The Lonsdale Medical Centre

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• 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 remains the same.

This service scored 82 (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, engagement, and understanding challenges and the needs of people and their communities.

The practice vision was to inspire people to live healthier lives. Staff had contributed to the development of the practice vision and underpinning values which focused on openness, honesty, excellence and compassion. There was a strategy, which was kept under review.

Staff spoke positively about the direction and culture and why the practice was a place they wanted to work, for example, citing a supportive and non-hierarchical team dynamic. They also described examples of how the practice was responding successfully to challenges, for example, to ensure the service was accessible.

The service had inclusive leaders 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 an explicit focus on integrity, openness and honesty.

Staff told us leaders in the practice was approachable and responded to any concerns raised. Staff also told us leaders modelled the values of the practice. We saw the leadership team worked to develop effective partnership working with other health and social care teams and voluntary sector partners. They were keen to engage in the development of primary care services within the local area.

There were clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

Leaders and managers supported staff, and all staff we spoke with were clear on their individual roles and responsibilities. One of the GP partners took a lead role on operational governance and was allocated more management time to do this. The provider had established governance processes that were appropriate for their service. Staff could access all required policies and procedures.

Managers met with staff regularly to complete appraisals and performance reviews. The GPs had an internal appraisal in addition to their professional external appraisal which included discussion of development goals in the practice context.

There were regular meetings including a twice-weekly clinical meeting which covered clinical concerns and case review, safeguarding and learning. The leaders identified and monitored risks to the service.

There were effective systems in place to manage patient confidentiality and information security.

The service clearly understood and carried out their duty to collaborate and work in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement.

The provider worked with other practices within their primary care network and with health and social care teams for the benefit of people using the service. We spoke with a representative from the palliative care team who told us that regular face-to-face meetings had been re-instated with the practice team following the COVID-19 pandemic and this had fostered effective working relationships.

The leaders’ vision for the practice was to become an integral part of the local community. They worked hard to engage people in health and wellbeing initiatives in addition to the provision of contracted primary care services. The partners had extended the premises using a sustainable design which included a large open area on the ground floor. This was transformed into a weekly wellbeing cafe in partnership with a local voluntary group. The space was also available for use by other community groups, for example, a local knitting group had started meeting here one afternoon a week.

The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. The practice encouraged creative ways of delivering equality of experience, outcome and quality of life for people.

The practice had identified access as an issue and had introduced a triage system whereby people electronically submitted their responses to three questions about their needs. Responses were reviewed by the triage doctors and actioned appropriately. Before introducing the system, one of the GP partners researched various alternatives and identified and spoke with a GP practice already using the preferred option before adopting it because this system was unfamiliar locally. The practice team consistently described this innovation as a step-change in improving safe and appropriate access to the service. Patients who provided feedback for the assessment and who had used the system were also positive. The practice now received over 200 patient requests a day and were able to offer most people who needed a consultation an appointment the same day.

Staff told us that they were encouraged to suggest improvements and the practice leaders responded positively, for example, in setting up the meditation/prayer room for staff.

The wellbeing cafe was an innovative way of bringing more vulnerable members of the community in to share experiences and participate in social and educational activities. The cafe had received a Brent adult social care award and recently been awarded a ‘Power of music’ grant which the team were using to host more musical events. People we spoke with were enthusiastic about recent events including an interactive session with professional musicians; an event to celebrate the poet Robert Burns (to coincide with Burns night); a flower posy making session and a Caribbean food-themed event. Staff were actively involved, for example, one of the GPs trainees had put on a Portuguese-themed cookery session.

One of the partners had an interest in supporting patients with mental illness. They worked closely with several consultant psychiatrists. For example, the GP and a consultant psychiatrist had authored BMJ reference material and learning for GPs on managing mental health in primary care which had recently been updated. They had also led a recently published scientific review of research into the impact of ketogenic diets for mood disorders.

The practice was participating in other areas of NHS medical research which the team considered to be of potential benefit and relevance to people. Recent projects included a study of the use of artificial intelligence-enabled stethoscopes for cardiac screening and involvement in part of the South Asia Biobank longitudinal study. People participating in the latter study received comprehensive baseline health checks and tailored recommendations on diet and lifestyle.

The practice was developing links with community groups, such as a neighbourhood residents association and local schools. Children from one of the local primary schools had attended the wellbeing cafe and performed songs.