Gnosall Surgery

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 assessment, we rated this key question as good. At this assessment, the rating remains the same.

This service scored 86 (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 very clearshared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities.

The practice took account of the projected increase in the local population and was working with partner agencies to address any future challenge. The practice had developed a ‘Future Strategy and Vision’ for the period 2026 to 2028; staff had contributed to the development of the practice vision and strategy, which was kept under review. This included focus on, workforce sustainability, improved access to care, digital transformation and innovation, inclusive and equitable service delivery and strengthened clinical governance and patient safety.

The service demonstrated effective strategic planning and a clear commitment to long‑term sustainability. At the time of the onsite visit, leaders were actively negotiating the building lease with relevant stakeholders, evidencing a long‑term commitment to serving the local community and investing in the continued development of onsite healthcare services. This proactive approach reflects strong leadership, effective partnership working, and a clear vision to support neighbourhood working and future service resilience. The service was taking proactive steps to improve patient access and responsiveness to local need by expanding onsite services through partnership working. This included arrangements with a CQC registered provider delivering NHS‑commissioned services within community settings to help reduce waiting times. Planned services included dermatology, gynaecology, and ultrasound scanning, supporting timely access to diagnostics and specialist care closer to home. This initiative aims to reduce unnecessary hospital attendance, promote faster diagnosis and treatment, and enhance patient convenience and satisfaction. The service utilised space within the practice to host external clinical teams delivering, vasectomy procedures, carpal tunnel treatments, private ear syringing.

The practice vision was to remain a sustainable, forward-thinking rural practice.

We found there was strong clear leadership. We saw colleagues listened to their staff at all levels, seeking to learn what was working, what they were proud of, as well as any concerns or improvement suggestions. There was diversity of thought and expertise throughout the team. The service promoted learning from quality improvement projects. An example included the use of electronic artificial intelligence systems with safeguarding measures which improved workflow. Staff had access to clinical supervision, learning and development events as well as educational support and all staff had access to online learning systems. The service provided regular reflective practice sessions and was a training practice for medical students and foundation year GP trainees.

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,experienceand credibility to lead effectively. They did so with integrity, openessand 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 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.

The practice had established Freedom to Speak up arrangements with other practices in the primary care network. Staff were aware of how to raise concerns, and we were provided with an example where staff had used the arrangements in place to positive effect.

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. We saw reasonable adjustments had been considered for the practice staff for example, in the use of certain supportive equipment staff used and flexible working arrangements to support staff were in place.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care,treatmentand support. They always act on the best information about risk, performanceand outcomes, and share this securely with others when appropriate.

Governance was well-embedded into the running of the service. Information about risk and performance was shared proactively and there were robust systems for capturing data. These systems demonstrated the ability to provide quality information for relevant data or submission requirements such as the practice’s CQC assessment.

The provider demonstrated an embedded culture of continuous learning and quality improvement through the effective use of performance and quality data in its governance functions. This information was consistently reviewed during learning time sessions attended by staff, ensuring shared learning and collective accountability. Staff told us discussions routinely included incidents and near misses, patient feedback and complaints, emerging risks, patient care and treatment, and current best practice. Learning was actively translated into service improvements to enhance patient safety and outcomes. External speakers were regularly involved, enhancing learning opportunities through specialist expertise, shared experience, and broader system knowledge. This approach supported reflective practice, innovation, and sustained improvements in the quality of care provided.

Staff could access all required policies and procedures. Managers held regular debrief ‘5 at 5 to 8’ meetings with staff which supported communication, learning, and team cohesion.

Staff took patient confidentiality and information security seriously.

A regular suite of searches of the clinal record system were being run to identify patient needs and ensure these were being met and our review of clinical records showed that this was effective.

There were arrangements for identifying, managing, and mitigating risks and a major incident plan was in place.

All staff we spoke with were clear on their individual roles and responsibilities. The practice maintained an organisational chart including staff’s lead roles and responsibilities. Managers met with staff regularly to complete appraisals and performance reviews. Staff and leaders actively monitored and anticipated current and future risks to delivering the strategy, including relevant local factors. All staff understood and were actively engaged in action plans to prevent and manage risks.

Staff told us that their wellbeing was considered, and their views respected, and concerns acted upon.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

Leaders consistently collaborated with other practices in their Primary Care Network to deliver extended access and ran flu and COVID vaccination programmes. 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 regular meetings centred on the care of those at higher risk of hospital admission.

The provider fully understood their duty to collaborate and work in partnership, ensuring services ran smoothly for patients. They regularly shared information and learning with partners and worked together to drive improvements. There were many clear examples of how partnership working had improved patient outcomes and how best practice had been shared across the wider organisation.

They worked closely with external stakeholders, commissioners, and partner agencies to develop and deliver effective services. The practice was supported by a Patient Participation Group (PPG).

The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcomeand quality of life for people. They actively contribute to safe, effective practice and research.The practiceto had a quality improvement plan in place to help drive improvements in services.

Innovation was embedded within wider quality improvement activities, including audits and strategic partnerships aimed at improving patient health outcomes. Leaders and staff were proactive in sharing ideas, taking part in research, and using good practice to improve care. They regularly listened to feedback from patients and the community, using it to shape and assess new ways of working. Leaders also invested time and resources to support staff and encourage collaboration with patients. This was illustrated by the recent partnership with providers to support their patients on site with additional services such as dermatology, gynaecologyand ultrasound services. The service supported initiatives to engage and encourage participation with health promotion events held at the practice site, this included dementia with the memory clinic cafe. This memory clinic café included memorabilia from various eras for example, a vinyl record player with records to be played, a ring dial phone, phtographs and posters of differing celebrities over the years and refreshments for all involved.

Improvement activities, including audits and strategic partnerships were aimed at improving patient health and wellbeing outcomes. Where improvement themes were identified in any area, the practice completed audits to test improvement measures. There were numerous audits conducted per annum, these included medicine related audits, access, complaints, significant events,clinical auditsand patient feedback.

The practice digital innovations included the use of Artificial Intelligence (AI) with scrupulous safeguards and piloting measures in place. They were committed to responsibly adopt digital solutions to enhance their efficiency, safety, and patient care. Their current implementations included: MyBot GP, which supports coding and workflow management of incoming clinical correspondence, improves accuracy and consistency of data entry and can enhance patient record safety. This had oversight from the Digital and AI clinical GP Partner. The practice was to implement Abtrace software to support long term condition management through an automated call and recall system, the identification of outstanding monitoring (for example, blood tests), the detection of potential gaps in care or misdiagnosis and therefore enable proactive population health management. Staff had time and support to build their skills in improvement and innovation, and there was clear evidenceof this being put into practice. Everyone was encouraged to come forward with ideas and take ownership of change, with innovation seen as part of everyday work.

The service described its future direction as continued exploration of AI technologies to improve administrative efficiency, support clinical decision-makingand enhance patient access and communication.