Patford House Surgery Partnership

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. 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 people including those related to protected characteristics under the Equality Act. Our review of care plans showed people who used the service were supported to understand their condition and appropriate safety‑netting and follow‑up advice was provided, with medicines discussed and selected in accordance with known allergy status. Examples included dementia care, where the person’s next of kin were supported with safety‑netting information and involvement from community nursing and mental health teams to inform care and treatment planning. The service also completed routine wellbeing calls and monthly reviews of care plans for care home residents and people who were housebound. A monthly search was used to generate an inclusion list to support ongoing review and follow‑up. The service provided care to 1 care home, which was overseen by a GP partner, with a weekly ward round completed.

People were able to seek support from a clinician of their choice. The service had ‘community connectors’, who supported people through a holistic approach tailored to their individual needs. The service made reasonable adjustments by offering longer appointments for people with a learning disability or those requiring translation assistance. People were involved in decisions about their care, as demonstrated by positive Friends and Family Test feedback received by the service and recent Give Feedback on Care submissions sent directly to CQC. The service held regular multidisciplinary meetings, including safeguarding, cancer care and end‑of‑life care discussions, to support holistic outcomes.

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. There were now established mechanisms for engaging with the community healthcare provider, including the district nursing team and the local hospice. The service also signposted people who used the service to local community groups, such as local dementia support cafes.

The service worked in partnership with other services to meet the needs of its population. For example, the service now worked with ‘Carers Together Wiltshire’ to provide tailored support to people identified as an unpaid carer. Additionally, a dedicated carers lead was appointed, and carers using the service were coded appropriately within the clinical system, which allowed them access to support and annual health check reviews. The service was also a Gambling Harm Accredited service and had trained staff to recognise and respond to gambling‑related harm, offering confidential discussions and timely signposting to specialist support services where needed.

The service had tailored its services to meet the diverse needs of its community. For example, the service used their ‘community connector’ role to engage with local partners through engagement events and a quarterly wellbeing forum, working with organisations such as social services, local authorities and voluntary sector groups. This supported access to local initiatives including the local Community Health Hub, iTalk mental health services and a carers’ café.

The service supplied appropriate, accurate and up-to-date information in formats tailored to individual needs and met the Accessible Information Standard. The service had updated its website following work with its patient participation group to make information more transparent and user‑friendly, including clearer policies and guidance on how people can request access to services via PATCHS. (PATCHS is an online consultation and triage tool that allows people to quickly and easily access GP services online, allowing people to request an appointment and submit medication queries, prescription requests or fit notes).

Information leaflets were often used to support people once a diagnosis had been confirmed. These were available in alternative formats, including different languages and large‑print versions, accessed through the NHS toolkit to support people’s individual communication needs. People who used the service were informed about how to access their care records and were supported to do so where needed.

When required, longer double appointments could be booked to allow additional time for communication. The service had access to a language interpretation line, which was used for planned appointments, and hearing loop systems were available across all 3 sites. The service also had access to remote British Sign Language (BSL) interpreting services when required.

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. According to the 2025 National GP Patient Survey, 96% of respondents felt involved in decisions about their care and treatment during their last appointment, which exceeded both the local and national averages. Leaders stated they routinely gathered feedback from people who used the service through the NHS Friends and Family Test. This information was reviewed to identify areas of improvement, and the results were shared with both staff and those who used the service.

Complaints were managed in line with the service’s policy. The service ensured people received apologies when appropriate and referred them to the Parliamentary and Health Service Ombudsman if they wanted to escalate their concerns. The service demonstrated learning from feedback and complaints. For example, following issues with delays in prescriptions and unaccepted referrals, safety netting audit logs were introduced to help staff keep track of actions, ensure they were completed, and provide clearer administrative oversight. Complaint and feedback themes were discussed at regular meetings, with actions agreed to support shared learning and improvement, and minutes were made available to all staff to ensure learning was communicated and acted upon.

