Middlestown Medical Centre Also known as Dr Swan and Partners

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. We found that the provider was responsive to the needs of people who used their services, and that these services were accessible to them..

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

This service scored 79 (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 patients were at the centre of their care and treatment choices and were given the time needed to discuss their concerns. Patients had access to appointments provided by clinicians including GPs, advanced nurse practitioners, members of the nursing team and pharmacists, as well as additional support via their primary care network (PCN), and onward referral to other specialist services.

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, 93% of respondents stated they were involved as much as they wanted to be in decisions about their care and treatment. This was slightly above the local and national average of 91%. In addition, 91% of respondents stated that the last health professional they saw or spoke with was good at listening to them, which was slightly above the local and national average of 87%. The practice appointment system gave patients the flexibility to discuss all their needs with the clinician, and they were not limited to raising single medical concerns.

Staff records showed that they had received additional training to support specific population groups, this included those with a learning disability or autism, or those with mental capacity issues. Staff were aware of the needs of transgender patients, and we saw evidence of learning around this. We also heard from practice staff who confirmed that processes were in place to support transgender patients with their health needs, and in particular to be actively included in national screening programmes.

Care plans reflected physical, mental, emotional, and social needs of patients including those related to protected characteristics under the Equality Act.

The practice 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.

We saw that the provider had a detailed understanding of the population health needs and had put in place measures to meet these. As examples, the provider had introduced a software platform to improve patient monitoring and management outcomes of patients with long-term conditions, and ran dedicated women’s health clinics. The flexible appointment system supported patient access and when possible, patient-clinician continuity of care. The operation of a main site and 2 branches with dispensary services offered patients access to care nearby to their own homes or workplaces.

The practice delivered care to a range of vulnerable patients. This included services to housebound patients or those with a learning disability. Staff from the practice also supported new mothers and babies in a nearby prison/young offenders’ institution.

The practice worked closely with others including their local primary care network to meet additional patient needs. This included access to social and wellbeing support, and evening and weekend appointments.

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

The practice had a comprehensive website which was regularly updated. The website included news and updates, information regarding clinics, and details of appointments including the NHS App and online access. The website also had an area dedicated to their Patient Participation Group, which included copies of their quarterly newsletter, and information about how to become involved in the group. Staff told us that they were able to support patients to access digital resources such as helping patients understand and log onto the NHS App.

Whilst digital information routes were utilised by the practice, we also saw that more traditional information sources were also available to patients. This included leaflets, and information displayed on the many noticeboards located across the sites.

Due to their open access appointment system, senior managers told us that clinicians had enough time to discuss issues with patients and give them the information required to better understand and manage their condition.

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

There was an active Patient Participation Group (PPG) in place which met regularly. 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. For example, they had given feedback to the practice regarding a number of issues including dispensary concerns, and the fact that the information relayed via the television sets in waiting areas was often too fast for patients to properly follow and comprehend. The representative told us that the practice discussed proposed developments with them as well as performance. The PPG took a proactive role in supporting the practice. For example, we saw that their quarterly newsletter carried important information which was useful to patients such as highlighting new staffing in the practice dispensary, and the importance of child vaccinations.

We saw that the provider 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 (FFT) The provider told us that, findings from patient feedback, including complaints, was reviewed formally at regular partner and clinical meetings, and were shared with staff.

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. In the previous 12 months the practice had received 60 complaints. 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. During the complaints process patients were able to access information about how to escalate complaints to the Parliamentary and Health Service Ombudsman, for example via the website or a complaints leaflet. However, it was noted during our onsite visit checks of complaint records, that final response correspondence from the practice did not contain this escalation information. We were told by the provider that this would be actioned in the future.

The practice was exceptional at ensuring people could access the care, support, and treatment they needed when they needed it, without physical or digital barriers, including out of normal hours and in an emergency.

The main practice site at Middlestown Health Centre was open from 8am until 6.30pm, with the 2 branches at Emley and Flockton opening less frequently with set hours of operation. Extended hours and weekend access were available to patients at another GP location as part of joint working arrangements.

The provider operated an open access appointments system which was based on patient choice, but with safeguards built into the assessment of requests to ensure that patient safety was prioritised. Patients were able to request appointments via a number of routes including in person, by telephone, or by digital communication methods such as email and NHS software applications. Appointments were patient directed and were in 2 main categories, Red – same day/urgent and Green -routine and non-urgent. Clinicians also had Purple appointment allocations for follow-ups, and for ongoing care.

