Bridport Medical Centre

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led - We looked for evidence that service leadership and management assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last inspection, this key question was rated Good. At this assessment, the rating has remained Good.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities. All staff had contributed to the development of the service’s vision and strategy, which was kept under review. The service was aware of the projected increase in the local population and was working to address challenges to accessing care, such as developing the two branch sites, Maiden Newton Practice and Tunnel Road Practice. There were clear, established and effective systems and processes in place for leaders to share their vision, experience and support with colleagues.

Staff told us there was a positive team culture and they felt supported by GPs and senior leaders. They told us they were able to contribute to discussions about service improvements, incidents and complaints. All staff we spoke with were proud to work for the service and had a vision to deliver high quality care.

The service’s mission statement and values were available and accessible to staff. Positive learning culture was demonstrated through meeting minutes which showed that performance, incidents, feedback and complaints were routinely discussed.

There were established and effective processes and systems in place for leaders to share their vision, practical experience and support with colleagues. This was achieved formally through governance meetings and clinical discussions.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Staff told us leaders at the service were approachable and responded to any concerns raised. Staff also told us leaders modelled the values of the service. We saw the leadership team worked with external stakeholders and other healthcare services who were engaged in the development of primary care services within the local area. For example, the service worked with the other practices within the Primary Care Network (PCN) and local hospital to improve the collaboration of services provided in relation to respiratory and diabetes care. Through this programme of work, several new clinicians were recruited including a respiratory specialist nurse, a podiatrist, a dietician and a diabetic specialist nurse who supported existing teams in providing an integrated provision. This enabled people to access specialist teams in addition to their general practice care.

The service demonstrated oversight of clinical performance relative to workload and activity through risk rated parameters that were reviewed daily, including tasks related to outstanding results for people, referrals, medicine reviews, and triage requests.

The service fostered a positive culture where people felt they could speak up and their voice would be heard. The service had established Freedom to Speak up arrangements in place as well as a whistleblowing policy.

The service had oversight of themes and trends which included positive outcomes for people, including staff being treated equally. Where constructive feedback trends were identified, leaders told us there were plans in place to review staff wellbeing and these areas were placed on the service’s improvement plan. The service had set up new ways to support staff. For example, there was a forum where staff could share feedback and concerns informally. In addition, there were extra communication channels to share updates about services, learn from experiences, and celebrate positive feedback through staff bulletins.

We reviewed the service’s incident management systems and processes, which demonstrated when something went wrong, people received an honest and timely apology and were told about any actions being taken to prevent the same happening again.

Staff were offered an employee assistance program (EAP) and the service had access to occupational health services where required.

There was a zero-tolerance policy in relation to the abuse of staff with mechanisms in place to protect people and minimise the likelihood of reoccurrence.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality for people who work for them. Policies and procedures to promote diversity and equality were in place. Mechanisms were in place to address concerns relating to discrimination. Adjustments had been made to ensure all staff were valued. For example, we noted there were reasonable adjustments in place to support the risks posed to the health and safety for workplace display screen equipment, ergonomics and movement and handling.

We received 23 staff feedback surveys as part of the inspection. We noted themes which highlighted positive culture that supported staff wellbeing, encouraged professional development and contributed to an inclusive working environment where individuals felt supported to contribute fully to service delivery. We were provided examples of how the service supported staff to carry out their roles effectively, such as implementing new medicine scanner equipment in the dispensaries and additional training and support for healthcare assistants to carry out physical assessments within learning disability reviews.

The service had a range of systems and processes in place to support governance and oversight. Leaders demonstrated a proactive approach to assurance by commissioning additional external health and safety and environmental assessments, beyond statutory requirements, to provide further confidence that risks were being identified and managed appropriately.

The service monitored medicines safety and prescribing through monthly clinical governance meetings, and clinical data was routinely reviewed to identify areas requiring follow up. The service also had a business continuity plan in place to support staff in preparing for and responding to major incidents. Staff demonstrated awareness of how to access policies and procedures and described how working arrangements had previously been adapted in response to identified risks or incidents.

