Carn to Coast Health Centres

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 the quality statements in the well-led question. Our rating for this key question remains good. Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. Managers worked with the local community to deliver the best possible care and were receptive to new ideas. 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.

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. Staff were positive about the direction and culture the senior leadership team had promoted. The service had a quality improvement plan to continue to progress their commitment to people. Staff told us there was an open-door policy where they could access and speak freely with leaders. Staff were encouraged to keep their knowledge and skills up-to-date in line with continued professional development to support the service.

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 leaders were visible and approachable, responding to any concerns raised. They said leaders supported them in professional and personal matters. Staff also told us leaders modelled the values of the practice. We saw staff and leaders worked with other practices in the locality 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. There were policies and processes to support speaking up and these were accessible to all staff online.The practice had a formal freedom to speak up guardian (FTSUG). Although staff we spoke with did not know who the FTSUG was, they all told us they would feel comfortable and able to raise their concerns with leaders.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them. Policies and procedures to promote diversity and equality were followed. Staff gave examples of reasonable adjustments the service had made to support them both at work and in personal circumstances. Staff were able to explain their understanding of equality, diversity and inclusion and had completed training in this area.

The service 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 act on the best information about risk, performance and outcomes, and share 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. Managers met with staff regularly to complete appraisals and performance reviews. The service had established governance processes that were appropriate for their service. Staff could access all required policies and procedures. Regular meetings were held to discuss clinical concerns, review incidents, and share learning. Managers clearly recorded any actions arising from these meetings and ensured they shared these with staff. Staff were aware of patient confidentiality and information security and took these seriously.

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 practice worked with other services within their locality to offer extended access, and flu and covid vaccination programmes. Staff had made adjustments to improve coordination of their service with community healthcare services. There were established systems with partner organisations to support people. For example, the research and development team had a focus on chronic disease management focus in collaboration with the local hospital.

The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. For example, there was a young person’s social prescriber that linked up with local schools and community services. Their role was to identify a plan to improve the young person's health, wellbeing and access to education. The service actively contributed to safe, effective practice and research. There was a dedicated research team that participated in external studies such as the trial and impact of Repatha, a medicine that can lower cholesterol and reduce the risk of cardiovascular disease. The practice had a quality improvement plan in place to help drive improvements in services. Staff were encouraged to put forward and test out new ways of working. The service was using Brave AI, a computer algorithm that helps to review patient records and assess risks of unplanned hospital admissions. For example, identifying people over a certain age that have not been in touch with the practice for over 12 months. This approach was not wholly relied on but was used alongside staff, their knowledge, skills and expertise and local intelligence. The practice was very aware of their patient population and a GP was taking the lead in an initiative known as ‘Deep End’. This was a network of GPs who were looking at understanding and improving primary care in areas of deprivation. This led to a training session for the whole staff team around health inequalities and tackling unconscious bias.