Guidepost Medical Group

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 has changed to Requires Improvement.The service was in breach of legal regulation in relation to good governance.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff described a positive, supportive, and inclusive culture, with strong teamwork, regular communication, and mutual respect. They felt valued and were committed to delivering high-quality patient care through open and constructive discussions.
Staff told us the working environment was friendly, welcoming, and professional, with a relaxed yet focused atmosphere, where they felt able to be open and honest. Leaders reinforced this view, describing a culture of strong team trust, regular meetings, and mutual respect, where all roles were valued and there was a shared commitment to good patient care, supported by open and constructive conversations.

Leaders were inclusive, visible, and demonstrated the skills, experience, and integrity to lead effectively. They understood the context of the service and promoted a culture based on openness, respect, and shared values.
They showed capability by recognising when staff needed additional support and putting appropriate measures in place, including reasonable adjustments, enhanced supervision, and mentoring. Staff felt able to raise concerns and reported that leaders were approachable and supportive.
Clear leadership structures, regular appraisals, and team meetings supported staff development and wellbeing. Leaders worked collaboratively within the team and with external partners, including the Primary Care Network, and were seen to model a positive, supportive working culture.

The service promoted a positive and open culture where staff felt able to speak up and were confident their concerns would be heard and acted upon. Clear arrangements were in place to support this, including a whistleblowing policy and access to a Freedom to Speak Up Guardian within the Integrated Care Board (ICB). Relevant information, including contact details, was readily accessible via the intranet.
Staff felt comfortable raising concerns directly with managers, who were described as approachable and responsive. Leaders actively encouraged open communication and made efforts to ensure staff felt safe and supported in speaking up. The leadership team also worked collaboratively with other practices within the Primary Care Network (PCN) and were engaged in the development of primary care services within the local area.

The service valued diversity within its workforce and promoted an inclusive and fair culture. Recruitment processes were open and accessible, and the team reflected a diverse range of backgrounds, contributing to an inclusive working environment.
Policies and procedures were in place to promote equality and diversity, and leaders were supportive in ensuring these were upheld. Reasonable adjustments were made where appropriate to meet staff needs, ensuring individuals felt valued and able to work effectively. Overall, the service demonstrated a commitment to equality, inclusivity, and supporting a diverse workforce.

Governance systems were not sufficiently robust to ensure effective oversight of clinical risks. Leaders did not consistently act on information relating to risk, performance, and outcomes, or ensure this was shared appropriately when required. This meant that systems were not always effective in identifying and managing risks in a timely way. Leaders had not identified or addressed these risks in a timely way, particularly in relation to medicines management and monitoring of long-term conditions.
We identified some gaps in the monitoring and oversight of high-risk and long-term conditions, as well as in the management of medicines requiring regular monitoring. Issues included inconsistent monitoring, incomplete or delayed reviews, inappropriate prescribing, poor documentation, and a lack of follow-up, all of which increased the risk to patients. In addition, some medicines and clinical consumables were found to be out of date, indicating shortcomings in stock monitoring processes. However, immediate action was taken to remove and dispose of these items, reducing risk at the time of inspection. These processes required strengthening and embedding, moving forwards.
Despite these concerns, there were areas where governance processes were working effectively. Leaders and managers supported staff, who were clear about their roles and responsibilities and worked within a system of high-level supervision. A no-blame culture was evident, supported through significant event analyses (SEA), which were anonymised and used to promote shared learning and improvement. Regular appraisals, performance reviews, and team meetings were in place, enabling discussion of clinical concerns and emerging risks, with actions clearly recorded and shared. Staff had access to relevant policies and procedures and demonstrated a strong understanding of patient confidentiality and information security.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They shared information and learning with partners and collaborated for improvement.
The provider worked with other practices within their primary care network to offer extended access, and flu and covid vaccination programmes. Staff had made adjustments to improve coordination 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.

The service demonstrated a strong focus on continuous learning, improvement, and innovation. Leaders and staff were committed to developing new ways of working to improve quality, outcomes, and patient experience.
Patient feedback was actively considered and used to inform service development. For example, following repeated feedback through the Friends and Family Test, the practice explored introducing music in the waiting room to improve patient experience. This was being progressed through discussion at partnership level, including consideration of costs and legal requirements.
The practice also demonstrated innovation in clinical practice. For example, a Primary Care Network (PCN) pharmacist developed a robust local pathway for the prescribing of a weight loss medication, despite no contractual requirement to do so. This included a pre-screening protocol which enabled the identification of patients who may appear suitable but had more complex clinical needs, supporting safer and more effective prescribing.