The Simpson 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.

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

This service scored 96 (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 patients 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.

Regular multi-disciplinary meetings were held with relevant professionals and services to discuss and plan person centred care and treatment so that people’s needs could be met holistically.

Feedback from patients who responded directly to CQC said they were well supported to understand their condition and felt involved in decisions about their care and treatment and in planning for their future needs.

The practice had a clear 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 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 a growing 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.

We also saw the practice had tailored its services to meet the diverse needs of its community, for example, the formation of an outreach service for the local Gypsy, Roma, Traveller community. The aim of this service was to increase levels of engagement with preventative care and long-term condition management. Nurses told us this was also a good opportunity to increase immunisation rates for both adults and children.

Throughout the inspection, we saw other examples of established mechanisms for engaging with a range of community healthcare providers.

The long-standing clinical staff team provided continuity and stability with minimal requirements for locum staff. However, when locum staff had been used, the provider used a pool of consistent staff. We observed the appointment system and saw how staff encouraged continuity of care by enabling people to request and see the same healthcare professional. Staff had forged excellent working relationships with many multi-disciplinary professionals to meet the needs of patients and all staff we spoke with were familiar with the patients who attended the practice. 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 3 care homes who accessed GP services from the practice was positive. The practice provided weekly visits to the homes enabling continuity of care and easy access to care and treatment for the people living in the care home. Care home staff told us they felt supported and able to discuss any concerns with the visiting teams.

The practice supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. This information was easy for patients to find, this included a clear, accessible practice website and the use of QR codes across the practice to provide information.

Staff and patients highlighted the benefit of the recently introduced QR codes as this enabled information to be current and reduced the amount of paper leaflets as the practice aimed to reduce their use of paper.

Information to promote the take up of screening and immunisation programmes was available in a range of formats and languages. The practice had access to interpreter services, including British Sign Language. Information provided by the practice met the Accessible Information Standard and staff told us how they encouraged patients and their carers to inform staff of their communication needs.

The practice had started running group consultations for groups like carers and those living with chronic pain. Clinicians explained these sessions enabled people with the same conditions to share personal experiences, helping them feel less alone.

Staff excelled in involving patients who have a disability, impairment or sensory loss to receive information that they can easily read or understand to get the right support and communicate effectively. For example, staff explained how they identified and recorded patients' information and communication needs. Steps were then taken to ensure patients received information in an accessible format and had the communication support they required. Feedback from people who responded to the national GP Patient Survey showed that 92% knew what the next step would be after contacting their GP practice. This was higher when compared to the local (84%) and national results (83%).

Patient feedback we received highlighted examples of practice staff providing information in a range of formats, for example, several patients highlighted they had received drawings and diagrams alongside exercise plans to improve their ongoing joint concerns.

The practice made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They 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. This included new telephony functions to reduce long waits at peak times, additional staff to improve response times and a restructured website.

In the national GP patient survey, 94% of patients who responded 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%). This was a 6% increase on the results for 2024.

100% of patients who responded 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%).This was a 2% increase on the results for 2024.

Feedback from the linked care homes and the patient participation group highlighted how involved they felt in terms of the practice and leaders within the practice actively listening and responding with inclusive involvement. Throughout the inspection, the practice told us patients were central to every decision and how important listening and involving people was and would continue to be with further changes in the local health economy with the introduction of integrated neighbourhood teams.

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

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

74% of patients who responded 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%). This was also a 1% increase on the results for 2024.

84% of patients who responded 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%).

The practice advised the triage and appointment system was under consistent review to ensure patients continued to access services and appointments in a way and at a time that suits them. Live dashboards and performance metrics were used which provided real time data to enable the practice to respond to patient activity, seasonality, capacity and ‘access versus demand’. The reception team advised the new triage and appointment system allowed patients to see the right person at the right time.

We reviewed data which highlighted the practices appointment system had a positive impact on avoided non-elective (NEL) hospital activity. Specifically, the practice rate for non-elective hospital activity was 51% which was lower than the Buckinghamshire average (94%) and the wider ICB average (78%).

We also saw Accident Emergency and Emergency Admission attendance rate was lower when compared to local averages. Specifically, the practice rate (per 1000 population) was 288 which was lower than the Buckinghamshire average (372) and the wider ICB average (302).

Further data showed that 73% of GP appointments at the practice were face to face. This was higher when compared to Buckinghamshire average (59%) and the wider ICB average (61%).

The practice team were proud of the high levels of patient feedback; the overall results and improvements made in how patients accessed services. The team told is they were eager to make further improvements and to share ideas across the local health system.

Both sites were purpose built and fully accessible for people with limited mobility. Both locations had lifts, and their waiting areas, consulting rooms, and treatment rooms were large enough to easily accommodate patients using wheelchairs or prams.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Feedback provided by people using the service, in response to the national GP patient survey and to both the provider as well as to CQC, was positive. For example, in the national GP patient survey:

67%of patients who responded usually get 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%).

88% of patients who responded 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%). This was also an 11% increase on the results for 2024.

Leaders proactively sought ways to address any barriers to improving people’s experience and worked with local organisations, to address any local health inequalities. This included regular work with local charities and local health experts as part of the health education events and early engagement with the local Gypsy, Roma, Traveller community.

The practice understood the local population profile and demographics by analysing equality data to identify and reduce inequalities in people’s experiences and outcomes. As a result, the practice was conscious there might be a cohort of patients who faced digital exclusion in using the practice website and a variety of mobile health applications on smart phones and other devices. In response, the practice arranged a digital workshop event for patients and their families. Patient feedback regarding this event was positive, comments included the event helped set up the NHS mobile app and highlighted a recent digital health scam.

Patients and where appropriate, their families and carers, 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.

Feedback we received highlighted end of life care was delivered in a compassionate and coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

Staff told us that where families experienced bereavement, their usual GP contacted them. This was either followed by a patient 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.

Similar to health promotion events, the practice had arranged an education event to support conversations about death and end of life care. The practice was aware the subject can be an uncomfortable conversation but used the national ‘Dying Matters’ campaign to support the session to encourage people to talk about death, dying and end of life care. The event and promotion of the campaign also recognised the vulnerability of equality groups including LGBT+ communities, black and ethnic minorities, and the Gypsy and Traveller population.

Staff told us there were compassionate and meaningful support and well-being arrangements in place when staff had been impacted by the death of patient they had cared for.