Welling Medical 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 service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last inspection in September 2021, we rated this key question as Good. At this assessment, the rating remains the same.

This service scored 64 (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 patients and their communities. However, not all staff felt they had contributed to the development of the practice vision and strategy.

The practice was aware of the projected increase in the local population and was working with partner agencies to address future challenges.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support. Leaders had the skills, knowledge, experience and credibility to lead effectively.

We received mixed feedback from staff regarding the approachability and visibility of leaders in the practice. Whilst staff generally felt comfortable in raising concerns and knew the appropriate procedure to follow, staff reported they did not always feel these were actioned in a timely manner. We saw the leadership team worked with other practices in the primary care network 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.

Staff were aware of how to raise concerns, and we saw examples where staff had raised concerns to senior leaders within the practice.

The service valued diversity in their workforce. They work 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 in place. We saw senior leaders had addressed concerns related to discrimination.

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 performance and outcomes, and share this securely with others when appropriate.

However, not all action plans following risk assessments contained sufficient information to track the progress of concerns identified. The practice provided evidence that amendments had been made to their action plans in response to risk assessment following the site visit.

All staff we spoke with were clear on their individual roles and responsibilities. We saw evidence that practice policies were regularly reviewed and updated. Managers met with staff to complete probationary and performance reviews. However, supervision for clinical staff were not always documented. For example, staff told us they would receive clinical supervision daily, but there was not allocated time scheduled to discuss progress formally at set intervals. Staff could access all required policies and procedures. Managers held regular practice meetings with staff, during which they discussed clinical concerns and emerging risks. Managers clearly recorded any actions arising from these meetings and ensured they shared these with staff. Staff took patient confidentiality and information security seriously.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for patients. They shared information and learning with partners and collaborate 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 attending borough-wide meetings on a quarterly basis to discuss care quality.

The service focused 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 patients. They actively contribute to safe, effective practice and research.

The practice had implemented a telephone system which enabled a call-back feature. The practice was able to view average wait times for calls to be answered and allocate the appropriate number of staff to reception during times of high call volumes.

In addition to this, the practice had introduced online consultations. A duty doctor would be allocated daily to triage these consultations. The practice reported more face-to-face appointments had been made available as a result.