Dalton Surgery

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 practice 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 due to identified concerns which included follow-up care not being provided in line with guidance and gaps in systems and processes for complaints management. At this assessment, the rating has changed to good due to improvements made by the practice.

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 practice made sure patients were at the centre of their care and treatment choices. Patients had access to appointments provided by clinicians, as well as additional support via their primary care network (PCN), and referral to other specialist services.

Our checks on medicines optimisation and long-term conditions management showed that overall patients were well managed, although there were some specific areas where continued improvement was required.

The National GP Patient Survey results from 2025 showed overall satisfaction which was in line with local and national averages. For example, during their last general practice appointment, 90% of respondents stated they were involved as much as they wanted to be in decisions about their care and treatment. This was slightly below the local and national average of 91%. The practice offered flexible duration appointments to patients, with more complex care patients being given additional time.

On the day of our assessment visit to the practice, we reviewed training records and saw that staff had received additional training to support specific population groups, this included those with a learning disability or autism, or those with an identified long-term condition and who required more specialised support.

Care delivery reflected physical, mental, emotional, and social needs of patients including those related to protected characteristics under the Equality Act, and reasonable adjustments were applied when appropriate to facilitate good care and treatment. For example, we were told of an example where a clinician held a consultation with a patient in a location where they were more comfortable, and were therefore able to engage with them more effectively.

The practice had recognised, and had a thorough understanding of, the diverse health and care needs of their patient population, so care was joined-up, flexible and supported choice and continuity. For example, the practice had reviewed their processes and procedures, and put in place measures to improve services for patients with a learning disability and autism. Actions undertaken by the practice included staff undertaking learning disability and autism training, the appointment of staff champions, increasing appointment times to 1 hour for patients, providing reasonable adjustments and reviewing the recall and care planning processes.

The practice delivered care to a range of vulnerable patients. This included services to residents of a residential care home and a home for people with a learning disability. This latter service told us that the practice responded to the needs of their residents and had built a strong relationship with them. Other services open to more vulnerable patients or those with complex needs included access to a range of community care services and social prescribers hosted within the practice. For example, the practice hosted a weekly mental health clinic for patients with severe mental health illnesses.

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

We saw that the practice website contained key information which included details of opening times, prescription ordering advice, details of available services and clinics, and how to raise concerns. It also contained information to patients regarding the move to a new triage-based appointment model. It was though noted that some information carried on the website was slightly out of date.

Whilst digital information routes were available via the practice website, we also saw that more traditional information sources were also available to patients. This included leaflets, and information displayed on the many noticeboards. Information was also available when required in easy-read formats.

The practice had access to interpretation and translation services, including British Sign Language. We saw that information provided by the service met the Accessible Information Standard and patient communication needs were noted on the patient record.

The practice had processes in place to engage with, listen to, and involve patients in the care and treatment they received.

The practice had established a Patient Participation Group (PPG). A member of the PPG told us that they felt recognised, respected and supported by the practice, and that the practice listened to and acted upon their views and suggestions. The representative told us that the practice discussed proposed developments with them as well as performance.

The practice routinely sought patient feedback following an appointment. Overall patient feedback was positive, with good performance being noted within the National GP Patient Survey and the NHS Friends and Family Test. Managers told us that, findings from patient feedback, including complaints, was reviewed regularly, and was shared with staff. This was corroborated by staff we received feedback from.

There was a complaints policy, and a complaints lead had been appointed. Staff we spoke with understood the complaints process and how to assist patients with any complaints or concerns they may have. Information on how to complain was also available on the practice website. The practice told us that it was their intention to review all complaints every 3 months to look for emerging themes and trends.

We saw that in the previous 12 months the practice had received 7 complaints. Both verbal and formal complaints were recorded and investigated. We examined 2 of these complaints in detail and saw that they had been handled appropriately. Investigations had been carried out in-depth and resulting learning measures put in place. We saw that complaints actively supported quality improvement activity, and saw an example when a complaint had led to direct changes in prescribing practices for patients from a specific patient group.

The practice offered a range of appointments to patients which included face-to-face consultations, telephone consultations, and home visits. The surgery was open from 8am to 6:30pm Monday to Friday with additional extended access appointments available every Tuesday evening from 6:30pm to 8:00pm. The practice also delivered a dedicated Saturday morning minor surgery clinic for patients once a month, as well as seasonal flu vaccination clinics. The practice also worked within their local primary care network (PCN) and through this their patients were able to access other extended access appointments, which included Saturday morning cervical screening clinics held at a nearby health centre. The practice hosted several other health and care services which included PCN social prescribers and wellbeing staff such as a health and wellbeing coaches. In addition, the practice supported patients who lived in 2 residential care facilities, 1 on which was a home for patients with a learning disability.

