Committed
to Quality
Our work in service redesign, clinical innovation, research, and patient feedback — evidence of what is possible in general practice at scale.
At Barclay Medical Practice, our vision is to deliver the best of modern primary care through strong local teams supported by the scale and resilience of a wider organisation. We believe this model improves access, strengthens continuity of care, and supports sustainable general practice for the future.
Quality remains central to everything we do. All of our practices are postgraduate and undergraduate training practices, helping develop the next generation of doctors while fostering a culture of learning and continuous improvement.
We are committed to listening to patients, reviewing our services, and continually improving the quality of care we provide. Below are examples of recent patient feedback, quality measures, and improvement work taking place across our practices.
Prescribing in general practice is high volume, variable, and poorly governed under traditional models. We undertook a system-wide redesign, establishing centralised prescription hubs operating on a mono-tasking model across our federated group of 14 practices.
Two centralised prescription hubs were established, each serving populations of around 30,000 patients. Each hub consists of GPs, pharmacists, and a trained administrative team working in a co-located environment with dedicated clinical sessions for prescription processing only.
All prescription requests were centralised through a single electronic workflow. Routine telephone requests were discontinued. Standardised medication intervals were introduced to enable coordinated, population-level review.
Serial prescribing rates rose from 9% to 22% at Hub A and from 1% to 8% at Hub B, reducing repeat requests significantly. We also completed 240 HRT reviews using asynchronous patient-completed questionnaires, achieving a 46% response rate — with most patients simply texted to confirm approval for a further year. This population-level approach is now being extended to other medication groups.
A survey of 23 clinicians found that 79% said the hubs had significantly reduced their workload, and 53% said it had transformed their workload entirely. 90% reported improved prescribing quality, and 90% would recommend the model to other practices.
A predominantly telephone-based appointment model was creating duplication, dissatisfaction, and administrative friction. We redesigned appointment allocation around a highly flexible template, submitted as an abstract to the RCGP Annual Conference 2026.
Only 4.5% of telephone consultations required conversion to face-to-face — demonstrating that, with the right navigation at first contact, the right consultation type can be matched to patient need without duplication or safety compromise. Clinicians reported that appropriate teleconsults helped workload, while prompt in-person appointments for the right indications improved the completeness of care.
We moved away from a birthday-month recall model to a disease-based system for chronic disease management — concentrating on one condition group at a time to deliver more structured, specialised care. Three sites have run formal QI projects under the Lothian Quality framework, each with measurable improvements.
Baseline attendance under birthday-month recall was 80%. Following the switch to a disease-based system and introducing a second invite to non-responders at 6 weeks, attendance rose to 92.5%. This also enabled identification of common barriers to attendance, leading to additional changes including targeted invites, Saturday HCA clinics, and a multilingual website.
ACR (albumin-to-creatinine ratio) completion in diabetic patients improved from 47.5% in November 2024 to 61.2% by June 2025 following the move to a disease-based recall system and introduction of a second invite. Further work includes setting up urine sample collection from a satellite location to improve compliance in outlying areas.
Extending diabetic review appointments from 20 to 30 minutes allowed healthcare assistants adequate time to complete foot checks. Foot check completion improved progressively from 62.8% in April 2025 to 71.4% by November 2025, with a clear upward trend across all four measurement points.
Access to long-acting reversible contraception in Scotland was severely restricted following the COVID-19 pandemic. Waiting times in our Lothian practices had extended to approximately five months. We designed Barclay Plus — a primary care–led LARC hub integrating primary and secondary care clinicians — to address this gap at population level.
A multidisciplinary workforce was recruited from both primary and secondary care — doctors, advanced nurse practitioners, sexual health practitioners, and practice nurses — employed on a sessional locum basis. Clinics are delivered across two sites on weekdays and weekends, open to all women registered with a GP in Lothian. A dedicated website enables self-referral, self-booking, and automated appointment reminders.
The service reduced pressure on both general practice and sexual health services across the health board. It improved access to contraception, treatment for heavy menstrual bleeding, and HRT support — and enabled timely implant removal for reproductive planning. Income is fully reinvested into the service and staff.
"Went to the coil clinic — fantastic and fast service. Really convenient considering how difficult it is to get an appointment for contraception in the Edinburgh area."
