Crawcrook 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.

At our last assessment, we rated this key question as requires improvement. At this assessment, the rating has changed to 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.

The service 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.

Staff and leaders had an understanding of the local population and complied with Accessible Information Standard. They had arrangements in place to identify people’s communication needs and preferences and offered interpretation services for those patients whose first language was not English.

Staff were able to refer patients to social prescribers to support their wellbeing and social issues. For example, staff took opportunities to identify carers by coding them on the practice’s clinical system to ensure they were appropriately signposted to link workers within the PCN. They then added carers to a list to receive future relevant communication. The provider had 1,451 recorded carers as patients at the last assessment and had continued to actively identify further carers. The total at the time of this assessment had increased to 2,358 which is in excess of 10% of the patient population.

Feedback from staff was consistent, they said they worked well together as a team to provide good care for patients.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

We saw the practice worked in partnership with other services to meet the needs of its patient population. There were established mechanisms for engaging with community healthcare providers.

We sought feedback from the care homes which the practice was aligned to support. They told us that access to the practice was straightforward and the practice responded well to their requests for home visits. A dedicated GP attended on a weekly basis, together with a Community Nurse to continue to strengthen joint working. Clinical staff spent time with patients and built trusting relationships, which helped enhance the quality of care delivered.

There was a process for identifying people with extra healthcare and communication needs. Alerts were added to their clinical records. For example, if patients were house bound or had a visual impairment, so that staff were immediately aware of how to assist them.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff communicated with patients in a way that helped them to understand their care, treatment and condition, and any advice given. They also supported patients and their carers in accessing further information, as well as community and advocacy services when needed. The practice website included a dedicated section with information specifically for carers. In addition, systems were in place to ensure access to translation services, supporting effective communication with individuals whose first language was not English.

Information provided by the service met the Accessible Information Standard.

The service 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 were managed in line with the practice’s policy. The practice had a positive approach to receiving feedback and complaints. From the records reviewed, we saw that responses were handled appropriately, transparently, and in a non-defensive manner.

Staff engagement with learning from complaints had improved, with most staff we spoke with or surveyed able to describe changes implemented as a result of patient feedback. For example, an increase in complaints relating to patient correspondence being scanned into the wrong records was identified. In response, leaders consulted with staff to understand the root cause. As a result, a process change was introduced whereby staff responsible for scanning documents were not assigned additional duties at the same time, reducing the risk of error.

The service also produced an Annual Patient Complaints Report, which clearly identified themes, trends, learning points, and actions. This report was shared with staff to support continuous improvement and promote learning across the practice.

Staff demonstrated an understanding of their Duty of Candour and the importance of being open, honest, and transparent when things go wrong.

Results from the National GP Patient Survey (January to March 2025) showed the practice performed slightly below the national average, with 81% of respondents stating that during their last appointment, the healthcare professional was very good or fairly good at listening to them, (the national average was 87%).

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

People could access the service to suit their needs for example online, in person and by telephone. To further support equitable access, leaders offered earlier appointment times from 7.30am for nurse and healthcare assistant appointments on some days. Later appointments, up to 7.30pm, were available on Thursdays with 2 Advanced Nurse Practitioners to accommodate patients with different schedules.

In response to feedback from the National GP Patient Survey and the local community, the provider had recognised areas for improvement and implemented changes to enhance access to the service. For example, the Care Navigation tool—introduced at the previous assessment and used by call handlers—was now fully embedded. This enabled staff to guide patients more effectively to the most appropriate healthcare professional and appointment for their needs

The provider implemented a range of changes to the existing telephone system and staff management processes to reduce patient call waiting times. As they introduced these changes, the practice actively gathered patient feedback and analysed performance data to evaluate their impact and identify areas for further improvement.

For example, they introduced a call-back system, and calls were allocated on a practice-specific basis. This approach enabled staff to build stronger relationships with patients and work more effectively within smaller, consistent teams. Leaders reported that, following these changes, average call waiting times had reduced by half, from 12 minutes to approximately 6 minutes.

Leaders told us their own survey found 53% of patients now reported they found it easy to access the practice by phone. This was a significant increase on 24% for the practice in the previous year’s National GP Patient Survey and equal to the national average at that time. We also noted that further actions to improve access were in progress, including the installation of a new telephone system.

Leaders also considered staff feedback regarding demand for certain appointments at specific times and adjusted appointment rotas accordingly to better meet patient needs.

The premises were wheelchair accessible, and all patients were seen on the ground floor. The practices had hearing loops in place.

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 from people using the service, both directly to the provider and to CQC, was mixed; however, overall, it indicated an improving trend. Results from the National GP Patient Survey (January to March 2025) showed that 64% of patients reported a positive experience when contacting the practice. This represented an improvement, although it remained below the national average of 70%. Leaders told us they regularly reviewed access and appointment data and had further actions planned to sustain and build on this improving trend.

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 to care and made adjustments to support equity in people’s experience and outcomes.

The provider had arrangements in place to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers. Systems were also in place to assist in identifying patients who may need extra support. This included alerts on patients records to show what support they needed with communication such as interpreters.

There were 138 patients registered with the practice with a learning disability. Of those registered, 114 had received annual reviews and 24 patients (or 17%) had not. Of these, 7 had failed to attend appointments booked and 3 were on the list in error. Over the past 3 years, designated administrators had been responsible for coordinating appointments with patients or their carers. This approach had led to improved outcomes, as staff had developed a better understanding of individual needs and the reasonable adjustments required to support and encourage attendance.

Information was available on the practice website on how to access an appointment online and by the telephone or in person when the practice was open, and how to access urgent care when the practice was closed.

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.

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.

The practice engaged in regular, well attended multi-disciplinary team meetings to assess and support patients in reaching decisions about their end-of-life care. This identified that patients’ views had been sought and respected.