attempt to travel to the practice.

The practice prided itself on responding to patients need wherever they were located. Posters in the practice exemplified this further – giving patients real options if they found engaging with clinicians uncomfortable. For example, use of notes instead of talking, quieter waiting rooms, clear expected wait times. Leaders emphasised to us they wanted to make patients feel comfortable as much as possible.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Staff told us they were valued by leaders. Leaders had taken steps to recognise and meet the wellbeing needs of staff, which included the necessary resources and facilities for safe working. Leaders showed faith in their staff and actively encouraged annual leave requests to be a group decision, using a yearly calendar in a communal area for leave and cover arrangements. Staff reported being supported if they were struggling at work.