"Really excellent Saturday IUD clinic. Specialist doctor, not at all rushed and happy to spend time in detailed discussion. Nurse present throughout and thoroughly professional. Actual procedure quick and almost painless. Genuinely, this was my best so far, by a country mile."
Musculoskeletal conditions account for up to a third of primary care consultations. Poor management leads to repeated appointments, high secondary care referral rates, and an inability to promote physical activity. We introduced a dedicated Sport and Exercise Medicine clinic and a new pain service to address this directly.
A weekly SEM clinic was embedded into a cluster of our GP practices, delivered by a SEM registrar and overseen by a GP partner. Over a 10-week period, 104 patients were reviewed. The clinic was designed to resolve MSK issues at first contact, promote physical activity, and reduce secondary care referrals.
82% of patients felt ready to make a lifestyle change following their appointment. 96% were very satisfied. 92% rated care as much better than previous experiences. 98% would recommend the service. Clinic utilisation rose from 56% to 100% over six weeks, while average wait time fell from 3.1 to 2.1 days.
We have also introduced a dedicated pain service within the practice, taking an evidence-based approach to MSK and chronic pain management. This service focuses on short-term use of analgesia for acute conditions, evidence-based alternatives for chronic pain, and active support for patients to manage their conditions through structured rehabilitation and physical activity — reducing dependency on long-term medication.
We recognised early that many GP digital systems were poorly integrated, triage-heavy, and created complexity for both patients and staff. Rather than adopting bolt-on solutions, we designed and implemented our own GP front-door system — built around patient choice, not mandatory triage.
The system replaces the traditional practice website while meeting all NHS requirements. It functions as a patient portal and app-style access point. Patients can select services, book appointments in advance, and submit online requests. Requests can be clinically reviewed and redirected without creating parallel workflows for staff. Fully integrated telephony allows text links to be sent to patients before or during contact.
We surveyed patients directly about the new digital access tool. 1,307 responses were received, with an average ease-of-use rating of 4.31/5 and an overall experience rating of 4.21/5. Approximately 30% of all patient contacts are now managed digitally, without excluding those who prefer telephone or in-person contact.
Download ReportWe reorganised medical reviews using text invites, online booking, and text follow-ups. 236 patients were surveyed specifically about the new heart health review appointment system. The average rating was 4.68/5 — among the highest scores we have recorded for any service change.
We carry out structured patient feedback surveys across all divisions and following specific service changes. Results are reviewed regularly and used to drive improvement. Below is a summary of our most recent divisional feedback across 1,450 responses.
We also surveyed patients specifically about our new direct booking service. Feedback was gathered alongside the broader digital access survey. Patient responses were consistently positive, with clear preference for being able to book appointments in advance without having to go through a triage step first.
Download ReportQuality care depends on a fulfilled, well-supported team. We survey our GP workforce regularly to understand how people experience working at Barclay — and to ensure we remain a place where excellent clinicians want to build their careers. Our most recent survey of 28 GPs, conducted in May 2026, reflects a team that is proud of what has been built and optimistic about what comes next.
We asked our GPs to share their thoughts on working at Barclay in their own words.
"The ethos of Barclay has been refreshing and revolutionary in the world of general practice."
"Barclay is a great team to work for. So much has been achieved in the past few years. We have such a positive outlook on the future of primary care and have a huge opportunity to shape that."
"I find Barclay excellent to work for and recommend the practice to peers as a place to work. I feel the team is welcoming and supportive and feel positive and excited about opportunities for career progression."
"Although Barclay is a big practice, each site retains a small team feel."
"Great ethos at work — help is always at hand. Things have improved significantly for us since the merge. Thank you."
"Continue to build a positive, supportive work environment — great colleagues and a shared goal to do the right thing by our patients."
"Nothing but positives for me. Happy, relaxed work environment."
"Amazing place to work — thank you."
We are committed to sharing what we learn. Our quality improvement work is written up, submitted for peer review, and presented at national conferences. We believe that evidence from real-world general practice at scale is valuable to the wider system.
If you are interested in any of our projects, would like to discuss replication in your own practice, or are interested in collaborative research, we would welcome the conversation. We are also open to sharing our GP front-door system, IT solutions, and service redesign frameworks with other practices.