Teldoc-Lawley Medical 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

The service had governance, management and accountability arrangements in place. Staff could explain their roles and understood their responsibilities. The provider had good systems in place to manage performance and staff were provided with developmental opportunities to ensure they had the skills and knowledge to provide good care and treatment.
We found that there was leadership in place to ensure there was adequate oversight and there were systems in place to manage risk, issues and performance, however governance arrangements required strengthening to ensure all risks were mitigated. The practice had designated roles for areas of accountability.
 

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Regular meetings were held with staff across the 6 locations and learning was shared from complaints and incidents were shared to mitigate future risk. Due to the number of practices within the organisation, the leadership team had various communication routes to ensure staff were kept informed. These included regular email updates and a staff newsletter.

The organisation website detailed the mission statement, vision and values of the practice. This included an approach to nurturing effective and positive culture within the practice, which is evidence based, innovative, forward looking and adaptable. The organisation offered a wide range of services and facilities, which included physiotherapy and minor surgery. The use of technology was being used to improve efficiency and effectiveness, and staff were invested in to further develop their skills and knowledge base. Staff we spoke with were aware of the practice vision and values. We found the mission statement, vision and values were on display in various areas of the practice.
There were systems to ensure compliance with the requirements of the duty of candour and processes in place for effective communication and shared learning. All staff had completed mandatory training which included equality and diversity.
 

Leaders understood the challenges to quality and sustainability and had business plans to ensure there was capable and effective leadership. The practice had the appropriate oversight and supervision to ensure staff were carrying out their roles effectively. There were plans in place for the development of staff as part of their succession planning.
Lead roles for accountability were in place and the leadership team were committed to working collaboratively with the local community to educate and achieve positive outcomes for their patient population.

The practice had clear policies and procedures accessible to all staff, for example, there was a whistleblowing, equality and diversity and duty of candour policy in place. Staff told they were aware of the whistle blowing policy, however there was no evidence of a freedom to speak up guardian. We spoke with the leadership team who told us that there is no such post in existence within the local integrated care system. An email was sent to the Integrated Care Board (ICB) who confirmed there is no named ICB contact for primary care. However, staff could contact the ICB in confidence if staff felt they couldn't share their concerns at the practice.

Staff told us the workforce was diverse, which we saw. There was a equality and diversity policy in place, this supported the provider to ensure their staff team reflected the community in which it was based. 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.
The provider had systems in place that promoted a working environment that was fair and equitable. They had regular staff meetings across the locations and in April 2024 had set up a staff wellbeing scheme, which gave staff the opportunity to buy additional annual leave days. Included in the regular staff meetings were nurse and health care assistant meetings. This gave individual groups of staff the opportunity to discuss areas of their role, share ideas and improved ways of working.
There were policies and procedures in place for the safe recruitment of staff and other policies included recruitment, equality and diversity, bullying and harassment and grievances. All staff had completed equality and diversity training and had access to regular appraisals, one to ones, coaching and mentoring, clinical supervision and revalidation.
 

Staff told us that practice policies were accessible, and they were clear about their roles and responsibilities and felt supported by the management and clinical team. All newly appointed staff had completed an induction and training and had opportunities through training and development to improve their job skills. We were told that there were regular management meetings to review sustainability and ensure there was enough staff in place.
During the on site assessment of the call centre we found the leadership team were unaware that a nominated clinical safety officer was required or an awareness of a clinical risk management application was in place to ensure the clinical safety of the IT software they had in place. Following the on site assessment we were advised by the leadership team that the current digital system had undergone a thorough programme to ensure clinical safety. A period of piloting the system had also taken place where no concerns had been identified. Regular meetings were held to review the Health Co-pilot and the implementation of the clinical triage system was a standing agenda item on the meeting of the Board.
We found the management of risk required strengthening to ensure risks were mitigated. We identified a safety alert that had not been actioned appropriately and people on high risk medicines were not receiving the appropriate reviews. For example: People aged 65 years and over on medicines called non-steroidal anti-inflammatory drugs also known as NSAIDS which were used to relive pain to relieve pain and reduce inflammation and people aged 75 years and over on antiplatelet medicines were to be offered medicines to protect the stomach. We found through the clinical searches that 35% of people on these medicines had not been prescribed stomach protection.
A business continuity plan was in place which gave guidance to staff for the preparation of major incidents. We found that policies contained clear information about the designated lead in areas such as infection, prevention and control and safeguarding. All staff were aware of the designated leads in these areas. The practice had policies in place for sharing information with third parties.
 

Leaders told us they worked with stakeholders and the local community and regular meetings were in place with staff to sharelearning, continuous improvements and to deliver services to meet patient’s needs.
Leaders told us they had a patient participation group (PPG), and meetings were held regularly. The practice had engaged with the PPG on areas of improvement and sought patient feedback through the friends and family test and discussing the outcome of the GP patient survey results with the PPG.

Staff told us they were able to learn from significant incidents and complaints as these were discussed in regular meetings. Information was shared with staff by managers as part of improving the service to people. The provider had clear processes to ensure learning from significant events and to support staff development and training. All newly appointed staff had completed a programme of induction and training which was reviewed by leaders to ensure training was monitored and kept up to date.
The leadership team were reviewing an integrated care platform, a project plan was in place and ongoing discussions were being held with the board to discuss implementation of the new system. We found that processes were in place and the practice had carried out a number of targeted quality audits and used information about care and treatment to make improvements.