Medwyn 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 patient’s needs, and that staff treated patients equally and without discrimination. The practice was easy to access. Direct feedback to CQC highlighted patients found it easy to make appointments. Results from the National GP patient survey also highlighted that patients could easily access the practice, 79% of patients found it easy to get through to the GP practice by phone (national average 53%), 84% found it easy to contact the GP practice using their website (national average 51%), and 76% found it easy to contact the GP practice using the NHS App (national average 49%). Patients received fair and equal care and treatment. The practice worked to reduce health and care inequalities through training and feedback.

We received 601 comments about the practice from patients. The overwhelming majority were very positive and many who gave feedback provided detailed examples that confirmed person centred care with effective outcomes.

At our last inspection, we rated this key question as outstanding. At this inspection, the rating remains the same.

This service scored 96 (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 was exceptional at making sure patients were at the centre of their care and treatment choices and they decided, in partnership with patients, how to respond to any relevant changes in patient’s needs.

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 percentage of respondents to the GP patient survey who responded positively to the overall experience of contacting their GP practice was 87% with the national average being 70%. In addition, 90% of patients described their overall experience of this GP practice as good, compared with the national average 75%.

Accessible standards and barriers to care were considered for patients, with alerts added to medical records so that the receptionists were aware the person had additional needs. For example, patients who were blind or hard of hearing were collected from the waiting room by the clinicians and a hearing loop was installed at reception. Autistic people or people with learning disabilities were offered a quiet place to wait for appointments.

An overwhelming majority of feedback from patients who responded directly to CQC said they were well supported to understand their condition and felt involved in decisions about their care and treatment and in planning for their future needs. Comments included “there was an in-depth conversation about my medical history” “They have helped me over the years by caring and helping and, most importantly, listening.”

Leaders and staff, we spoke with, felt patients were directed to the right clinician the first time, which enabled them to provide effective person-centred care. For example, referring patients to the pharmacy for minor illnesses and to the social prescriber where the person did not have a health care need.

The practice had an exceptional understanding of 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 to promote the take up of screening programmes. There were established mechanisms for engaging with the community healthcare provider.

The long-standing clinical staff team provided continuity and stability with minimal requirements for locum staff. Staff had forged excellent working relationships with many multi-disciplinary professionals to meet the needs of patients and all staff we spoke with were familiar with the patients who attended the practice.

Our review of the clinical system demonstrated that referrals to other services were made promptly, and information shared by other services was managed effectively and timely to support good outcomes for patients.

The practice had identified that 4% of the practice population was using 20% of the appointments offered. Analysis of this group was used to create a flag on the patient record and this group of patients (around 244), when requesting an appointment were offered a 20-minute appointment booked with their usual GP for continuity of care. These consultations were structured to provide a holistic review using a frequent attender template, which also prompted consideration of wider referrals. For example, referrals to the DHC Live Well service, incorporating social prescribers, health and wellbeing coaching, and mental health support through DHC NHS Talking Therapies and GP Integrated Mental Health Service (GPiMHS). At the end of the consultation, a further review appointment could be scheduled (usually at 4–6 weeks) to reduce the frequency of unscheduled presentations. An audit had been completed from 1 May to 1 July 2025, with follow-up data to 1 August 2025. The audit demonstrated that more than half of patients seen had no further consultations in the subsequent two months, indicating a reduction in recurrent attendance.

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. Information provided by the practice met the Accessible Information Standard. Patients were informed as to how to access their care records.

Results from the National GP patient survey showed that 100% of patients knew what the next step would be within two days of contacting their GP practice. This was above the 93% experienced by patients locally and nationally.

The practice identified through feedback that patients had difficulty in understanding how to sign up to the NHS App. The practice created a step-by-step guide and drop-in sessions with an NHS champion. This saw an increase in use and 70% of patients are registered users for the App. In addition, the guide was recognised by Surrey Heartlands ICB as an exemplar and shared system wide.

The practice was exceptional at enabling patients to share feedback and ideas, or raise complaints about their care, treatment, and support. They always involved patients 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.

Complaints we reviewed showed the practice responded to feedback appropriately, openly and in a non-defensive manner. Learning from complaints was evident and staff were able to identify changes made because of patients’ feedback, including complaints. Staff were aware of their duty of candour and to be open and honest when things went wrong.

The practice routinely asked patients to complete Friends and Family Test (FFT) feedback forms and reviewed the feedback for any trends or themes. Data from the FFT showed that for each of the months for June, July, and August 2025 the practice had received positive comments from 96% of the patient who had provided feedback.

