The Mill Medical Practice

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked for evidence that the practice involved patients and treated them with compassion, kindness, dignity, and respect.

We received 90 comments from patients using the practice, which included predominantly very positive comments about the care they received. Comments included: ‘my GP has been outstanding, ‘staff cheerful, knowledgeable and efficient’, ‘absolutely excellent and ‘very diligent, caring and attentive’.

We found that the culture of the entire team was patient-centred, and staff members told us they felt empowered to deliver high-quality, considerate and empathetic care. We were given evidence of where staff had gone above and beyond for patients. This included delivering medicines to patients whilst completing home visits and nonclinical staff delivering required paperwork for an urgent hospital admission and staying with the patient and their partner until the ambulance arrived to offer reassurance and support. Results for both the National GP patient survey and the NHS Friends and Family Test feedback were positive and above national averages.

At our last inspection, we rated this key question as good. At this inspection, the rating has been changed to Outstanding.

This service scored 95 (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 treating patients with kindness, empathy, and compassion and in how they respected patients’ privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect. The practice demonstrated that they were continually striving to improve services for patients.

Arrangements were in place to promote patients’ privacy. Staff that chaperoned patients were aware of their responsibilities in maintaining a person’s dignity and safety, including during an intimate examination. We observed notices around the practice advising that chaperones were available and how to request one.

The practice gathered NHS Friends and Family Test feedback, which consistently reflected high levels of patient satisfaction. Feedback from patients was shared with staff to encourage and reinforce good practice. The practice used all comments as an opportunity for learning and improvement.

We noted that 90 patients shared positive experiences of the practice directly with the Care Quality Commission. Comments from patients included: “outstanding, compassionate, efficient expert and committed”.

We saw a number of compliments. We noted in the staff lunch area a book titled Mill’s Meaningful Moments. This was updated monthly and held letters and testimonials to the practice thanking staff for their care and support during difficult times. Comments reflected how staff went the extra mile and supported patients. The management team told us this was shared with all staff members to celebrate achievements, reinforce good practice, and foster a positive culture.

Results from the National GP patient survey consistently scored higher than both the local and national averages. Notably, 96% of patients felt their needs were met during their last general practice appointment. This was above the local average and national average of 90%. Similarly, 89% said the healthcare professional they saw or spoke to was good at treating them with care and concern during their last general practice appointment, (the national average was 86%). 96% of patients found the reception and administrative team at this GP practice helpful, compared to the national average of 83%

National GP patient survey data highlighted that 89% of patients felt listened to (national average 87%). Staff we spoke with understood Gillick competency (children under the age of 16 can consent to their own treatment if they are believed to have enough intelligence, competence and understanding to fully appreciate what is involved in their treatment). There was also a process to ensure young adults had control over their own privacy and the amount of parental involvement in managing their care and support.

Staff we spoke with, and evidence seen during our inspection showed times when staff had provided additional care for patients. This included a paramedic completing a home visit where it was observed that the house was very cold and there was a concern that the patient would be unable to remain in their own home. The heating was put on for the patient, and they were also made a warm drink. The paramedic informed the GP who then organised a second visit from a paramedic later in the day. On the second visit it was discovered the heating was not working properly. The staff member bled the radiators and sorted the thermostat for the patient who was then able to stay in their own home.

A second example of where during a home visit, environmental and safety concerns were raised. With the patient’s consent, arrangements were made for a local plumber to attend the property, and a referral was made to the Fire and Rescue Service, as well as the Safe and Well team for a home safety assessment. The patient’s GP was also informed and liaised with the social prescribing link worker to explore additional community support.

The practice treated patients as individuals and was exceptional in how they made sure care, support and treatment met patients’ needs and preferences. The practice took account of patients’ strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. Patients’ personal, cultural, social, religious and equality characteristics needs were understood and met. Patient communication needs were considered and met to enable them to be fully involved in their care. The practice was able to use translation services and visual aids to help aid communication with patients.

The practice identified patients who were carers and offered them health checks, vaccinations, flexibility with appointments and could provide information and guidance on support available to them as well as referrals to social prescriber services. The practice had also designed and built a collection of printable, easy-to-understand resource packs which could be shared with patients according to their condition or support need. Resources had been created in-house to ensure relevance, accessibility, and alignment with current local pathways and priorities. Examples included: carers and caring responsibilities, mental health and wellbeing and ADHD and autism. The practice worked closely with a range of local organisations to support patients’ health and wellbeing.

All staff had received training surrounding autism and learning disabilities and were able to support patients who may need extra support to be independent and access services.

The practice supported all patients, including homeless people, to access healthcare. Patients with no fixed abode could use The Mill Medical Practice as their postal address.

Patients who were transgender were encouraged to take up required screening. We reviewed a reflective account where a clinician had undertaken training specifically for inequalities in LGBTQ screening. They had shared this training with other staff members and had ensured that patients attending screening for the first time was called by their preferred pronoun and processes were explained in detail, so they were aware of what the procedure involved and would be encouraged to attend other appointments for required screening.

Between October 2024 and September 2025, the practice had taken part in a pilot supporting frail and vulnerable patients through a programme called My Care My Way. Initially practices were capped to 4 patients, but this was relaxed, and the practice was able to invite 17 patients with 14 accepting to be included. The patients were identified as individuals who were frail or vulnerable and at risk of deterioration or could be helped to avoid hospital admission. Patients had a ReSPECT form in place and a personalised safety plan. The plan incorporated safeguarding considerations, medication reviews and a holistic assessment of medical, personal and social care needs. This was overseen by a GP partner and each patient had access to the My Care My Way Matron, who coordinated multidisciplinary input, which included social prescribers, hospital at home team and community and specialist nurses.

