During an assessment under our new approach
Date of Assessment: 8 October 2026. Heswall and Pensby Group Practice is a GP practice and delivers service to approximately 20,980 under a contract held with NHS England. The provider operates Commonfield Road Surgery as a branch site under this registration. The National General Practice Profiles states that the ethnic make-up of the service area is approximately 96.1% White, 1.6% Asian, 1.5% Mixed, 0.3% Black and 0.4% Other. Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the 8th decile (8 of 10). The lower the decile, the more deprived the practice population is relative to others. This assessment considered the demographics of the people using the service, the context the service was working within and how this impacted service delivery. Where relevant, further commentary is provided in the quality statements section of this report.
The service had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly and learning was used to improve systems and processes. People were protected and kept safe. Staff understood and managed risks, although some assurance processes used to monitor environmental risks, infection prevention and control, and staff health checks were not always fully effective. The facilities and equipment met the needs of people, were well maintained and risks were generally managed appropriately. There were enough staff with the right skills, qualifications and experience. Managers made sure staff received training and regular appraisals to maintain high-quality care. Staff managed medicines well and involved people in planning any changes.
People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on current evidence and good practice. Staff worked with other services involved in people’s care to support positive outcomes and smooth transitions between services. Staff made sure people understood their care and treatment to enable them to give informed consent. Where they did not have capacity staff involved appropriate people in making best interest decisions.
People were treated with kindness and compassion. Staff protected their privacy and dignity. Staff treated people as individuals and supported their preferences. People had choice in their care and treatment. The service supported staff wellbeing.
People were involved in decisions about their care. The service provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The service worked to improve access and reduce barriers to care, although further improvements were needed in this area. People received fair and equal care and treatment. The provider used targeted support, engagement and feedback to help reduce health and care inequalities. People were involved in planning their care and understood options around choosing to withdraw or not receive care.
Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. Managers worked with the local community to improve services and were receptive to new ideas. There was a culture of continuous improvement with staff given time and resources to try new ideas.