Essex Way Surgery

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 At our last assessment, we rated this key question as Good. At this assessment, the rating remains the same.

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 based on providing high-quality and compassionate care. This was based on transparency, equity, equality and human rights, diversity and inclusion. Staff understood the practice’s focus on improving care and described a positive, supportive and open culture. The service also understood the challenges and the needs of people and their communities. The service was aware of the projected increase in the local population and was working with partner agencies to address future challenges.

Staff told us they were involved in developing the service’s vision and strategy and felt able to contribute ideas. They said leaders were approachable, listened to their views and acted on suggestions. Examples included staff involvement in website development and the introduction of new processes and systems. Staff were kept informed of changes through team communication, including meetings, memos and tasks shared across the team.

The service demonstrated a commitment to equality, diversity and inclusion. Staff told us the service did not discriminate or refuse registration to people because of their circumstances, and staff described supporting a diverse population.

There was evidence of a supportive and compassionate team culture. Staff described the service as family-orientated, with colleagues supporting each other and an open-door approach from leaders.

The provider understood the needs of its local population and was taking steps to develop its services. A business manager had been appointed to support the leaders with future planning and the service was considering improvements to the premises and systems with the aim of improving care for people.

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 oftheir 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. Staff also told us leaders modelled the values of the practice. We saw the leadership team worked with other practices in the Primary Care Network and were engaged in the development of primary care services within the local area.

Staff told us leaders were visible, approachable and supportive, and they felt able to raise concerns and seek advice when needed.

Leaders had arrangements in place to support staff and maintain effective oversight. Staff received regular appraisals and clinical staff had access to supervision and informal support. Leaders used an open-door approach and provided opportunities for staff to discuss clinical issues, including debriefing and support following consultations where required. There were also arrangements for staff to seek support with mental health and wellbeing. Staff described leaders as fair and were treated equally.

Staff also described leaders as supportive of their wellbeing and willing to make reasonable adjustments where required.

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

The practice had established Freedom to Speak up arrangements with other practices in the Primary Care Network. Staff were aware of how to raise concerns, and we saw examples where staff had used the arrangements in place to positive effect.

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work 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 and adjustments to support staff were in place. For example, staff could work from home where appropriate, swap shifts when needed and take annual leave flexibly. Protected time was provided for staff training including the option to complete training for home where appropriate, and staff were paid for this time. Adjustments were also made to support staff to attend significant personal commitments.

The service had an open-door approach, and staff knew they could raise concerns with the managers. There was a bullying and harassment policy in place, with expectations discussed with staff during meetings. Staff were aware that concerns would be addressed if they arose.

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 act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

Leaders had established clear lead roles and responsibilities, including safeguarding, infection prevention and control, dementia and the patient participation group. Governance was discussed through regular practice, clinical and nursing meetings, with safeguarding a standing agenda item. Multidisciplinary team meetings were also held, including with the palliative care team, nurses and care coordination team.

There were arrangements to monitor quality and improvement outcomes. Clinicians undertook clinical audits which included for example, chronic kidney disease. Two cycle audits included asthma and diabetes, with areas for further review identified and where improvement could still be made. The leaders also used the Friends and Family Test and feedback to understand people’s experience and improve the overall quality of care to their local population. The service actively promoted the use of digital services available through the NHS App, with evidence demonstrating increased uptake amongst the local population.

Managers met with staff regularly to complete appraisals and performance reviews. The provider had established governance processes that were appropriate for their service. Staff could access all required policies and procedures.

Managers held regular meetings with staff, during which they discussed clinical concerns and emerging risks. Leaders clearly recorded any actions arising from these meetings and ensured they shared these with staff. Staff took people’s confidentiality and information security seriously.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share 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 support to people who lived in a residential home including flu and Covid vaccination programmes. Staff had made adjustments to improvecoordination of their service with community healthcare services, including through recently established weekly meetings centred on the care of those at higher risk of hospital admission. There was an active Patient Participation Group (PPG), whilst meetings were not currently regular, there was a new lead taking over responsibility and arrangements being made to support attendance, including adjustments to meeting times where required. Whilst the provider has reviewed this, members we spoke to informed us that they were still able to contact managers in the interim to address any views or queries and felt confident that they are actioned.

The provider demonstrated they engaged with both professional partners who use the service to share information, identify needs and support improvements to services.

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 contribute to safe, effective practice and research.

The service had a quality improvement plan in place to help drive improvements in services which focussed on the appointment system. Staff were encouraged to raise ideas during huddles and meetings and were given opportunities to discuss and contribute ideas.

All staff were encouraged to put forward and test out new ways of working, and we saw examples of staff who suggested flexible ways of working to support the reception function, including the ability for staff to answer calls remotely when required. We saw evidence that this approach had been implemented.

Staff described regular opportunities for learning and development, including individual and team induction, training and protected learning time. Staff had developed their skills and competencies across a range of areas including telephone and email systems, clinical coding, interpreting services, emergency procedures and supporting people with specific needs. Staff were also encouraged to support each other and share learning, with colleagues covering shifts where required.

Evidence was seen where staff developed skills in areas including asthma, smoking cessation, cervical screening and other areas. Staff also described emergency equipment and scenario- based training and the use of guidance and protocols to support safe decision-making and escalation where required.

The provider had introduced and used new ways of working to improve access and care for people. Examples included reviewing the morning appointment system, responding to increased demand, use of online services and the development processes to support people waiting for secondary care.