Christchurch Family Medical Centre

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 assessed all quality statements in the well-led key question.

At our last assessment, we rated this key question as requires improvement. At this assessment, the rating has changed to Good.

We found that the provider had clear and effective governance processes, which supported the safe delivery of care. Staff were clear on their individual responsibilities and knew who was accountable for each aspect of the service. The practice encouraged candour, openness and honesty. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Leaders were visible and had oversight to ensure the effective running of the service. They were capable, supportive, and inclusive, helping staff develop in their roles. There was a culture of continuous improvement with staff given time and resources to try new ideas.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Leaders had a detailed vision, strategy and culture for the service, based on transparency, equity, and inclusion. Some staff told us they felt engaged and involved in service development, others were unaware of the strategy and felt excluded from decisions affecting their roles. Staff were supported in their professional development and encouraged to keep their skills up to date. Staff described a friendly and supportive culture, with strong teamwork and a positive working environment. The staff we interviewed expressed enjoyment in their roles and valued the collaborative environment. Regular team meetings were held to share updates and promote open communication across the practice. Records of the minutes and actions were stored and accessible to all staff on the practice electronic system. Staff wellbeing was supported through monthly recognition awards, seasonal gifts, and celebration of personal milestones. The practice promoted openness and used staff surveys to drive improvements. There were clear procedures to address behaviour inconsistent with the practice’s values.

Leaders at all levels were inclusive, compassionate and understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. They had the skills, knowledge, experience and credibility to lead effectively, and did so with integrity, openness and honesty. Leadership promoted a culture of accountability, learning and collaboration, underpinned by multidisciplinary working and data-informed decisions.

Staff consistently reported feeling supported through regular check-ins and responsiveness to any concerns raised. Updates were communicated through meetings, emails and the practice intranet. Leaders were visible and approachable, and executive and clinical leaders were praised for their support during personal and professional transitions. Duty doctors were available daily for clinical queries, and nurse managers were described as fair and receptive. Leaders valued staff as central to delivering safe, effective and equitable care. Staff feedback led to meaningful changes, including improved privacy in baby clinics, installation of a water fountain, secure sample storage, and provision of free sanitary products. While staff felt supported, some requested improved flexible working and more opportunities for whole-practice meetings.

Staff felt confident to raise any concerns with their managers and leaders people felt they could speak up and their voice would be heard. The practice had a whistleblowing policy which clearly laid out the process of raising concerns within the practice and externally, including where to find the name and contact details of the freedom to speak up guardian (FTSUG). The policy was accessible to all staff on their computer system. Some staff were aware of the FTSUG role and how to access their support.

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

Leaders and managers supported staff effectively. All staff had completed training in equality and diversity. Policies and procedures were in place, including policies on equality, diversity and inclusion, anti-bullying and harassment. Staff we spoke to told us they had not experienced discrimination or discriminatory behaviour whilst working at the practice. Staff gave examples of how the practice made reasonable adjustments to support their health needs.

Staff and leaders were clear on their individual roles and responsibilities. Staff took patient confidentiality and information security seriously. Staff told us they received supervision and annual appraisals, although documentation of ongoing clinical supervision was not always evident. Following our site visit, the provider submitted evidence confirming that managers met with staff regularly to complete appraisals and performance reviews and that tailored support was in place during induction, probation and ongoing clinical supervision. Staff told us that learning and development opportunities were identified during annual appraisals and appropriate training was sourced.The provider had established governance processes which were appropriate for their service, and staff were able to access all required policies and procedures. There was a system to monitor the completion of mandatory training and evidence showed that staff training was up to date. Managers held regular practice meetings with staff, during which they discussed clinical concerns and emerging risks. Managers clearly recorded any actions which arose from these meetings and ensured the information was shared with staff. The practice had a business continuity plan which provided guidance and information for staff to follow in the event of systematic failures. The provider had oversight of contracts with external providers and liaised with them regarding any issues or changes required.

The service understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement. The provider worked with other practices within their PCN to offer enhanced access to services, for example, flu and covid vaccination programmes and improved flexibility in appointment times and locations. An active PPG represented the views of people using the service. A representative from the PPG provided positive feedback regarding the practice’s engagement with the PPG.

Staff were supported to grow in their roles and take on new responsibilities. The service supported a strong culture of continuous learning, innovation and improvement.

Staff were encouraged to contribute their ideas. Learning needs were discussed in team meetings and identified in annual appraisals. The practice encouraged and supported professional development and career progression. Staff had completed training such as moving from healthcare assistant role to undertaking nurse training, independent prescriber qualifications, and following the Centre for Pharmacy Postgraduate Education (CPPE) pathway. The practice offered placements to GP Trainees and F2 doctors.

Leaders created an open environment where staff felt confident to share improvement ideas. We saw clear examples of improvements made following staff feedback. For example, feedback from salaried GPs identified they felt isolated in their roles and suggested the need for a more collaborative working environment. The practice took proactive measures to foster peer relationships and provide access to senior clinical support by launching the GP Hub. The GP Hub supported triage, managed complex cases, and enhanced safety and quality of care.

To meet the demand for resources staff were supported to identify improvements and streamline processes. Workflow audits were conducted and identified areas for improvement. The practice reviewed its non-clinical staffing model and introduced a new role of General Practice Administration Assistant (GPAA) to support administrative functions. This helped maintain service continuity, improve efficiency, and gave staff broader insight into primary care.

To support better use of clinical resources the practice introduced specialist clinics to utilise clinical expertise and improve patient experience. Clinics focused on specific conditions, allowing for more efficient case management.

The practice identified a safety risk with repeat medication requests via the NHS App, which allowed patients to request repeat medications, including controlled drugs, without safeguards. The Medicines Management Team introduced a new triage process adding another layer of clinical governance, improving the quality of prescribing decisions, safe prescribing and reducing workload for prescribers.

To support safer, more personalised care and to inform future service development, the practice implemented automated searches within its clinical system to support proactive, data-driven care. Patients were grouped according to risk levels to help prioritise clinical need and guide follow-up.

The practice adopted a range of digital tools to improve efficiency and patient experience. This included automated registration processes, the use of artificial intelligence to reduce administrative workload, and platforms to streamline internal procedures. There was a plan to transition the PPG to a virtual model to improve accessibility and engagement.