The Miller 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

We looked for evidence that practice 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, we focused on 2 quality statements relating to the key question Well-led: Shared direction and culture and Governance, management and sustainability

At this assessment, the rating remains the same.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The practice had a shared vision, strategy and culture. This was based on transparency, equity, equality, human rights, diversity, inclusion and engagement. Staff and leaders understood the challenges and the needs of people and their communities.

All staff had contributed to the development of the practice’s vision and strategy, which was kept under review. Leaders monitored and reviewed progress against the delivery of their strategy. The practice was aware of challenges which affected their service. These mostly related to the current premises, where space was limited and building work restricted due to the listed building status. However, the practice had recent confirmation that a move to a new location had been approved. This will allow for the planned expansion of the service.

Staff and leaders actively promoted equality and diversity and worked to identify the causes of any workforce inequalities. They demonstrated a positive and compassionate listening culture that focused on learning and development. The feedback we received from 13 members of staff supported this.

Staff feedback included:

• They are a warm, friendly team. I feel supported both clinically and as a staff member. I also like that the practice is professional but still personal, where we are treated with kindness and respect.
• The practice is focused on providing good patient care and listening to the patient experience as well as looking after staff.
• Feels like a family practice.

There was an active Patient Participation Group (PPG), which had been re-established in November 2024, following a suspension during the COVID pandemic. Originally 9 patients were involved but now there is a core group of 5 members. We spoke with them during the assessment. The general view was of positive engagement with the practice, but that the PPG was in the process of evolving and was not wholly representative of the patient list. They would welcome younger patients and those with families being encouraged to take part. We noted a poster advertising the PPG and seeking applicants. Staff told us they would continue in efforts to recruit more members. Face to face meetings were held quarterly. The members told us they felt listened to and that the practice was very open.

We discussed with staff the possibility of setting up a wider PPG covering all the practices within the primary care network to engage with more patients.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The practice had 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.

In their feedback to us, staff were clear on their individual roles and responsibilities. Leaders proactively supported staff and regularly met with them to complete appraisals and performance reviews. We noted some delays in carrying out appraisals over the previous year but were shown that any outstanding ones had been scheduled.

The practice had established governance processes in relation to the quality statements we reviewed during this assessment, which were appropriate for their service. Staff could access all required policies and procedures, which were kept up to date and reflected latest guidance. We looked at number of the practice’s governance policies, such as those relating to Safeguarding, Health and Safety, Repeat Prescribing, Confidentiality, Chaperoning and Whistleblowing and noted they were reviewed regularly and updated as necessary.

Leaders held regular meetings with staff, during which they discussed emerging risks and potential improvements to the service. These included weekly clinical meetings, informal daily “huddles” and Practice Learning Meetings, involving all staff, held quarterly. We saw the administrative team had regular separate meetings. We saw from various minutes and notes that leaders clearly recorded any actions that arose from the meetings and shared them with staff.

Staff took confidentiality and information security seriously, which included verifying people’s identity during remote consultations. We saw evidence they had received training in Information Governance and the General Data Protection Regulation. Staff submitted data and notifications to external agencies as required.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.