Millbarn 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 looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination.

Millbarn Medical Centre is located in a modern purpose-built premises. Patients reported the practice was responsive and accessing services was easy, quick and effective. Patient feedback was positive and highlighted the practice provided accessible person-centred care and staff listened and responded to their feedback. Results from the National GP Patient Survey highlighted:

• 80% of respondents found it easy to get through to the GP practice by phone (national average 53%).
• 66%of respondents usually got to see or speak to their preferred healthcare professional when they would like to (national average 40%).
• 92% of respondents knew what the next step would be after contacting their GP practice (national average 83%).
• 92% of respondents felt they waited about the right amount of time for their last general practice appointment (national average 67%).

Evidence collected during the inspection indicated patients received fair and equal care and treatment.

The practice worked in partnership with other services to meet the needs of its patient population. For example, Millbarn Medical Centre also provided the Buckinghamshire wide non-urgent community Ear, Nose and Throat (ENT) service from the practice.

This is the first inspection for this practice since its registration with CQC. This key question has been rated as OUTSTANDING.

This service scored 93 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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

Care plans reflected physical, mental, emotional, and social needs of patients including those related to protected characteristics under the Equality Act. Our review of clinical records showed patients were supported to understand their condition and were involved in planning for their care needs. They were also involved in decisions about their care.

Accessible standards (providing diversity of communication and access to meet various needs) and barriers to care were considered for people, with a range of personalised alerts added to medical records so that staff were aware the person had additional needs.

Leaders and staff, we spoke with, felt people were directed to the right clinician the first time, which enabled them to provide effective person-centred care. For example, referring people to the pharmacy for minor illnesses and to the social prescriber where the patient did not have a health care need.

The practice had identified those who were at risk of experiencing barriers to health care or having poor health outcomes and developed initiatives to support equity in access. For example, patient segmentation, people with learning disabilities, digital isolation, patients with caring responsibilities and Armed Forces Veterans support initiatives. Staff told us, the aim of these work streams was to ensure patients were at the centre of their care and treatment choices with a collaborative partnership between the patient and the practice. This partnership working to provide patient centre care was reflected in the feedback we reviewed as part of this inspection.

The practice had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The practice had tailored its services to meet the diverse needs of its community and worked proactively in partnership with other services to meet the needs of its patient population. For example, work with the local primary care network (PCN) and Integrated Neighbourhood Team (INT) in the creation of a multidisciplinary frailty service for an increasing moderately frail population. The aim of this service was to try and improve the provision of care and support to people before they reach crisis point and needing reactive emergency care.

Our review of the clinical system demonstrated that referrals to other services were made promptly, and information shared by other services was managed effectively and timely to support good outcomes for people.

Feedback from the local care home supported by the practice was positive. The practice provided weekly visits to the homes enabling continuity of care and ease of access for the people living in the care home. Care home feedback highlighted that long-standing staff visiting teams gave continuity which helped the care home staff and resulted in an exceptional understanding of the health and individual needs of the care home residents.

Throughout the inspection, staff we spoke to highlighted the importance of building relationships with patients and care continuity, this was reflected in patient feedback regarding continuity of care, for example, the National GP patient survey highlighted:

• 66% of respondents usually got to see or speak to their preferred healthcare professional when they would like to. This was significantly higher when compared to the local average (46%) and national average (40%).

We saw the practice worked in partnership with other services to meet the needs of its patient population and the wider community. For example, in addition to the standard General Medical Services (GMS) contract, Millbarn Medical Centre also provided the Buckinghamshire wide non-urgent community Ear, Nose and Throat (ENT) service from the practice. Approximately 4,000 patients from GP practices in Buckinghamshire accessed this service each year for a range of conditions including vertigo (sensations of spinning or dizziness), otitis externa (ear infections) epistaxis (nosebleeds), hearing concerns or tinnitus (perception of sound such as buzzing). This service was run by 2 GP partners and a salaried GP who had additional specialised ENT training. Additional practice staff supported the audio, administration and reception duties for this service. The practice shared data which demonstrated the positive impact the community ENT service had, including a significantly shorter waiting time (average of 8 weeks as opposed the national average of 18 weeks) with less than 5% of cases referred on to secondary care.

