The surgery has, undoubtably, been tidied up. In general terms the impression, for me, is that the business has benefitted from a lot of investment. However, today the entrance stairs needed at least vacuuming if not a good clean; there are marks on the walls where the handrail is fixed (perhaps artistic endeavour). I was addressed by a polite young man at the reception desk by my first name despite my having made my preference to be called by my title and surname (Mrs Swainson). That omission of good manners does not upset me but does show a disregard of clients preferences. I was kept waiting for almost ten minutes for my appointment even though “George” did not have a client with him. No explanation, or apology, was given to me. A female member of staff passed through the waiting room several times but did not have the courtesy to say “good morning”. On leaving my appointment I gave the young man some feedback about keeping clients informed which he accepted and thanked me for.