Reception team members had been trained in care navigation, and were therefore able to assist patients to choose and access care services which were most appropriate to their needs. Whilst patient choice was central to their appointments system, the practice used clinical triage to assess clinical need and would call and discuss with patients what they felt was the appropriate appointment suitable to their needs. For example, a patient requesting a routine appointment, but who had symptoms of more immediate concern, would be asked to attend a same day/urgent appointment.

The provider told us that by using this system, and their detailed demand and capacity planning, patients were not limited to set appointment durations, and were able to raise numerous issues at a single appointment. As mentioned, the provider used historical demand data to effectively plan capacity to meet service needs. They informed us that in 2025 they had never needed to close the Red – same day/urgent care list.

We saw evidence, given to us by the provider, which showed an overall increase in capacity. For example, appointments volumes had showed a 22% increase from 2021 to 2024 (37,829 face-to-face and telephone appointments to 46,228). The ratio of appointments was approximately 2:3 between face-to-face and telephone consultations.

The practice’s cloud-based telephony system was effectively managed, and offered enhanced functionality such as call-back. Evidence submitted to us by the practice showed that between 1 July 2025 and 30 September 2015 the practice received 14,645 incoming calls. The average waiting time to pick up by an advisor was 123 seconds, with 62% of calls being answered within 60 seconds.

Patient satisfaction with access was positive and generally above local and national averages. As examples, 78% of respondents to the 2025 National GP Patient Survey reported that it was easy to contact the practice on the telephone compared to a local average of 51% and a national average of 53% and 80% of respondents reported that they felt they waited about the right amount of time for their last general practice appointment compared to 69% locally and 67% nationally.

A range of services and clinics were open to patients. These included dispensary services across the 3 sites, the fitting of coils and implants, baby checks, well women’s services, and joint injections.

Physical accessibility into sites was good with car parking being available at all sites, including parking for those with a disability at the main site. All sites had consultation rooms located on the ground floors. Waiting rooms were well laid out, with some provision of high-backed seating to better support the elderly or those with additional needs. For housebound patients, home visits were available, and the dispensary offered the home delivery of medicines.

Staff understood the importance of providing an inclusive approach to care, and made adjustments to support equity in people’s experience and outcomes. This included the use of interpreters and translated materials, the provision of detailed advice and signposting, and providing longer, multi-issue appointments.

The provider had a good understanding of the care needs of their population and had put in place measures and services to meet these needs. For example, we saw that the practice offered and undertook health checks to some of their most vulnerable patients including those with a learning disability. In the previous 12 months we saw that the provider had undertaken 94% of their disability health checks. The provider also recognised the importance of carers, and kept a register of those with dedicated caring responsibilities and offered them additional care inviting them for flu vaccinations. The provider actively encouraged patients with caring responsibilities to highlight their caring responsibilities to them, and staff had been appointed to roles as carers champions.

Other population specific support included training staff to recognise needs and deliver dedicated care to service veterans and their families, and ensuring transgender patients received necessary recalls for screening, and were appropriately supported for any other health concerns they had.

Adjustments were made to support the communication needs of patients; this included the use of translation and interpretation services, the availability of hearing loops at all sites, and the provision of easy read materials explaining care and treatment. The provider informed us that the Individual communication needs of patients were recorded on the patient’s notes which allowed them to recognise when additional support or adjustments may be required

Managers and staff told us about the ways in which they supported national initiatives to engage with and educate patients, for example signposting or referring patients to weight management, and offering in-house stop smoking support.

The provider utilised joint working arrangements with their primary care network (PCN) and through this offered a range of services including health and wellbeing coaching and care coordination.

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. We found that staff understood the requirements of legislation when considering consent and decision making when patients were making decisions for their future care needs.

Care planning, including palliative care planning processes, were embedded within the practice. We saw that the practice worked with patients, their carers, and other stakeholders to ensure that effective care was being provided. The provider kept a palliative care register, and we saw that patients on the register were reviewed regularly in conjunction with other health and care providers, and internally staff could discuss patients at their weekly clinical meetings. At the time of our assessment the provider was supporting 32 palliative care patients. The dispensary delivery service supported the despatch and receipt of medication to vulnerable patients.

Staff told us how they worked with patients, and their carers, to support their understanding of their future care options. We saw that ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) forms were completed in line with guidance, and that forms completed by practice clinicians were audited to assess quality compliance.