The Mill Medical Practice

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 patients’ needs, and that staff treated patients equally and without discrimination. The practice was easy to access. Direct feedback to CQC highlighted patients found it easy to make appointments. Results from the National GP patient survey also highlighted that 65% found it easy to contact the GP practice using their website (national average 51%), and 72% found it easy to contact the GP practice using the NHS App (national average 49%). Patients received fair and equal care and treatment. The practice worked to reduce health and care inequalities through training and feedback.

We received 90 comments about the practice from patients. The overwhelming majority were very positive and many who gave feedback provided examples that confirmed person centred care.

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

This service scored 82 (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 making sure patients were at the centre of their care and treatment choices and they decided, in partnership with patients, how to respond to any relevant changes in patients’ needs.

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 percentage of respondents to the GP patient survey who responded positively to the overall experience of contacting their GP practice was 81% (with the national average being 70%). In addition, 86% of patients described their overall experience of this GP practice as good, compared with the 75% national average.

Accessible standards and barriers to care were considered for patients, with alerts added to medical records so that the receptionists were aware the person had additional needs. For example, patients who were blind or hard of hearing were collected from the waiting room by the clinicians and a hearing loop had been installed at reception.

The practice understood the diverse health and care needs of patients 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, building relationships with community groups to promote the take up of screening programmes. There were established mechanisms for engaging with the NHS community healthcare provider.

The long-standing clinical staff team provided continuity and stability with minimal requirements for locum staff. Staff had forged excellent working relationships with many multi-disciplinary professionals to meet the needs of patients and all staff we spoke with were familiar with the patients who regularly attended the practice.

Our review of the clinical system demonstrated that referrals to other services were made promptly, and information shared by other services was managed effectively and timely to support good outcomes for patients.

The practice supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The practice provided patients with information in a variety of methods including a practice newsletter, seasonal campaigns, and the text messaging service. We observed the practice waiting areas had a range of health and wellbeing leaflets and posters on display for patients. The practice had also developed its own website, alongside the Integrated care Board (ICB) created website. The Mill Medical Portal (website) was designed as an online information hub specifically for the patient community. The website contained health and wellbeing information, links to local support groups and charities, self-referral options, and digital tools such as the NHS App.

The practice had access to interpreter services, including British Sign Language. Information provided by the practice met the Accessible Information Standard. Patients were informed as to how to access their care records.

Results from the National GP patient survey showed that 94% of patients knew what the next step would be within two days of contacting their GP practice (national average 93%). In addition, 96% of patients felt the healthcare professional they saw had all the information they needed about them during their last general practice appointment (national average 92%).

The practice also used a visual aids book for those patients who might have difficulty with verbal communication. These tools were beneficial for a wide range of individuals, including those with language barriers, cognitive impairments, or anxiety, making interactions clearer and more accessible.

The practice made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved patients in decisions about their care and told them what had changed as a result.

The practice held registers for a number of different patient groups, this included those with learning disabilities, mental health problems and also those on end-of-life care. They were regularly reviewed and updated to ensure these patients were supported.

We saw complaints were managed in line with the practice’s policy. Learning from complaints was evident and staff were able to identify changes made as a result of patient feedback, including complaints. All complaints were discussed at the monthly partnership meeting and was a standing agenda item. Themes were also reviewed and any learning from the complaint and any subsequent actions. These meeting were minuted. The practice had a positive approach to receiving feedback and complaints we reviewed showed the practice responded to feedback appropriately, openly and in a non-defensive manner. The practice had completed an audit of complaints received from April 2024 until March 2025. Areas reviewed included staff groups, subject area and themes, any improvements made, and the quality of information recorded in both the responses sent to patients and the minutes from partnership meetings. The audit included learning points and recommendations. For example, after patient feedback regarding staff behaviours the practice arranged conflict resolution training for all staff. This was completed via in-house training in March 2025, as well as on the practice e-learning platform. Staff were aware of their duty of candour and to be open and honest when things went wrong.

The practice routinely asked patients to complete NHS Friends and Family Test (FFT) feedback forms and reviewed the feedback for any trends or themes. Data from the FFT showed that for the month of August, 407 patients had responded, and the practice had received 97% positive comments. This was similar for July (522 patients responded with 97% positive comments), and June (386 patients responded with 97% positive comments).

In the national GP patient survey, 89% of patients who responded felt that during their last appointment, the healthcare professional was very good or fairly good at listening to them. The national average was 87%.

We also noted 95% of patients who responded indicated that during their last appointment they were involved as much as they wanted to be in decisions about their care and treatment. The national average was 91%.

