Practice Plus Group - Devon OOH/CAS

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 were knowledgeable and supportive, helping staff develop in their roles'

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. However, feedback we received from staff and from the providers survey showed that not all staff considered they had been involved in developing the strategy.

Results from the survey of staff who worked in OOH showed that staff were satisfied with health and safety arrangements and the majority considered they received management support. There were mixed views on the effectiveness of the rota.

Some concerns were raised about lone working and rota capacity. All respondents said they had the necessary equipment to carry out their role and were satisfied with induction and training provided. There were comments that senior leaders were not always visible, which aligned with comments were received from our staff questionnaires.

Staff also considered that the service had evolved and developed to meet people’s needs and morale and culture were improving. This was in line with comments we received from staff.

Staff interviewed expressed enjoyment in their roles and valued the collaborative environment. Regular meetings were held to share updates and promote open communication across the service.

Staff described a friendly and supportive culture, with strong teamwork and a positive working environment. There were systems and processes to support staff in professional development, but not all staff considered they were provided with these opportunities as reflected in the service’s staff survey.

An annual all staff survey was carried out between September and October 2025 by the provider. There was an 78% response rate, up by 1% from the previous year. The top 3 positive findings included that staff would feel able to report bullying or harassment (89%); Practice Plus Group embracing diversity (89%); and within a member of staff’s area of work there was enough attention to risk management (89%).

The bottom 3 negative findings were related to positive change being made as a result of patient satisfaction survey results (44%); staff having sufficient input into decisions that affected them (49%); and support to achieve career aspirations (49%).

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 survey results from the annual staff survey were positive about staff’s line managers. For example, 82% of respondents said that their line manager allowed them to make their own decisions; and 78% considered they received feedback to improve their performance.

However, 44% of respondents considered they had input into work related decisions which affected them. (13 percentage points down from 2024.)

Results from the provider’s staff survey were mixed on leadership. For example, 65% of respondents had confidence in the leadership provided by the executive team, (down 2 percentage points from 2024); 54% considered senior management were visible (no change from 2024). A total of 65% of respondents considered the executive team had clear set goals and objectives (down 7 percentage points from 2024). A total of 58% of respondents (down 5 percentage points from 2024) considered that teams worked together to achieve goals and objectives.

The provider had developed an action plan to work on areas which required improvement.

Staff interviewed reported that they felt leaders treated them with care and compassion. Support for staff was provided through regular appraisals, check ins and open communication via meetings, messaging systems and emails.

Staff described a strong team culture, feeling respected, valued, and inspired by the leadership team.; and considered the network of peers within team and local operations was strong.

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

The Freedom to Speak Up Guardian had received appropriate training to carry out their role. Staff could report concerns anonymously if they were concerned about being identified. Members of staff had been trained as freedom to speak up champions and wellness champions to support staffs’ wellbeing and enable them to raise any concerns or issues.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Policies and procedures to promote diversity and equality were in place. We saw senior leaders had addressed concerns related to discrimination. Adjustments had been made to ensure all staff were valued, for example we saw adjustments to support disabled staff were in place.

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.

Leaders and managers supported staff, and staff we spoke with were clear on their individual roles and responsibilities. Managers met with staff regularly to complete appraisals and performance reviews. Staff could access all required policies and procedures. The provider had established governance processes that were appropriate for their service.

The service carried out a range of audits of service provision. This included clinical and operational work, staff had regular audits of telephone consultations and face to face contacts. Audit tools and timings were in line with relevant guidance.

Another audit was carried out using end to end case reviews to assess service provision; and audits were carried out in response to significant events and complaints.

Audits carried out were reported on in monthly quality assurance meetings to ensure management teams had oversight. When needed additional training and support were provided to address any shortfalls.

Teaching sessions focused on areas which affected service provision, such as updates on sepsis; safety alerts; and care and treatment. The sessions were held regularly and at set times to allow staff to make plans to attend. Staff received certificates following attendance at these sessions which supported appraisal preparation and evidence of continued professional development. All teaching sessions provided an opportunity for case discussion and supervision.

A range of meetings were held for clinicians bi-monthly which focused on case-based discussions gathered from interesting cases across all services the provider was registered to provide. The meetings were recorded for staff who were unable attend in person.

There was a corporate Health Care Divisions Governance, Risk and Compliance Committee who monitored aspects of service performance, such as incident, complaints and supervision of staff. The committee also looked at staffing levels, recruitment and retention, and staff absence.

There was a business continuity policy in place. When we reviewed this, we found that it did not detail that the Care Quality Commission should be contacted in the event of an interruption to service provision.

Managers had access to an incident response plan, which detailed actions to take dependant on the situation. There was a clear command and control structure in place and leaders implemented effective internal process for managing incidents with internal network support and local manual business continuity protocols

End to end person reviews and audits were carried out in response to significant events and complaints. Systems and processes were in place which supported service provision. These included regular service performance reports; clinic audits; and medicines management audits.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They shared information and learning with partners and collaborate for improvement.

The provider worked with other practices within their primary care network to offer extended access, and a flu outbreak support service. The service worked with the local ambulance service under an agreement to ensure when an ambulance was required it was the most appropriate response for the person.

The service was transparent, collaborative and open with stakeholders about performance: monthly meetings were held with commissioners to report on performance.

The service 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.

Staff were supported to develop in their roles and take on new responsibilities. Learning needs were discussed in team meetings and identified in annual appraisals. The service encouraged professional development and career progression.

Examples of learning included having a lead clinician responsible for overseeing end of life care; the roll out and use of electronic treatment escalation plans contained within in local care summary records. Also, the service worked with local AE services to enable them to refer appropriate cases to the out of hours service to be seen.

There was also an unscheduled care coordination service which had been introduced in November 2024 with the aim of ensuring that all ambulance requests to take a person to an acute hospital were clinically indicated and whether their needs could be safely met in other settings such as at out of hours bases or via use of urgent community response teams.