Results from the GP patient survey showed the practice performed above the national average, achieving 98% for involving patients in decision-making, (the national average 91%). In addition, the national GP patient survey showed, 97% of patients who responded felt that during their last appointment, the healthcare professional was good at listening to them, (the national average 87%).

Feedback from patients received by CQC and in addition to FFT data demonstrated positive responses from patients about feeling involved in decisions about their care and treatment. Comments included, “I was extremely pleased that the GP had time to listen to me about my concerns” and “They take the time to explain blood tests to me” and “Fantastic staff who are proactive and listen.”

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

The premises was wheelchair accessible, and there was lift access to rooms on the first floor. The practice had a hearing loop. Patients could access appointments online, over the phone and in person. Patients could access pre-bookable appointments at extended hours on Tuesday, Wednesday, and Thursday until 8pm. Patients could also be booked in extended access appointments which was provided through Dorking Healthcare for Dorking PCN, in the evenings during weekdays or on Saturdays. This ensured access for working patients and others who were unable to get to the surgery during normal opening hours.

The practice offered a range of appointments. These included emergency on the day, pre-bookable and clinics for conditions such as diabetes or asthma reviews.

The provider prioritised and allocated resources and opportunities as needed to tackle inequalities and achieve equity of access. They maintained registers of patients with protected characteristics to be able to inform them of services available to support them.

Through patient complaints and survey feedback the provider was able to identify some patients’ difficulties in accessing the right clinician first time. In response a new triage and care navigation model was introduced and refined through testing. Staff training was provided, daily huddles held to support consistency, and appointment requests, call volumes and DNA (did not attend) rates were monitored. The outcome of the changes resulted in care navigation–related complaints reducing, call handling performance had improved, and more patients were directed correctly at first contact.

Results from the GP patient survey showed the practice performed significantly better than local averages in several areas concerning access. For example, 86% of patients felt they waited the correct amount of time, compared with the national average 67%.

Staff and leaders were innovative in how they listened to information about patients who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support, and treatment in response to this.

Feedback provided by patients using the practice, both to the provider as well as to CQC, was positive. Staff treated patients equally and without discrimination. Leaders proactively sought ways to address any barriers to improving patient’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 patient’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 and Travellers. Staff used appropriate systems to capture and review feedback from patients using the practice, including those who did not speak English or have access to the internet.

For transgender, non-binary and intersex patients’ arrangements were in place to ensure they would continue to receive appropriate health checks, and their preferred name was used.

Systems and processes were 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. Patients at risk of social isolation or poverty were supported via social prescribing. For example, Period Angels, Men’s Shed, MASH (Men Alone Self-Help) food banks, food vouchers, Live Well services, breastfeeding support areas, and DHC menopause or perinatal support services.

The practice was responsive to the needs of older patients and offered home visits and urgent appointments for those with enhanced needs and complex medical issues.

The practice adjusted the delivery of its services to meet the needs of patients with a learning disability and autistic patients. Staff had received appropriate training. Receptionists could alert clinicians if delays could risk causing anxiety to the patient and allow the patients to be seen out of order if required. When the person or a carer / family member contacted the practice to book their health check, the individual needs of the person were discussed. Where possible, patients were offered quiet time appointments, specific members of staff, and longer appointments.

The practice liaised regularly with community services to discuss and manage the needs of patients with complex medical issues.

The practice audited its referral process in both 2024 and 2025 to ensure fair and equal access for all patients suspected of being neurodivergent.

There was an equal opportunity and diversity policy in place which was accessible to all staff and all staff had received training to improve their understanding and awareness.

Patients 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 patients 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 had conducted an analysis on patients’ passing away from January 2025 to June 2025. This reviewed the total number of deaths, the proportion of patients who were receiving care in line with the Gold Standard Framework (GSF) register or were in a nursing/residential homes (GSF enables a more proactive, personalised care for patients in their final year of life, focusing on symptom control, coordinated communication across care providers, and better support for patients and their families to help them live and die in their preferred place). The audit reviewed the proportion achieving their preferred place of death, DNAR/RESPECT completion rates and the reasons for non-completion (e.g. sudden deaths). Findings of the audit were reviewed by the practice and at PCN level to drive improvements and achieve consistency across practices. The local hospice also conducted a similar audit which was shared with the practice and was used to help benchmarking.

The practice fully 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. Minutes of these meetings were recorded, saved, and shared with relevant agencies. We were assured that safeguards were in place to ensure that decisions were made which were in the person’s best interest. When patients did not have mental capacity to make their own decisions regarding end-of-life care, family members and carers were involved in decision making.