Townfield Doctors 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 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. The service was in breach of legal regulation in relation to good governance because people were not always able to access care and treatment in a timely way. 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.

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. The care plans we reviewed for people with diabetes and those who were housebound were well documented.

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. The practice had tailored its services to meet the diverse needs of its community, for example, building relationships with community groups and places of worship to promote the take up of screening programmes. They worked with Primary Care Network (PCN) social prescribers to share health information with minority and non-digital communities. The practice worked in partnership with the local community interest company (confederation) home visit service to meet the needs of care home residents and with the community matrons for housebound patients.

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

Information on the practice’s website was available in a range of languages. Practice leaflets, posters, and campaign materials were also available in multiple languages. Patients received information about clinics via text messages or letters in their preferred language. The practice had access to interpreter services, including British Sign Language services. Information provided by the service met the Accessible Information Standard. Patients were informed as to how to access their care records. A notice board in the waiting area informed patients of interpreter and sign language services, the complaints procedure, notices to encourage patients to join the PPG and advice for young people. Chaperone posters were displayed throughout the premises.

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. Learning from complaints was evident and staff were able to identify changes made as a result of patient feedback, including complaints. All the complaints we reviewed had been resolved satisfactorily and none escalated to the Ombudsman.

The practice engaged with patients via text message, posters, social media, leaflets surveys and the Patient Participation Group (PPG). Regular patient access surveys were carried out which had been codesigned by PPG members within the wider Primary Care Network (PCN). The practice held biannual PPG meetings which had been documented.

The service demonstrated it was committed to making sure that people could access the care, support and treatment they needed when they needed it. Since the last inspection, the practice had implemented a total triage system whereby patients submitted an online form which was triaged by a duty doctor. The online system could also be accessed by the NHS app via a smart phone or computer. On the site visit we saw the practice had a primary care network (PCN) care coordinator in the waiting area supporting patients with signing up to the app. Since the last inspection the practice had upgraded to a cloud-based telephone system with a call back facility. Patients who were digitally excluded could phone the practice where a receptionist would fill out the form on their behalf. Since the last inspection the practice had started a dedicated phone line for patients over 75 and under 5 years of age who were offered same day appointments. We did receive some feedback from patients we spoke to who said that they required more support to fill out the online form which was quite challenging when their first language was not English. In addition, patients with complex conditions felt there was a lack of continuity of care due to having to go through the online triage system for each appointment. However, when we raised this with the practice, they sent us evidence of forms filled out on behalf of a range of vulnerable patients including those with complex needs and non-English speakers which demonstrated the practice was committed to equality of access.

In response to the National GP Patient Survey data and from feedback from members of the community the provider had identified changes to improve access to the service. For example, they had extended appointments for people with a learning disability. People could access the service to suit their needs for example online, in person and by telephone. Treatment rooms were available on the ground floor, a ramp and automatic door had been fitted to the entrance, a disabled toilet and disabled parking spaces were available and elevator access to the first floor.

Results from the 2025 National GP Patient Survey showed that 35% of respondents responded positively to how easy it was to contact their GP practice on the phone compared to the national average of 53%.

Results from the 2025 National GP Patient Survey showed that 61% of respondents responded positively to the overall experience of contacting their GP practice compared to the national average of 70%.

We reviewed telephone call monitoring data from January 2024 to September 2025. The data showed consistent improvement in calls abandoned and reductions in time to answer.

Since the last inspection, the practice had employed additional reception staff and increased hours of existing staff. Through the primary care network (PCN) patients could access out of hours hubs in the evenings and weekends and urgent same day appointments 2 days a week with an advanced nurse practitioner to treat minor illnesses. In addition, patients could access a PCN funded microsuction service and musculoskeletal clinics.

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.

All staff had completed equality and diversity, inclusion and communication with vulnerable groups.

Feedback provided by people using the service, both to the provider as well as to CQC, was positive. 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 processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people. 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.

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.