Patient feedback regarding the ENT service was very positive, we reviewed the most recent responses collected and verified between October 2025 and December 2025 (207 responses). Using the combined responses for this period, 205 responses (99%) rated the ENT service ran by the practice as either ‘Good’ or ‘Very Good’.

The practice was exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The practice provided patients with information in a variety of methods and throughout the building health related information was displayed in a range of formats.

Staff could access interpreter services, including British Sign Language to support patients and provide accurate information when needed. Information provided by the practice met the Accessible Information Standard. Patients were informed as to how to access their care records and who had access to their information via third proxy access.

Feedback from people who responded to the National GP patient survey regarding the provision of information was positive, for example:

• 98% of respondents said they had all the information they needed about them at their last appointment. This was higher when compared to the local (93%) and national average (92%).
• 92% of respondents knew what the next step would be after contacting their GP practice. This was higher when compared to the local average (84%) and national average (83%).
• 100% of respondents knew what the next step would be within 2 days of contacting their GP practice. This was higher when compared to the local average (94%) and national average (93%).

The practice and the patient participation group (PPG) worked in collaboration to provide accessible, accurate and up to date information to patients. For example, in readiness for the October 2025 national changes on how patients access on line primary care, the practice and PPG had worked together to produce an accessible and easy to read guide for patients to navigate the changes. The guide included various elements about what the changes actually meant for patients with top tips to ensure access was optimised. Patient feedback highlighted the guide was a success.

The practice was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. They always involved people in decisions about their care and told them what had changed as a result.

We saw complaints whilst infrequent, were managed in line with the practice’s policy. Learning from complaints, compliments and other feedback was evident and staff were able to identify changes made as a result of patient feedback.

Feedback from people who responded to the National GP Patient Survey regarding how practice staff listened and involved patient voice and feedback was positive, for example:

• 91% of respondents felt that during their last appointment, the healthcare professional was very good or fairly good at listening to them. This was higher when compared to the local average (88%) and the national average (87%).
• 99% of respondents indicated that during their last appointment they were involved as much as they wanted to be in decisions about their care and treatment. This was higher when compared to both the local average (92%) and national average (91%).

We noted ‘Give feedback on care’ submissions received by CQC and ‘Friends and Family’ data demonstrated positive responses from patients about feeling involved in decisions about their care and treatment. Comments referenced how good practice staff were at listening.

Feedback from the linked care home and the PPG highlighted how involved they felt in terms of the practice and leaders, who actively listened and responded to them.

Further feedback from the PPG regarding involvement was highly positive, they described the relationship as a ‘business like collaboration but patient focused’. Independently, members from the group and the practice both highlighted current challenges they faced and how they had tried to encourage marginalised groups to join the group to encourage a wider range of views and to inform practice development.

The practice website included a section known as ‘Have your say’. This was a designated section of the website which enabled patients and their families to be involved and share feedback, ideas and opinions. There were 6 separate topics of feedback (compliments and suggestions, complaints, NHS Friends and Family Test, information about the patient participation group, the patient survey and patient opinion). We saw all 6 topics were regularly reviewed to provide oversight of patient feedback.

The practice was exceptional at ensuring people could access the care, support and treatment they needed when they needed it.

We looked at the practice’s appointment system and could see that patients were able to book appointments that suited their individual needs. This included face to face, telephone and online appointments. During the visit we saw that there were still appointments with a variety of clinicians available on the day and in the forthcoming days. We also observed inbound calls were managed quickly with minimal wait or delay.

Leaders and reception staff told us the introduction and continued refinement of online access had significantly reduced call volumes. Reception staff told us about the positive impact this had made and allowed them to spend more time with patients, addressing their queries, and where required, signposting to further avenues of support.

The practice had reviewed the online form patients completed to access services. Each form completed through this system was reviewed by a duty doctor who triaged the priority of their form and either telephoned the patient, responded to queries or requested reception staff liaised with the person to book an appointment. An audit of the appointment and triage system identified 96% of appointments were clinically appropriate in the most recent results, this was significantly higher than local and National averages.

