Crown Street 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 good. At this assessment, the rating remains the same. We found the practice was providing a responsive service overall, however we identified an area for improvement as there was no active patient participation group.

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 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 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.

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, the practice offered extended access for patients of the wider primary care network (PCN). There were established mechanisms for engaging with community healthcare providers.

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

They practice 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. Complaints were acknowledged, and investigated, people were given an apology, actions were taken and learning was shared with the team in meetings. The Patient Participation Group (PPG) was no longer active, and the practice used Friends and Family Tests (FFT) and used feedback from an online reviews website to obtain regular feedback. 94%of people who responded to theNHS Friends andFamily Test said that they would beextremely likely orlikely to recommend the practice.The leaders informed us of the 2.7% negative responses received, themes were reviewed and used to make improvements to the service such as those for access.

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

In response to the 2025 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 offered extended appointments for people with a learning disability or Serious Mental Illness (SMI). 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 and there was a ramp and automatic door on entrance.

In the 2025 NHS National GP Patient Survey results, the practice performed lower than local and national averages concerning access, for example:

66% respondents said that their experience of contacting their GP practice was good compared to a national average of 70% and local average of 71%.

44% said that it was easy to get through to the contact their GP practice on the phone compared to a national average of 53% and local average of 60%.

The practice was aware of these results and used monthly patient feedback related to access to make improvements. Leaders were also planning on arranging for digital access support by installing devices at reception to allow patients to complete online forms.

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. The 2025 National GP patient survey found 78% of patients had a good overall of the practice which was slightly above national (75%) and local (75%) averages.

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. For example, some leaders were trustees for the local community charity and the practice is involved in providing funding to local initiatives within the area such as providing books and laptops for students. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. The practice 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. Feedback provided by people using the service, both to the provider as well as to CQC, was positive.

People and their relatives 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.