The practice had reflected on results from the 2025 GP Survey and had created an action plan in response. For example, the practice had received a lower score than the previous year for the question relating to ‘healthcare professional (last seen) was good at considering their mental health during the last GP appointment’. In response, this was discussed with all staff for feedback, and the practice organised a visit from a local psychiatrist. This was to improve the understanding of services available and pathways for referral and reinforce the importance of asking about mental health at post-natal checks and at chronic condition disease reviews. Other areas discussed for development was the use of the telephone call back system and a virtual assistant to allow patients to book slots directly over the phone.

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

The practice had a hearing loop. Patients could access appointments online, over the phone and in person. Phone lines were opened at 8am and any patients attending in person to the practice to book appointments were held in an ordered queue until 8am to ensure they have parity of access to those on the phone or applying online.

The premises was wheelchair accessible, and patients who were seen on the 1st floor could access this by stairs or lift.

Patients could pre-book extended hours appointments at the practice (Monday to Friday 7.30am to 8am and 6pm to 6.30pm). Once a month patients could book Saturday appointments (8.30am to 12.30pm including appointments with a nurse or healthcare assistant). This ensured access for working patients and others who were unable to get to the surgery during normal opening hours.

The practice offered a range of appointments. These included emergency on the day, pre-bookable and clinics for conditions such as diabetes or asthma reviews. The provider maintained registers of patients with protected characteristics and informed them of additional services available for them.

Weekly, twice weekly, or monthly visits were conducted to residential and nursing homes caring for frail elderly patients, homes specialising in dementia care and for young adults with neurodegenerative disease. The visiting GP was familiar with the residents and provided continuity of care.

Leaders regularly monitored, audited and evaluated access to appointments. Appointment numbers were reviewed weekly and 5 weeks in advance to ensure that there were sufficient appointments slots each working day in relation to historic demand. On days when the practice was below the number of GPs required, adjustments were made, including changes to outside commitments or by securing additional sessions from partners, salaried GPs or locums.

Staff had worked to improve access to the service by promoting the usage of the NHS App. The practice also had a member of staff who was an NHS App ambassador that champion the NHS App and provided guidance and support for patients.

Results from the National GP Patient Survey were extremely positive in regard to contacting and accessing the surgery:

61% of patients found it easy to get through to this GP practice by phone, this was above the national average of 53%.

65% of patients found it easy to contact this GP practice using their website which was also above the national average of 41%.

72% of patients found it easy to contact this practice using the NHS App, again this was above the national average of 49%.

64% of patients were offered a choice of time or day when they last tried to make a general practice appointment. This was above the 58% local average and 54% national average.

81% of patients described their experience of contacting their GP practice as ‘Good’ which was above the national average of 70%.

83% of patients felt they waited the correct amount of time, compared with the national average 67%.

Staff and leaders actively listened to information about patients 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 patients using the practice, both to the provider as well as to CQC, was positive. Staff treated patients equally and without discrimination. Leaders proactively sought ways to address any barriers to improving patients’ experience and worked with local organisations, including within the voluntary sector, to address any local health inequalities. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in patients’ experience and outcomes. The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people.

Systems and processes were in place to assist in identifying patients who may need extra support. This included alerts on patients records to show what support they needed with communication such as interpreters.

The practice was responsive to the needs of older patients and offered home visits and urgent appointments for those with enhanced needs and complex medical issues.

The practice liaised regularly with community services to discuss and manage the needs of patients with complex medical issues.

We noted 86% of patients who responded to the patient survey described their overall experience of the practice as good. The national average was 75%.

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.

Our records review showed patients were supported to consider their wishes for their end-of-life care, including decisions on cardiopulmonary resuscitation. This information was shared with other services when necessary.

The practice used the Marie Curie Daffodil Standards to improve end-of-life care for patients. The standards consist of eight core domains that cover aspects like early identification of need, planning and delivering personalised care, and providing support to carers and families after death. The practice had conducted quarterly retrospective audit of deaths. The audit reviewed areas such as if the patient was on the palliative care list, if they had achieved their preferred place of death, and if a ReSPECT form was in place. A ReSPECT form isa Recommended Summary Plan for Emergency Care and Treatment that outlines personalised recommendations for a person's clinical care in an emergency where they cannot speak for themselves. Findings of the audit were reviewed by the practice and actions put in place to drive improvements. The practice had been recognised in the 2025 RCGP (The Royal College of General Practitioners) and Marie Curie Daffodil Standards Awards and had received two national awards. Finalists for GP Practice of the Year and Highly Commended Non-Clinical Team Member of the Year.

The practice fully engaged in regular, well attended multi-disciplinary team meetings to assess and support patients in reaching decisions about their end-of-life care. This identified that patients’ views had been sought and respected. Minutes of these meetings were recorded, saved, and shared with relevant agencies. We were assured that safeguards were in place to ensure that decisions were made which were in the person’s best interest. When patients did not have mental capacity to make their own decisions regarding end-of-life care, family members and carers were involved in decision making.