The Great Britain Cycling Team Medical Facility

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 Outstanding.

This service scored 89 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff and leaders established a very clear shared vision, strategy and culture, which they based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and a deep understanding of the challenges and expectations involved in supporting world-class riders to perform at the highest level. Leaders worked hard to create a positive culture of ‘high challenge, high support’ and implemented a clear evidence-based approach to their work.

Riders, staff, coaches and the wider Great British Cycling (GB Cycling) team demonstrated a strong commitment to the shared aims and objectives during the inspection, confirming that the medical team prioritised riders’ physical and mental health throughout their elite-level careers. They established a culture where challenge was possible and rider health came before performance.

The Great Britain Cycling Team Medical Facility (Medical Facility) set an ambition to become the benchmark for elite sport. Evidence and published research showed the service was well on its way to achieving this ambition. Several tools developed by the medical team were already used across other elite sports, and their research and guidance influenced healthcare for elite athletes and grassroots communities, particularly in improving concussion care and protocols and enhancing treatment for female athletes.

The service also developed a mental health strategy and delivered a holistic approach to all aspects of riders' healthcare. Staff and riders described a psychologically safe environment and felt empowered to speak up and raise concerns to support learning and improvement. Staff remained highly motivated and consistently felt well-supported by leaders.

Equality, diversity and human rights approaches were embedded throughout the organisation and understood by all staff. Staff and leaders monitored and anticipated current and future risks to delivering the strategy, including changes in legislation, sports medicine and sport governing bodies.

Leaders at all levels demonstrated exceptional inclusivity and understood the context in which they delivered care, treatment and support. They embodied the culture and values of their workforce and organisation. Leaders possessed the skills, knowledge, experience and credibility to lead effectively, and they always acted with integrity, openness and honesty.

Leaders held high levels of credibility not only within the Medical Facility but also across GB Cycling and elite sports more widely. They consistently fulfilled their commitments and communicated in transparent and accessible ways. Leaders maintained insightful and impactful oversight of the high-performance environment and accessed high-quality resources, support and development in their roles.

Leaders established a robust, credible framework through the development of an independent clinical governance committee to ensure that UK Sport governing bodies and the public could have confidence in the work of the medical team. Inspectors noted a strong awareness and oversight of organisational culture dynamics, and that all concerns were listened to.

The service fostered a positive culture where people felt they could speak up and their voice would be heard. The provider had established Freedom to Speak up arrangements and staff were aware of how to raise concerns and told us they were confident that if concerns were raised, they would be acted upon.

The service valued diversity in its workforce and worked towards an inclusive and fair culture by improving equality and equity for all staff. Leaders put in place policies and procedures to promote diversity and equality. They addressed concerns related to discrimination and made adjustments to ensure all staff were valued.

Leaders and staff embedded governance effectively into the running of the Medical Facility. They established an independent clinical governance committee to maintain clinical governance standards and reported to the British Cycling Board.

The committee provided a robust framework of accountability to oversee the work of the medical team, monitor risk, stay up to date with sports governing bodies, and serve as a sounding board for staff and leaders. The clinical governance committee included an independent chair, a healthcare and sport legal advisor, a pharmacist, a sports physician, a sports scientist, the chief medical officer, and the British Cycling head of legal, compliance and safeguarding.

Alongside the clinical governance committee, leaders and staff defined clear day-to-day responsibilities, roles, systems of accountability and governance. They used these to manage and deliver high-quality, sustainable care, treatment and support. They always acted on the best available information about risk, performance and outcomes, and shared this securely with others when appropriate.

Staff and leaders implemented robust systems designed to be intelligent and responsive to best practice. These systems captured data to provide high-quality information that monitored performance, drove improvement and supported the development of evidence-based practice. Staff shared outcomes more widely with other elite sporting bodies where appropriate.

Managers met with staff regularly to complete appraisals and performance reviews. Staff accessed all required policies and procedures. Managers held regular meetings with staff to discuss clinical concerns and emerging risks, recorded any actions arising, and ensured these were shared with staff.

Staff took riders' confidentiality and information security seriously.

The service understood its duty to collaborate and worked in partnership to ensure services operated seamlessly for riders. They shared information and learning with partners and collaborated to drive improvement. Staff regularly shared learning and best practice with others and developed exemplar protocols and clinical templates, which were later adopted by other elite sport medical facilities. They actively contributed to safe, effective practice and research.

The service also shared protocols and learning, where appropriate, with the public via the GB Cycling website for use in the community and at the grassroots level of sport. For example, the service published guidance on several health-related topics, including treating concussion and road rash, a common injury for riders who fall off their bikes on the road.

The Medical Facility focused strongly on continuous learning, innovation, and improvement across the organisation and the wider field of elite sports medicine. Staff and leaders encouraged creative approaches to delivering high-quality care within the evolving environment of world-class cycling. They drove improvements, shared expertise across world-class cycling, and contributed to safe, effective practice and research. They led the development and dissemination of best practice.

Leaders and staff built a wide range of external networks, participated in and led research to continually learn and develop innovative approaches to the care and treatment of world-class cyclists. One area in which they led was the development of research and guidance to accelerate understanding of the specific medical needs of female athletes competing at the highest level. For example, they published the Cycling Pregnancy and Postpartum Guidance and joined the sport’s gynaecological forum as active members.

They embedded a proactive approach to innovation, learning and development within a robust clinical governance framework across the organisation, and the care and treatment they provided consistently reflected evidence-based practice.