Tieve Tara Medical Centre

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• 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

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

At our last assessment, we rated this key question as requires improvement. At this assessment, the rating has changed to 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.

We spoke with, or received written feedback from, staff as part of our assessment process. When discussing the culture and direction of the practice this feedback was mostly positive. Staff whilst not directly involved in developing the practice’s vision and values showed a very good understanding of the overall ethos of the provider and sought to provide the best care possible to their patient population. However, some feedback from staff noted that at times staffing and ongoing transformational changes had had, or continued to have, a negative impact on the service. In addition, some staff comments indicated that they felt that communication from managers with them could be improved upon regarding operational changes. Managers and leaders told us that they felt that these changes were essential to the long-term future and sustainability of the service, and had put in place governance measures to manage these changes. Though they recognised that more staff and patient communication was required moving forward.

Operationally the planning to deliver the practice’s vision and strategic aims was detailed within the practice’s new business plan. This included key work areas such as financial stability, equitable patient access, workforce management and capacity and the attainment of high-quality clinical care. When discussing the transformation work and quality improvement, leaders and managers showed that they had a good understanding of the needs of their local population, and the challenges they faced delivering services against these needs.

Overall, we saw that the service had inclusive leaders and managers at all levels who clearly understood the context in which they delivered care, treatment and support. Leaders and managers had the skills, knowledge, experience and credibility to lead effectively, and we saw they did so with openness and honesty.

From staff interviews and questionnaire feedback we saw that in the majority of instances staff felt leaders and managers were approachable, supportive and friendly. Managers told us that they felt that they in turn were approachable, and had an open-door policy to encourage staff to contact them if they had concerns or needed additional support. Leaders also said they dedicated time to meet with staff either formally, or informally such as over break periods.

We saw the management team worked with other practices in the primary care network and were engaged in the development of primary care services within the local area.

The service fostered a positive culture where patients felt they could speak up, and their voice would be heard. The practice had put into place freedom to speak up arrangements, and staff we spoke with or received written feedback from knew how and who to contact if they had a concern that they wished to discuss with them. However, it was noted that some staff felt that concerns may not always be fully addressed if they raised them, although others felt that their concerns would be looked into and had more confidence in the process.

There was a freedom to speak up policy, and processes were in place in respect to the duty of candour. On a review of complaints and significant events raised within the practice we saw that the duty of candour had been applied when discussing issues with patients.

Managers told us that they had an open-door approach which allowed staff to raise concerns with them directly, and this was corroborated by feedback we received from staff. The majority of staff told us that they felt that leaders and managers were approachable and supportive.

We saw evidence which showed that the practice valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

We saw that there were key policies and procedures in place to promote diversity, equality, and the protection of staff. This included a zero tolerance policy and grievance, speaking up, and whistleblowing procedures.

Staff were able to discuss their careers and any concerns or opportunities at regular appraisals and less formal one-to-ones and ad hoc meetings. The practice was seen to be supportive of training and staff development. For example, we saw that staff had been given additional training and opportunities to gain experience in other areas of work within the practice which added capacity and supported succession planning.

The provider had recently undertaken a staff survey. This showed that staff were motivated, had a clear understanding of their roles and responsibilities, and valued team relationships. Overall, the majority of staff appeared to be satisfied working at the practice. However, they also told the provider that they felt that the practice needed additional capacity to help deliver services and balance workloads. They also said that they wanted development opportunities, and a stronger voice in the ongoing transformational changes that the practice was undergoing. The provider told us that it was working on this feedback. For example, recruitment was underway for additional GP capacity, and at the time of the assessment 4 GPs had been recruited, and an additional post was looking to be filled.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment and support. The practice acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate. The provider had a good understanding of the challenges they faced operating the practice and was working to tackle these.

At the last assessment of the service in 2024, we found significant concerns in relation to governance, management and sustainability, which included limited organisational oversight of training, not taking actions to manage premises safety, a failure to fully action past medicines concerns, and a lack of a business plan. In light of these issues the provider was found to be in breach of Regulation 17 Good governance.

At this assessment we saw that the provider had made significant improvements to their management and governance processes and practices. A transformation team and board was established in 2025 which focused on developing the practice in a number of key work areas. These included workstreams such as workforce, operations, estates and clinical governance. Meetings were held weekly to drive forward quality improvement, and performance and the implementation of new ways of working were closely monitored. Actions, developments and achievements had included the recruitment of substantive GPs, thus reducing the reliance on locum services, ongoing work into demand and capacity management, and improved oversight processes. In relation to past concerns we saw that training was being monitored and progress was being reported on a regular basis, correspondence backlogs had been tackled, estates issues had been actioned and managed, and key performance areas had shown improvement. To give direction a business plan had also been developed for the practice.

The provider told us that it was important that staff were brought on board the transformation work, as well as routine changes to operational practice, and that change needed to be planned and supported. Whilst we saw that meetings and communication channels were available and used, some staff still felt that communication could be improved and felt that their views could be better heard.

The provider leadership and management team had developed a detailed and comprehensive management structure which covered all areas of service delivery. In addition to clinical duties staff had lead roles across the organisation such as safeguarding and performance. This structure was supported by performance monitoring and quality assurance processes. Managers held regular practice meetings, during which they discussed clinical concerns and emerging risks. Though we saw that some meetings had been suspended in the recent past, but had been reinstated at the time of our assessment.

The service understood their duty to collaborate and work in partnership with others, so services worked seamlessly for people. They shared information and learning with partners, and collaborated to achieve improved services and outcomes for patients. For example, we saw that the provider hosted and coordinated work with their local primary care network, and also with Spectrum People, a local Wakefield-based charity which provider therapeutic and arts-based services, as well as social prescribing support to the patient population.

In addition, we heard that the provider met and worked regularly with a range of stakeholders and partners which included those involved in palliative care and safeguarding.

Feedback from staff was very focused on their desire to meet the health and care needs of patients. Staff from the practice held or attended social and community events to promote and publicise health issues, and to encourage uptake in health improvement programmes.

The practice had a vibrant patient participation group (PPG). When we spoke with a member of the PPG they told us that they felt well supported by the practice, and found them responsive to suggestions made to them regarding improvements and future developments.

The service had a focus on continuous learning, innovation and improvement across the organisation and the local health and care system. They frequently encouraged different ways of delivering equality of experience, outcome and quality of life for patients.

The practice had a programme of quality improvement activities which included clinical and non-clinical audits, clinical supervision, and regular searches of the clinical system to ensure compliance with best practice principles. The practice also had performance monitoring processes in place, and used this to identify areas for service improvement. For example, we saw evidence that actions had been taken to increase performance in areas such as cervical screening, hypertension and diabetes care.

This approach to improvement was in addition to learning from significant events, near misses, complaints, and feedback from patient surveys and their patient participation group.