The Harefield Practice

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 this service met people’s needs and staff treated patients without discrimination. At this first assessment of the service since its registration with CQC, this key question has been rated as good because the practice demonstrated person-centred care for the patient population and provided information to support people to make an informed decision about their care and treatment.

This service scored 71 (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 with people, how to respond to any relevant changes in people’s needs. Our review of clinical records showed that people were supported to understand their condition and were involved in planning for their care needs. The practice involved people in decisions about their care and delivered care and treatment tailored to the needs of each patient in accordance with the Equality Act.

The practice understood 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 in partnership with other services to meet the needs of its patient population. The shared care agreement reviewed as part of the assessment process was in line with good practice.

The practice supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The practice had access to interpreter services, including British Sign Language. Patients were informed as to how to access their care records.

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. The practice had an active patient participation group (PPG) that was involved in ensuring that the feedback from the PPG was used to improve service delivery. For example, the PPG was involved in getting high back chairs in the patient wating area to support patients with mobility issues. Complaints were managed well with responses to patients sent timely and learning shared with the staff as part of good practice.

The practice ensured that the patient population could access the care, support and treatment they needed. The practice worked and continued to work with the Patient Participation Group (PPG) to improve the patient experience when using the phone to access the practice. The practice introduced a new phone booking system following feedback from the PPG and there was continued work to improve the phone booking system to ensure access for all. The practice informed us that there was rapid access for patients under 1 year of age, under palliative care, and patients living with any mental health disorders or dementia. The practice introduced a sister phone line that was designated for patients living with dementia and their carers including care home patients to quickly reach the practice. Patient judged to not be technologically adept were encouraged to come to the front desk to be supported to access the online systems while vulnerable cohorts were offered home visits. This showed that the practice took decisive steps to improve patient experience following the result of National GP Patient Survey in 2024. The survey result showed the practice (29%) was significantly below the national (50%) and local (58%) averages in how easy it was to get through to the GP practice by phone. Thirty-five percent of the respondents to the National GP Patient Survey found it easy to contact the practice using their website compared to the local (52%) and national (48%) averages. The practice, as confirmed by the PPG chair, said they are working in collaboration with the PPG to improve the patient experience for all. The National GP Patient Survey 2025 result published after the assessment process was completed showed that 46% of the respondents found it easy to contact the GP Practice by phone compared to the national (53%) and local (60%) averages. Fifty-six percent of the respondents to the 2025 National GP Patient Survey found it easy to contact the practice using their website compared to the local (52%) and national (51%) averages. Seventy percent of the respondents of the 2025 survey results had a good experience overall at this practice compared to the local (75%) and national (75%) averages. The results showed improvement in patient experience in some areas.

However, patient feedback collected by the local Healthwatch and passed to CQC showed that more actions were needed to ensure equity in access for the traveller community, expectant mothers and patients under the age of 1. A young mother told CQC of her experience of how her newborn child was not seen timely by the practice and ended up going to the A E where it was discovered that her child had developed sepsis.

We were informed that some of the patient population had difficulty booking hospital transport when attending booked appointments especially in relation to the administrative forms needed to be completed. The practice informed us that online forms were now in use, and patients were assisted to complete necessary documentations when unable to do so and needed requests were sent to the hospital transport teams for approval but not all of them were approved. In some of those instances, the practice supported the patients to attend their appointments.

Feedback received by CQC from patient experience forms showed that the patient population did not understand how the same-day appointments booking worked, increasing the frustration they experienced when booking appointments. However, there were other patients who felt their experience of care could be improved especially when seeing the doctors and being referred to specialist services such as physiotherapy.

The practice was in a two-storey building and all the treatment rooms were located on the ground floor. The practice informed us that there was an ongoing discussion with the Integrated Care Board (ICB) to gain access to the first floor, which was currently not in use, to improve patient access. This would create more appointments slots if approved.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience and outcomes and tailored their care and support and treatment in response to this. For example, consultation times for the elderly patient group of the travelling community was increased from 10 minutes to 15 minutes; the digitally excluded were encouraged to come to the practice to access the online booking system. Feedback received by CQC from people using the service was positive about the practice and its staff. Staff treated people without discrimination. Leaders sought ways to address any barriers to improving people’s experience and worked with local organisations to address any local health inequalities. The practice had processes to ensure people could register to use the services available including people who may experience vulnerable circumstances. Appropriate systems were used to capture and review feedback from people using the service.

People were supported to plan for important life changes so they could have enough time to make informed decisions about their future, including end of their life. The practice ensured personalised care plans for patients who did not have capacity and treated them as individuals while respecting their wishes and preferences.

The practice worked together with the local palliative care team to ensure the patients were well looked after as they approached end of life. The practice also provided support to the bereaved family. Our review of the clinical records showed people were supported in their wishes for end-of-life care, including cardiopulmonary resuscitation. The Do Not Attempt Cardiopulmonary resuscitation (DNACPR) records we checked as part of the assessment process were reviewed and updated according to the Mental Capacity Act 2005. Relevant records were made accessible to palliative care team when needed.