The Wall House Surgery

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 the service met people’s needs, and staff treated people equally and without discrimination. At our last assessment, we rated this key question as good. At this assessment, 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.

We did not look at Person-centred Care during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Listening to and involving people during this assessment. The score for this quality statement is based on the previous rating for Responsive.

The service was exceptional at ensuring people could access the care, support and treatment they needed when they needed it.

People could access the service when they needed it in a way that suited their needs, such as by telephone, in person or through the service’s website. The service performed very close to the national average in the results of the 2025 National GP Patient Survey question about whether respondents overall experience of contacting this service was positive with 68.6% agreeing compared to a national average of 69.6%. This result had not been expected by the service based on feedback it had received and in response the service completed its own survey with more targeted questions. 1,453 people were selected and the response rate was 46% (666 people) and the results showed 89% of respondents had been able to access healthcare when they needed it and 80% felt they had a choice of time or day for their appointment. The survey also explored what the service could do to give better patient choice and experiences for people of using online requests on the website or the NHS app.

The service had also surveyed people regarding making changes to their extended access provision and in response to feedback from people who used the service, staff had made changes to improve access. This included earlier appointments before work or education, increased choice of weekday appointments, more GP appointments, more availability on Saturdays and care being provided at the service’s own premises instead of at other locations. Before changes were made an Equality Impact Assessment had been completed to assess the impact of proposed changes. We also found the service was aware that public transport links for people living in an area with higher deprivation were not as good as for others. The changes made reduced the burden of travel and the service had also sought funding to trial offering taxi vouchers to ensure everyone had equal opportunities to attend the service in person for care and treatment.

We also saw evidence that the service had identified 458 high frequency patients. People included in this category had received targeted interventions, continuity of care and proactive reviews with the outcome being a reduction in avoidable demand and improved patient outcomes. According to data we reviewed which was not verified, there was also positive impact on other services in the area including a 21.2% reduction in AE attendance and 36.5% reduction in emergency admissions.

The service had 83% of people registered to use the NHS app which was higher than the local and national averages of 65% and 56% (in 2024). The patient participation group (PPG) had supported this initiative by supporting pupils from a local school to complete their volunteering requirement in their Duke of Edinburgh award. The pupils had attended the service and offered face to face tutorials on how to use the NHS app. The benefit for people was that it ensured access to service and empowered them to use the app and in doing so reduced demand on the telephone lines for people who could not use digital access. There was also a benefit for the pupils who gained skills in communication and an insight into careers in healthcare.

The service also shared the results of a survey of vulnerable patients with COPD, Serious Mental Illness and Learning Disabilities who had been reviewed by a care coordinator in the last 12 months to ensure equality of access. 203 patients were reviewed and the responses to the survey were that 95% of people said their care had improved, 95% said the review made access easier for them, 98% had received additional support where needed. 90% of people had reasonable adjustments made. The outcomes were that people had preferred communication methods adapted, families and carers were involved when appropriate, barriers were reduced for patients with complex needs and everyone had equitable access to high-quality care.

Treatment rooms were available on the ground and first floors and were accessible by lift with disabled toilets on both floors. Baby changing facilities were also available. A ramp and automatic door had been fitted to the entrance to ensure ease of access to the service.

Staff and leaders were innovative in how they listened to information about people who were most likely to experience inequality in experience or outcomes. They actively used this information to provide exceptionally tailored care, support and treatment.

Staff treated people equally and without discrimination. Leaders proactively sought ways to address any barriers to improving people’s experience and worked with local services and stakeholders, to address any local health inequalities. For example, the service had identified there was nationwide inequality in menopause care. People were having to travel for care and treatment and told the service they wanted good quality care, closer to home. GPs were also finding it hard to find trainers to complete qualifications in menopause care and the service’s own team reported low confidence in menopause management. In response, the service supported a GP partner to complete an advanced qualification in menopause management and to become a trainer. The service then developed its own menopause training scheme which allowed a specialist menopause clinic to be started for its own patients with longer appointments than would normally be available. This also ensured complex cases can be managed at the service without the need for external referral. The service held a patient information evening for people registered with their service and deliberately prioritised the first appointments for people living in more deprived areas to promote equality in access, experience and outcomes. Flexible appointment times were offered to remove any barriers to care for working people, carers and those unable to travel. Patient feedback shown to us by the service showed 93.8% of people were satisfied overall with their menopause care.

As well as improving the care for their own patients the service told us they worked with the NHS Federation to set up a Surrey wide NHS menopause clinic for all Surrey practices with shorter waiting times of between 2 and 8 weeks (previously 18 months). So far 13 trainees had completed the training qualification through the service with 18 staff actively training, 12 on the waiting list and 2 further menopause trainers created from this programme.

We also found the service had employed a trainee nurse associate because it had identified a group of patients that it was concerned were at risk of receiving inequality in experience and outcomes. These were housebound patients living with chronic diseases and long-term conditions who did not meet the criteria for care from the District Nursing service. In response the service had employed a nurse associate 3 days per week to work in their community and complete home visits. The service had found significant benefits resulted and not only for health management. For example, they had found patients with Chronic Obstructive Pulmonary Disease (COPD) experiencing exacerbations of their condition, but they had not told the service they smoked. With this information, care could be changed, managed and improved for these people. They had also found people living in deprivation, for example without food, and had referred them to foodbanks, charities and community support.

Staff followed processes to ensure people could register at the service, including those in vulnerable circumstances such as homeless people. We heard how the service supported its homeless patients by ensuring reasonable adjustments were made so they had access to primary care in a way that met their needs, such as prioritising appointments and being flexible with appointment times in recognition of their circumstances. Also, we were told referral letters included relevant information such as ‘this person does not always have access to electricity so please continue trying to reach them because their mobile phone may not have been charged’.

We also heard how reasonable adjustments were offered to people with a learning disability and autism. This included offering earlier appointments so people could wait in a less crowded waiting room or allowing them to wait in the car and be called in once the clinician was ready to consult with them. We also heard there were plans to develop an outdoor waiting area to better support people with sensory needs. This would provide a more private and comfortable space for people to prepare for, or process, difficult diagnosis and information before returning to their family, friends or carers.

We also found that the service made adjustments for people that misused substances or alcohol. This was done by trying not to call them at times when they were likely to be intoxicated or under the influence of substances because this risked a negative interaction which could lead to a zero-tolerance letter or potentially removal of the practice. Instead, they tried to work with people to understand their needs and how best to meet them.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.