Leaders within the practice were proud and confident of the systems within the practice and emphasised patients could access care, treatment and support when they needed to and in a way that works for them, the patient as opposed to the practice. This aligned to the main ambition of the triage system within the practice: Right appointment, Right clinician at the first time.

Staff were able to signpost patients to the most appropriate pathways when required. This included the pharmacy first scheme, social prescribers and health and wellbeing coaches. Whilst infrequent, patients were also signposted to the local urgent care centres if this was clinically appropriate

Throughout the inspection, all patient feedback (verbal and written) complimented the appointment system, advising of very good telephone access and appointment system.

Staff feedback, specifically reception staff also spoke positively of the level of access provided and how the practice’s use of systems and technology enabled better access. Representatives from the PPG we spoke with during the inspection spoke clearly and confidently about their role in ensuring the practice reviewed and managed access ensuring patient needs remained central to systems and process.

In the National GP Patient Survey, patients’ responses to the survey questions about how they were accessed services was significantly higher when compared to local and national averages. For example:

• 80% of respondents found it easy to get through to the practice by phone. This was significantly higher when compared to both the local average (54%) and national average (53%).

• 75% of respondents found it easy to contact the practice using the practice website. This was significantly higher when compared to both the local average (51%) and national average (51%).

• 89% of respondents described their experience of contacting their GP practice as good. This was significantly higher when compared to both the local average (70%) and the national average (70%).

• 92% of respondents felt they waited about the right amount of time for their last general practice appointment. This was significantly higher when compared to the local average (67%) and national average (67%).

The practice presented a variety of data which demonstrated how effective their access, triage and appointment systems were which resulted in low usage of additional services within the health system. Over the last 9 months the number of Millbarn Medical Centre patients accessing urgent treatment at other services such as the local urgent treatment centres was lower than the local average for the Integrated Care Board (ICB) and Primary Care Network (PCN) averages. For example, in October 2025 the total percentage of patients attending alternative urgent care was 1.2% compared to the PCN average of 1.7%, in November 2025 it was 1.1% compared to the PCN average of 1.7% and in December 2025 it was 1.4% compared to the PCN average of 1.9%.

The practice premises were modern, purpose built and fully accessible for people with limited mobility. There were lifts, and the waiting areas, consulting rooms, and treatment rooms were large enough to easily accommodate patients using wheelchairs or prams.

Staff feedback, specifically reception staff, spoke positively of the level of access provided and how the practice’s use of systems and technology enabled better access. Representatives from the PPG we spoke with during the inspection spoke about their role in ensuring the practice reviewed and managed access ensuring patient needs remained central to systems and processes.

Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

We observed staff treated people equally and without discrimination. 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 towards patients, the local community 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. For example, the practice was also a registered ‘Safe Surgery’ and supported people who were homeless, in temporary accommodation or seeking asylum. A ‘Safe Surgery’ is a GP practice with a declared commitment to addressing the barriers people face in accessing healthcare or support, including refugees.

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. This included actions to tackle digital isolation. For example, signposting patients to the monthly digital café to support patients and their families to navigate the health system when using digital and online platforms.

Staff made positive comments regarding how the new online access system had provided people with equity to access the service. They explained this meant people received appointments according to need rather than in order of request.

Feedback provided by people using the service, regarding outcomes was positive, for example, in the National GP Patient survey:

• 89% of respondents described their overall experience of the practice as good. This was significantly higher when compared to both the local average (76%) and the national average (75%).

Further feedback collected via the NHS Friends and Family Test results was also positive. the combined responses from the last 3 months (553 responses), 525 responses (95%) rated the service received at the practice as either ‘Good’ or ‘Very Good’.

Patients and their families 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.

Our records review showed people were supported to consider their wishes for their end-of-life care, including cardiopulmonary resuscitation. This information was shared with other services when necessary.

Staff told us that where families experienced bereavement, their usual GP contacted them. This often included a consultation at a flexible time and location to meet the family’s needs and by giving them advice on how to find a support service.

The practice made use of the gold standards framework for end of life care and worked with other services when supporting end of life care. It had a palliative care register and had regular internal meetings as well as multidisciplinary meetings to discuss the care and support needs of patients and their families. The practice presented evidence of complimentary feedback from the family of a palliative care patient.