South Westminster Centre for Health Also known as South Westminster 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

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. This is the first inspection for this service since its registration with CQC. This key question has been rated as Good.

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 very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights and an exceptional understanding of the challenges and the needs of people and their communities.

HCL was led by a board including a managing director and the clinical directors of the four primary care networks in Westminster, two of whom were appointed as the chair and vice-chair of HCL. The leaders stressed the importance of engaging their member GP practices to ensure services provided at the federation level met people’s needs. The service had held an away day at which staff had contributed to the development of the organisation’s vision and strategy. The service was aware of projected changes in the local population and was working with partner agencies and local communities to address current and future challenges.
 

The service had exceptionally inclusive leaders 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 internally and externally. They did so with integrity, openness and honesty.

Staff told us leaders in the service were inspiring to work with but also approachable and responded to any concerns raised. Staff also told us leaders modelled the values of the service. We saw the leadership team understood the power of effective partnership working across the primary care networks and more widely to deliver a more integrated approach to people in the area. Clinicians who delivered clinical services on a sessional basis told us there was good communication with operational managers and they were updated about any changes.
 

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

The service had established Freedom to Speak up arrangements. Staff were aware of how to raise concerns and told us they would feel comfortable about doing so.
 

The service valued diversity in their workforce. They worked towards an inclusive and fair culture for all employees.

Policies and procedures to promote diversity and equality were in place. We saw examples of how adjustments had been made to enable staff to work effectively at the service.
 

The service had clear responsibilities, roles and systems of accountability. However, some governance systems were not always functioning as intended.

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 the service with a clear board structure and a quality and safety committee which met monthly to review risks, relevant updates and identify areas for improvement. Staff could access all required policies and procedures. Sessional staff additionally had access to key information (for example, the safeguarding leads) in a summary sheet at each location. However, we identified gaps in the system for incident reporting as a relevant incident had been resolved locally and not reported upwards to identify and share learning. We also found that while relevant national patient safety alerts were identified and shared with clinicians, the associated guidelines were not always being implemented consistently. There was weak central oversight of required training completion although the managers were in the process of rectifying this at the time of the assessment.
 

The service clearly understood and carried out their duty to collaborate and work in partnership to provide seamless and consistent service delivery for people across Westminster. They always shared information and learning with partners and collaborated for improvement.

The provider worked with member practices strategically and operationally across the four primary care networks to deliver services, for example, through provision of the access hubs, flu and covid vaccination programmes. HCL continued to engage with a wide range of partner organisations (including primary, community and hospital providers, health commissioners, the local authority, public health and education providers and local voluntary organisations) to coordinate work to tackle health inequalities and outcomes by adopting a community-led model of working. Participants we spoke with described HCL and its leaders as playing a major role in driving this programme.
 

The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.

The organisation monitored its performance and carried out regular audits of clinical records. Staff in the additional and enhanced access service told us they understood this was being carried out but they did not receive individual-level feedback unless there was an issue. The dermatology consultant audited the cases triaged to the diagnostic clinic and other dermatology audits included an audit of referrals for lower-grade cancers. As a relatively new service there remained scope to expand the use of 2-cycle clinical audit across some of HCL’s services, for example, to review prescribing patterns in the extended and additional access services. The service could demonstrate how it used complaints, incidents and feedback to improve although we found one relevant incident that had not been reported.

The leaders were passionate about improving health outcomes across Westminster. They had researched international interventions and were engaged in research and evaluation to understand the impact of the community-led work that was being piloted in parts of the borough (as the ‘Octopus’ model). Early findings were demonstrating improvements, for example, in cancer screening coverage in local populations where this had historically been low. HCL leaders were actively sharing the results with interested audiences, including national policy makers.