York Street Health Practice

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

Leaders and staff had a shared vision and culture based on learning, transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of the population.

Leaders promoted diversity in the workforce, the provider actively supported people who had used the service into volunteering and full-time paid roles within the organisation.

Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Leaders recognised, acknowledged and rewarded the value and input of the whole practice team.

Staff understood their roles and responsibilities and demonstrated a clear commitment to providing good quality healthcare for vulnerable groups.

Staff worked collaboratively with other services including secondary care, community services and voluntary groups to achieve the best possible outcomes for patients. There was a culture of continuous improvement with staff given time and resources to develop.

This service scored 86 (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.

Staff had a good understanding of the needs of patients and people who use the service. It was clear from conversations that access to healthcare for vulnerable groups was the driving force behind the service and all staff demonstrated a genuine commitment to supporting this.

All the staff we spoke with and received feedback from were positive about working at the practice. Words used to describe the service included ‘welcoming, respectful and a safe space for everyone, staff and patients alike’.

Leaders explained how they valued and supported staff with opportunities such as leadership development plans and coaching and mentoring frameworks.

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 in the practice was approachable and responded to any concerns raised. Examples provided included feeding back to staff when anything positive had happened and checking in on staff if they were having a bad day. We heard how staff could access in-house therapy with a member of the leadership team who was also a mental health nurse.

We saw the leadership team worked with other stakeholders to develop and promote health and social care service for people who used the service.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

The practice had a Freedom to Speak Up and Whistleblowing policy which clearly outlined the process for escalating concerns. We saw there were systems in place to ensure all staff had sight of the policy. For example, posters were displayed within the premises, and the policy had been highlighted in the staff newsletter in which staff were signposted to the full policy.

Staff could raise concerns internally and had access to an external Freedom to Speak Up Guardian which had been arranged via a local GP practice. All of the staff we spoke with and received feedback from were aware of how to raise concerns.

The service strongly valued diversity in their workforce. They had an inclusive and fair culture which had improved equality and equity for people who work for them.

Policies and procedures to promote diversity and equality were in place. A dedicated equality, diversity and inclusion network had been formed by 2 staff members to support improvement across the organisation which included celebrating equality, diversity and inclusion and input into policy development and implementation.

Adjustments had been made to ensure all staff were valued. We saw adjustments had been made to support staff. For example, easy read versions the Freedom to Speak Up and Whistleblowing Policy were available, along with visual aids to ensure accessibility for staff with learning disabilities or those who benefit from simplified language.

We saw senior leaders proactively supported diversity in the workforce. For example, we were able to view the website which contained evidence of service users being supported into paid roles within the organisation via volunteering roles in which they had then been supported to develop.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

There was a comprehensive risk register in place which clearly outlined controls to prevent and mitigate risk.

Leaders and managers supported staff, and all staff we spoke with were clear on their individual roles and responsibilities. The provider had established governance processes that were appropriate for their service. Staff could access all required policies and procedures. Managers held regular practice meetings with staff, during which they discussed clinical concerns and emerging risks. Managers clearly recorded any actions arising from these meetings and ensured they shared these with staff. Staff took patient confidentiality and information security seriously.

The practice understood and carried out their duty to collaborate and work in partnership, and services worked seamlessly together to support people. They always shared information and learning with partners and collaborated to achieve improved services and outcomes for patients. For example, providing a weekly drop in at a local homeless shelter to support people experiencing homelessness, working alongside the local drug and alcohol service, housing and benefits advice teams, optical and dental care services.

The practice worked with other organisations to offer a variety of services including women’s safe space, Hospital In-Reach Team and hosting drug and alcohol services via Forward Leeds.

The practice hosted services in conjunction with their Primary Care Network (PCN), this included social prescribing and physiotherapy services.

The practice focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

We saw evidence of learning from a number of sources including clinical and non-clinical audit activity, learning from complaints and learning events, and reflective learning as a result of interactions with patients and people who use the service.

The provider proactively piloted new ways of working to address and reduce health inequalities. For example, the provider had piloted cancer pathway safety-netting to actively manage patients referred for urgent cancer referral who were likely not to attend their secondary care appointment. A template was designed on the clinical system to support safety-netting and a multidisciplinary team worked together to understand individual barriers to access and create a plan to reduce the likelihood of missing an appointment with secondary care. The pilot supported 44 patients over a 10-month period and resulted in 72 appointments being attended.

At the time of our inspection the provider was developing a proposed accreditation framework for inclusion, ‘The Bevan Badge’. This work was in conjunction with people who use the service and experts by experience. The aim of the accreditation was to encourage health, social care and education service to deliver system wide change.