Information governance arrangements were effective. Patient information was stored securely in line with digital security standards and General Data Protection Regulation (GDPR) requirements. Clear information was available to people about how their data was used, consent choices and online safety, through registration materials, privacy notices and the practice website.

However, despite these systems, governance processes were not always fully effective or embedded, and some risks were not consistently tracked through to completion. The service had commissioned enhanced fire and health and safety assessments as part of its wider assurance framework. These inspections identified several high-risk actions, including remedial work relating to an inward opening fire door at Maiden Newton Surgery and the installation of two additional fire exit doors at Tunnel Road Surgery. While these actions arose from proactive, non-mandatory checks, they had not been completed within expected timescales. This highlighted a gap in governance arrangements to ensure that actions identified through enhanced assurance processes were consistently monitored and progressed to completion.

The service undertook additional water testing beyond statutory requirements as part of its environmental assurance approach. This testing identified pseudomonas at one site. The finding was assessed as very low risk, affected only a staff kitchen sink, and all patient facing areas tested negative. The service acted immediately, in line with environmental health advice, and the issue was managed and resolved promptly. The service does have a formal safe water policy and documented risk assessment framework in place to support consistent oversight and routine monitoring.

While medicines safety was reviewed regularly, governance systems were not sufficiently robust to ensure that all actions identified had been completed, particularly for people prescribed medicines for hypertension. Clinical searches showed that some individuals had not received recommended renal function and electrolyte monitoring in line with national guidance. There were also examples of people with raised HbA1c (blood test measuring average blood sugar levels over the past 2-3 months) results without a confirmed diagnosis who required further investigation or coding review.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They shared information and learning with partners including community teams and external stakeholder healthcare providers.

The service worked with other GP practices within their local primary care network to offer extended access appointments, such as for cervical screening, leg ulcer clinics and vaccination programmes. Staff made adjustments to improve coordination with community healthcare services. This included establishing regular multi-disciplinary team meetings. These meetings focused on the care of people at higher risk of hospital admission, as well as those who are frail or vulnerable.

Staff told us they had strong relationships with healthcare professionals within the local community to support care provision and joined-up care. Staff spoke positively about the work that was happening in the local community such as pharmacy services, frailty care and social prescribing. These shared initiatives helped increase service capacity and aimed to improve outcomes for patients with complex or long‑term needs.

The service engaged regularly with its Patient Participation Group (PPG), using feedback to shape service improvements such as appointment messaging, website accessibility, and communications regarding local housing developments impacting healthcare services. Leaders demonstrated awareness of emerging community needs, including population growth linked to new housing developments, and were working with commissioners on future premises planning and demand‑management strategies. This reflected a forward‑looking approach and a commitment to maintaining accessible and sustainable services for the local community.

Partnerships were also established with community voluntary groups, carers’ support services, mental health providers and local authority safeguarding teams.

The service focused on continuous learning, innovation and improvement across the organisation and the wider local health and social care system. They encouraged creative ways of delivering positive outcomes and experiences for people.

Staff were encouraged to participate in training, supervision, competency-based development and protected learning time sessions.

The service had an established programme of quality improvement and used audits to review the effectiveness and appropriateness of the care it provided. There was a clear audit schedule covering both clinical and non‑clinical areas, and findings were shared with staff so that learning and recommendations could be put into practice. The service demonstrated this through its audit on sodium valproate prescribing and monitoring. The aim of the audit was to ensure people prescribed this medicine received appropriate counselling about associated risks, and that this was documented in line with national guidance. This included confirming that women of childbearing potential were enrolled in the Pregnancy Prevention Programme and using effective contraception, and that men were counselled on reproductive risks during treatment and for three months after stopping the medicine. The service identified 19 people who had not been contacted within the previous 12 months. All were subsequently reviewed and received the required counselling or were confirmed as exempt. The service completed further audit cycles as part of its quarterly medicines monitoring processes. Updated prescribing workflows, standard operating procedures and clinical templates supported improvements. Later audit findings showed that all people prescribed sodium valproate had received appropriate monitoring because of these changes.