Dr Kanjana Paramanathan

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 service scored 68 (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.

Leaders demonstrated a positive, compassionate and listening culture and equality and diversity was actively promoted. The provider demonstrated an understanding of the challenges and evolving needs of the local population. Staff reported a positive experience of working at the practice. They described strong teamwork and a shared commitment to delivering high-quality, patient-centred care. Team members highlighted effective communication and stated that they felt included in decision making processes relating to the service.

The practice had a realistic strategy and supporting business plans to achieve sustainability. The leadership team were committed to working collaboratively with their Primary Care Network (PCN) and the local community to educate and achieve positive outcomes for their patient population

There were systems to ensure compliance with the requirements of the duty of candour and processes were in place for effective communication, however shared learning needed to be strengthened with all staff to mitigate future risks. There was a whistleblowing policy in place and a named freedom to speak up guardian. Mot staff had completed mandatory training which included equality and diversity. Following the onsite assessment, we were provided with assurances that all outstanding training had been completed.

Staff had access to clinical supervision, learning and development events as well as educational support and all staff had access to online learning systems.

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 told us that their wellbeing was considered, and their views respected, and concerns acted upon. Staff told us leaders in the practice were approachable and responded to any concerns raised. We saw the leadership team worked with other practices in the PCN and were engaged in the development of primary care services within the local area.

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

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 and a nominated freedom to speak up guardian to support staff if they wanted to raise an issue. Leaders told us they encouraged the reporting of incidents to identify ways in which the practice could continually improve.

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

There were policies and procedures in place for the safe recruitment of staff. Other policies included recruitment, equality and diversity, bullying and harassment and grievances.

All staff had access to regular appraisals, one to ones, coaching and mentoring and revalidation. There was an induction process in place for newly appointed staff and staff told us that they were well supported and felt able to ask for advice. Staff told us they were encouraged to develop within their roles and training opportunities were available. Policies and procedures to promote diversity and equality were in place. We saw senior leaders had addressed concerns related to discrimination.

The service did not always have effective governance systems to identify, monitor and address risks. Opportunities to learn from incidents, complaints, patient feedback and performance information were not consistently used to improve the quality and safety of care.

The provider had some established governance processes that were appropriate for their service, however strengthening of some systems was required to mitigate risks. For example, prescription security and ensuring patients with potential long-term conditions receive the appropriate reviews.

Staff could access all required policies and procedures. We received mixed responses on how often practice meetings were held. On reviewing the minutes of meetings, we found there was no set agenda for how often meetings were held and this was confirmed by staff we spoke with.

Significant events and incidents were not discussed at staff meetings and we found no evidence to demonstrate they were a standing agenda items. 2 recent significant events were shared with us, but we were told that there was no record of any other incidents or significant events recorded at the practice.

Leaders and managers supported staff, and all staff we spoke with were clear on their individual roles and responsibilities. Managers met with staff regularly to complete appraisals and performance reviews.

The practice had no audit plan in place to monitor service provision and improve the quality of services provided. For example, complaints, significant events and patient feedback.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. The service worked collaboratively with partner organisations and the Primary Care Network to support coordinated care and meet the needs of the local population.

Leaders told us they worked with stakeholders and the local community. The practice was part of a Primary Care Network (PCN) which provided enhanced services to patients. The PCN met regularly to deliver services to meet patients’ needs and to support care provision and service development.

The practice offered extended access, flu and covid vaccination programmes. Staff had made adjustments and collaborated with local services to further support community healthcare services. For example, a range of events had been organised throughout the year to provide information on health and wellbeing improvements, for example well women’s event

The practice had not had an active patient participation group (PPG) since the pandemic, which limited opportunities for ongoing patient involvement in service developments. The practice was trying to recruit patients to the group and information was available in the waiting area of the reception and on the practice website.

The leadership team were aware there had been increases in demand and they were working with the PCN and stakeholders to ensure that resources were planned with continued collaboration and partnership working to meet the needs of the service.

The service did not always have effective systems to support learning and continuous improvement. Opportunities to identify, document and share learning from incidents were not consistently used to improve patient safety and outcomes

The leadership team held staff meetings, however these were not on a regular basis and on reviewing the minutes of meetings that had been held we found there was no evidence to demonstrate learning had been shared from incidents to mitigate future risks For example, we were provided with details of a significant event that had occurred in May 2026. On reviewing the minutes of the practice team meeting that had been held in June 2026, no actions had been recorded or learning shared to improve patient outcomes.

The provider worked collaboratively with stakeholders to improve the experience of people using the service and to support the wider needs of the local community.