The practice had recently moved to a digital triage-based appointment booking and service request system. Patient requests (other than those for nurse appointments and follow up appointments) were submitted digitally to the practice and then triaged (screened) by an experienced clinician. At this point, based on need, an appointment or home visit can be arranged at the practice if this is seen to be necessary, or the patient can be signposted to a more appropriate service such as a pharmacy. Administrative requests can also be dealt with via this approach. The practice had in place measures to support patients who were either digitally excluded or otherwise unable to access and complete the digital triage process. A small survey of patients undertaken by the practice showed that most patients who responded found the process accessible and met their needs. The practice told us that the new approach had transformed the way they delivered care by improving access through prioritising need, whilst also creating a safer and more sustainable workload for staff.

Nurse appointments could be made over the telephone or in person rather than via the digital system due to many appointments requiring different appointment time slots. Follow up appointments were able to be directly booked into slots on the appointment ledger.

Data submitted to us by the practice showed that total appointments had increased from around 3,200 in May 2025, to 4,400 in May 2026.

Overall patient satisfaction with access using feedback from the 2025 National GP Survey showed that patient satisfaction was in line with national averages.

Physical access to the practice was good with treatment rooms being located on the ground floor, and accessible parking spaces available in the car park.

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.

Overall feedback provided by people using the service was positive. For example, results from the 2025 National GP Patient Survey showed that 89% of respondents felt that their needs were met during their last general practice appointment. This was in line with the local and national averages of 90%. Staff used appropriate systems to capture and review feedback from people using the service, including those who did not have access to the internet.

Leaders proactively sought ways to address any barriers to improving people’s experience and worked with local organisations, including their own primary care network to address any local health inequalities and improve outcomes such as through access to Saturday morning cervical screening sessions.

The practice recognised the importance of carers and kept a register of those with primary caring responsibilities. The practice had appointed a Carers Champion, and we were told that carers were offered additional support which included vaccinations, and referral to social prescribers. We were informed that the practice had identified 74 patients as carers.

Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. Examples, of actions included access to longer appointments, and the provision of interpretation and easy read materials. Staff had also received training in providing care and support to patients with more complex needs.

The practice had developed and embedded a revised approach to the support of patients with a learning disability or autism. Actions included the enhanced training of staff, increasing appointment times to 1 hour, and nominating 2 clinical and 2 non-clinical learning disability champions. Their role was to improve service safety and quality for these patients, and lead on the support of these patients by managing and making adjustments when necessary to meet their needs, such as through the provision of a quiet room, and having ear defenders and sunglasses available for patients who were sensitive to noise or bright lights. The practice had also strengthened their recall and review processes for patients, and sought to increase take-up of vaccinations and health screening for those patients. The practice had recently undertaken an audit into the provision of services for patients with a learning disability and autism which they planned to undertake again in January 2027. In the previous 12 months the practice had delivered health reviews to 91% of eligible patients on their learning disability register. Feedback from the residential care home for patients with a learning disability which was supported by the practice was positive.

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.

Staff understood the requirements of legislation when considering consent and decision making when patients were making decisions for their future care needs, and had access to training and advice to support them. Staff helped and supported patients to make informed decisions about their future, including at the end of their life. The practice held a register of patients who were approaching the end of their lives, and we saw that staff from the practice met regularly with other health and care partners to jointly plan and manage the care of these patients. To enhance communication the practice used an internal digital collaboration tool to effectively share information around patient care, this included a channel for those at end of life. Staff told us how they worked with patients, and their careers, to support their understanding of their future care options.

We saw that ReSPECT forms (Recommended Summary Plan for Emergency Care and Treatment – a document which holds personalised recommendations for a person's clinical care in an emergency), which included decisions related to Do not attempt cardiopulmonary resuscitation (DNACPR) decisions were accessible to staff, and had generally been completed in line with relevant legislation. ReSPECT forms and DNACPR completion was identified on the home page of the patient’s record. Since the last assessment in 2025 the practice had put in place a process for checking new ReSPECT and DNACPR documents completed by other health and care providers. They had introduced a proforma which assessed the document for key areas such as consent, and when necessary, family or carer involvement, as well as assuring themselves that it was available on their clinical system.