Limestone Surgery

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment, we rated this key question as Good. At this assessment, the rating remains the same.

This service scored 80 (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 always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

The practice demonstrated that dignity is promoted through compassionate care, proactive planning, responsive access, and attention to the wider patient environment. For example, the practice identified that outdated signage, poor wayfinding, unclear identity, and a deteriorating entrance environment were negatively impacting patient confidence, dignity, and access particularly for vulnerable groups such as migrant patients, those with language barriers, and individuals unfamiliar with NHS services. Recognising this as a dignity, equality, and access issue, the practice submitted a structured Premises, Signage and Patient Access Inequality Case to request improvements for its patient population.

The practice also held regular multidisciplinary meetings to review palliative care patients, supporting anticipatory and compassionate planning. This included Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions, preferred place of care, symptom management, family involvement, and coordination with community services. Palliative patients were flagged on practice systems to enable timely GP access when needed.

National GP Patient Survey data showed 86% of people said the healthcare professional they saw or spoke to was good at treating them with care and concern during their last general practice appointment. This was above the local average of 82% and in line with the national average of 86%.

Further results from the national patient survey showed 80% of people found reception and administrative team helpful, this was lower than the national average of 83% and above the local average of 79%.

Feedback we received from patients in preparation for the assessment consistently demonstrated that staff were kind and caring. Patients told us they felt listened to, reassured and supported, particularly those with complex or long‑term conditions. Patients described staff at all levels, including reception, secretarial and clinical teams, as helpful and approachable. Several patients highlighted that clinicians took extra time to explain next steps in care and to reassure them, which supported informed decision making.

Arrangements were in place to promote patients’ privacy. Staff we spoke with understood Gillick competency and there was a process to ensure young adults had control over their own privacy and the amount of parental involvement in managing their care and support.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Leaders actively promoted staff wellbeing by maintaining an open-door approach, providing visible wellbeing initiatives within the practice, supporting staff through social and recognition events, and offering access to free external Human Resource (HR) advice and counselling services. The practice also undertook regular health and safety audits and made appropriate reasonable adjustments to support individual staff needs.

Through the National General Practice Improvement Programme (GPIP), the practice reviewed reception, administration, and secretarial workflows. This enabled identification of avoidable demand, introduction of standardised call-handling, clearer signposting, improved appointment allocation, and protected same-day capacity. As a result, avoidable reception workload was reduced by over 67 hours annually, with improved role clarity, consistency, and team resilience. In addition, practice leaders demonstrated a proactive and supportive approach to staff wellbeing by formally escalating building related risks impacting staff safety and working conditions, with clearly defined actions and timescales for resolution.

Staff feedback collected through Care Quality Commission (CQC) questionnaires and interviews were overwhelmingly positive with staff feeling valued by the service. For example, 100% of staff reported feeling listened to, said managers were visible and felt supported.

The service promoted people’s independence, ensuring patients understood their rights and had choice and control over their care, treatment, and wellbeing. Patients and carers were supported to access advocacy and community based services, including through a Primary Care Network (PCN) social prescriber who provided information and signposting to local support. Feedback from patients confirmed they felt involved in decisions about their care.

The practice demonstrated a proactive and compassionate approach to carers, who were identified through multiple routes and coded on the system to ensure visibility across the team and coordinated support, including social prescribing and wellbeing interventions. The practice reviewed its approach following low engagement with digital surveys and introduced more accessible, opportunistic paper-based feedback. At the time of the assessment, this work was being further developed as part of a research collaboration, with learning to be shared across the PCN.

Bereaved relatives were offered appropriate follow-up, emotional support, and signposting. Palliative and vulnerable patients were clearly flagged on systems to support timely access to care.

The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

There was a system for appointment triage that ensured people with immediate needs had access to services. The practice implemented a policy with system alerts to identify emotionally distressed and palliative care patients, ensuring staff could prioritise and provide timely, short notice GP access when required.

Staff knew how to respond when a patient needed urgent attention and knew the processes to follow to ensure emergency support was given. We reviewed staff training and found that staff were up to date with their Cardiopulmonary Resuscitation (CPR), anaphylaxis and sepsis training.

Staff we spoke with knew the process for referral to emergency support, including mental health crisis teams. The practice had achieved Veteran Friendly Practice accreditation, a program designed to support practices in providing the best possible care for people with a military background and their families. They were also registered as a ‘safe surgery’ to remove barriers for vulnerable migrants, refugees, and homeless individuals. This commitment was clearly demonstrated through visible information displayed within the practice in a range of languages, helping to promote inclusivity.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Leaders actively promoted staff wellbeing by maintaining an open-door approach, providing visible wellbeing initiatives within the practice, supporting staff through social and recognition events, and offering access to free external Human Resource (HR) advice and counselling services. The practice also undertook regular health and safety audits and made appropriate reasonable adjustments to support individual staff needs.

Through the National General Practice Improvement Programme (GPIP), the practice reviewed reception, administration, and secretarial workflows. This enabled identification of avoidable demand, introduction of standardised call-handling, clearer signposting, improved appointment allocation, and protected same-day capacity. As a result, avoidable reception workload was reduced by over 67 hours annually, with improved role clarity, consistency, and team resilience. In addition, practice leaders demonstrated a proactive and supportive approach to staff wellbeing by formally escalating building related risks impacting staff safety and working conditions, with clearly defined actions and timescales for resolution.

Staff feedback collected through Care Quality Commission (CQC) questionnaires and interviews were overwhelmingly positive with staff feeling valued by the service. For example, we received 11 questionnaires and 100% of staff reported feeling listened to, said managers were visible and felt supported.