The practice was exceptional at promoting patients’ independence, so patients knew their rights and had choice and control over their own care, treatment, and wellbeing.

The practice provided information in a way that patients could understand and offered time for discussion so patients could consider their options. Interpreters and accessible communication formats were available when needed. The practice had disabled access and hearing loops.

The practice identified patients who were carers. The practice’s computer system alerted staff if a patient was also a carer. We were shown written information available for carers to ensure they understood the various avenues of support available to them.

Staff helped patients and their carers to access advocacy and community-based services.

The practice listened to and understood patients’ needs, views and wishes. Staff responded to patient’s needs and acted to minimise any discomfort, concern, or distress.

Patients could book appointments by telephoning the practice, attending in person, or through completing an online form. There was a system for appointment triage that ensured patients with immediate needs had access to services. Patients who required a same day assessment and treatment were booked into the daily ‘Duty Surgery’ which was run by a combination of paramedics and nurse practitioners with an “on call” GP overseeing and reviewing any complex needs and providing advice to colleagues. Patients’ needs were usually managed on the day of contact with the practice. The remaining were either signposted or offered an appointment in the future rather than having to call back. Patients were booked in with their usual GP to ensure continuity of care where required or directed to the most appropriate person to meet their needs. Staff knew the process for referral to emergency support, including mental health crisis teams.

The practice had conducted a review to identify patients who would benefit from continuity of care by seeing the same GP each time (this may not be the assigned GP to the patient but instead a GP that the patient had seen the most so was more aware of the patient and their needs). An alert was placed on 424 patient records which encouraged care navigators to book with the GP they saw most often. This had seen a 24% reduction in the number of appointments taken by this group of patients.

The practice completed yearly Before and After Death Audits to assess how effectively carers and patients approaching the end of life were identified, supported and followed up after death. The June 2025 audit reviewed 358 patients on the carers list and 74 patients on the palliative care list. All were coded correctly on the patient record system and had the correct alerts. It was noted that each year the number of cares had increased and in 2025 the practice had registered 82 new carers. The audit also showed that recognition and earlier identification of patients with palliative care needs had also increased with an increase in numbers on the palliative care list. The practice planned to complete a further audit in 6 months’ time rather than 12 months to ensure staff awareness and coding was continuing to improve.

Findings from the audit also showed where improvements could be made including bereavement follow ups being standardised and being more consistent where support for carers before a patient death was offered. The practice created an action plan from their findings. We saw evidence of a new patient bereavement support pack which was being used. This contained practical guidance, emotional support resources, and helpful contacts for patients.

We observed several examples where patients and their carers received timely, coordinated support. For example, for a patient who lacked capacity and required a blood test, an ECG, and dental treatment. Rather than subjecting the patient to multiple stressful procedures, a Best Interest Meeting was convened with relatives, carers, and consultants to ensure their needs and rights were fully upheld. The outcome was all 3 procedures were completed in one session under a single general anaesthetic. This approach safeguarded the patient’s wellbeing, significantly reduced stress and ensured that the patient received the care they required in a timely manner. A Best Interests Meeting is a formal, multidisciplinary gathering held to make significant decisions about the care, treatment, or welfare of an individual who has been assessed as lacking the mental capacity to make specific decisions for themselves.

The provider cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care.

Staff told us they were valued by leaders. Leaders had taken steps to recognise and meet the wellbeing needs of staff, which included the necessary resources and facilities for safe working, such as regular breaks and rest areas. Staff reported being supported if they were struggling at work. We saw team building days were established within the practice. The practice also supported their staff by having organised social events, such as quizzes, in house crazy golf, Get Fit with Rick, and a weekly conundrum. Staff we spoke with were enthusiastic about these events and were proud to have won The Big Team Challenge (a virtual activity challenge, used to motivate people to be more active through walking or cycling). They told us these events helped staff to bond and created an inclusive working environment.

The practice actively sought staff feedback through surveys, including one conducted in August 2024. Responses indicated that staff felt well supported overall, and the survey provided a valuable platform for suggesting innovative ideas and improvements. Leaders acted on the feedback and had created a comprehensive action plan.

A key theme from the feedback was the need for stronger communication between administrative staff and doctors. To address this, the leadership introduced a new initiative where a GP now attends quarterly admin meetings. An area for improvement highlighted by staff was that not all relevant information reached staff consistently. In response, the practice implemented more frequent team meetings and launched a monthly newsletter from the Practice Manager, ensuring transparency and keeping everyone informed. Staff we spoke with told us they felt internal communication was good and that there was a cohesive working environment across the practice.

We also noted a wellbeing noticeboard in a staff area with information to support staff health and wellbeing. There was information on local services and wellbeing techniques such as mindfulness and anxiety grounding techniques, alongside a suggestions box, mindfulness colouring activities, and books providing resources.

Staff we spoke with, and evidence seen demonstrated a high level of training opportunities for staff. Staff told us they were encouraged to expand their roles and or achieve career progression. We saw internal training sessions were provided for staff to increase their knowledge on a variety of subjects.

Leaders demonstrated the systems they had in place to support staff, and staff reported how their views and feedback were listened to, carefully considered and used to drive change. For example, one of the reception staff members had expressed wanting to develop a mentor role within the reception team. This was to ensure newer members of the team were trained on basic practice procedures in a more uniformed way and had access to a mentor for help. We saw evidence that this had been developed with help of the individual and a Receptionist Training Passport had been created.

We were also told by clinical staff that any feedback was listened to and acted on if possible. We were given an example of a new nurse suggesting adding a special airway device to the emergency medicines which had been agreed by partners.