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

People could access the service to suit their needs, for example online, in person and by telephone. Urgent demand was managed through GP oversight and a range of daily urgent appointment slots, including protected capacity for vulnerable groups and NHS 111 referrals. The service supported improved access to care through enhanced access arrangements, including appointments outside core opening hours such as evenings and Saturdays. This provided greater flexibility for people, including those working standard office hours, to access healthcare at times which better met their needs. The service had arrangements for home visits, with requests overseen by senior leaders and GPs, and visits carried out by a paramedic and GP partners.

The service provided various ways to book appointments and order prescriptions, making care accessible for all, especially supporting elderly people and those experiencing homelessness who may struggle with digital technology. The service recognised whilst some older people were able to use online systems confidently, others required additional support. Therefore, the service put arrangements in place to meet people’s accessibility needs. This included proactively contacting a small number of people by telephone each month to support prescription ordering, while encouraging online requests where appropriate to maintain access for those less able to use digital systems. In addition, staff provided fortnightly drop‑in sessions at the local library, where they helped people complete online requests, demonstrated how to use systems such as PATCHS, and offered practical guidance using laptops to build confidence in accessing services digitally. Logs kept by staff indicated people who attended these sessions had reported positive experiences of the training and support provided.

The service had a dedicated ‘VIP’ telephone line for people who were coded as vulnerable, including people receiving end‑of‑life care or with a cancer diagnosis, which enabled their calls to bypass the standard call queue. A separate bypass line was also available for health and care professionals, including district nurses and paramedics, to request urgent support.

In response to National GP Patient Survey data and feedback from people, the provider had worked to improve access to the service. For example, the service introduced a new cloud‑based telephone system with call queuing and call‑back functionality, enabling leaders to monitor call volumes and waiting times, and to arrange staff and resources more effectively. Telephone access performance was monitored during daily huddles and reviewed at weekly leadership meetings, with additional administrative support provided at peak times to manage demand and ensure call queues were cleared before the service closed. However, feedback submitted directly to CQC from people using the service continued to report long call waiting times. During the assessment, the longest recorded wait for people to make an appointment at the service was 16 minutes and 51 seconds, for general enquiries it was 11 minutes 7 seconds, and for prescription queries it was 1 minute 35 seconds. In response to long waiting times, the service told us how it rotated staff to answer calls for the department which had the longest call wait time, demonstrating real-time action to address the issue.

Many people who used the service gave positive feedback about access and noted recent changes, including the introduction of the PATCHS booking system, had improved their ability to access care in a timely way. However, there was an emerging theme of access delays in relation to baby immunisations from feedback sent directly to CQC. In response, service leaders described the work they had implemented to strengthen its call and recall processes. They also outlined plans to further strengthen these arrangements by exploring improvements within the clinical system to better identify children who may have missed vaccinations and support ongoing monthly oversight of immunisation needs.

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. Feedback provided by people using the service, both to the provider as well as to CQC, was positive. Feedback indicated staff treated people respectfully, without discrimination, and made adjustments where needed. 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.

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, due to the local demographic, some staff members recently attended training to improve their understanding of the Gypsy, Roma, Traveller and Boater (GRTB) communities, which focused on identifying barriers to access and supporting people with additional needs, including literacy, language and preferences for care. Staff told us learning from the training will be shared with all staff and be used to help engage better with people from these communities to make services more accessible.

The provider had processes to ensure people could register at the service, including those in vulnerable circumstances such as homeless people and Travellers. For example, people with no formal address were able to register under the service’s address. This also helped to ensure any correspondence from secondary health providers were reviewed by the service for summarising.

Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. The service had systems to make reasonable adjustments to support people’s communication needs. For example, the service’s online PATCHS request system enabled people to indicate their preferred language when contacting the service, with a translation function, and for people unable to type, there was a voice-to-text function.

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. 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. Systems were used to record, review and update Do Not Attempt Cardiopulmonary Resuscitation (DNACPR), Treatment Escalation Plan (TEP) and Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) decisions. The service worked with the community teams to run regular searches for care plan updates and scheduled tasks at 6 and 12 month intervals to review these decisions to ensure they remained accurate.

The service had arrangements to support planning for future care, including a bereavement process, with families contacted by a GP or senior leader to provide information about coroner and medical examiner processes and offer support. The service worked with local hospice services, care homes and other professionals through regular multidisciplinary meetings, where end‑of‑life care cases were discussed.