Little London 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 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 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.

The provider had a vision and business development plan/strategy to show how they wanted to continue to deliver safe, effective, responsive, caring and well-led services to their patients. Staff worked in line with this vision and had an awareness of the provider’s expectations. They also wanted to continue to work alongside extended access services, utilising its share of appointments to help support access arrangements for their patients.

The provider wanted to continue to collaborate with the Primary Care Network (PCN) to enhance their patients care and treatment.

The provider had a whistle blowing policy so staff could work in a culture of feeling able to share concerns whenever and not feel threatened to do so. The culture with the service was one of openness and constantly learning and developing their skills.

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 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 and had a good working environment that was inclusive.

The provider had clear expectations as to how they expected staff to behave with patients, and we saw staff showing patients’ compassion.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

The practice had established a Freedom to Speak up policy that staff confirmed. Staff told us they felt able to share their views whenever and the working culture was one of openness. There was also a whistle blowing policy that staff could use to share concerns if they wanted to.

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 found that all staff were treated in a way that ensured fair access to training, fair recruitment process, reasonable adjustment for staff where required and equity amongst the staff team.

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 staff we spoke with were clear on their individual roles and responsibilities. We saw that regular clinical and non-clinical meetings were held, which supported a consistent approach to the delivery of care and treatment. We saw that the provider had systems in place to monitor key areas of the service, supporting continuity of care and patient safety. Regular audits formed part of the governance framework to ensure effective oversight and to drive improvement.

There was clear governance in place that was effective and appropriate for the service. Patient records were kept confidential and secure using the provider electronic patient system. General Data Protection Regulation (GDPR) requirements were in place, and staff took patient confidentiality and information security seriously.

Staff could access all required policies and procedures when needed. Records were kept of meetings and where needed actions arising from them were followed up.

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.

The provider worked with other practices within their PCN to offer extended access, and flu and other vaccination programmes. They were also working with the PCN on several other initiatives, some involved working to develop a proactive housebound patient visiting programme and many more. Staff had made adjustments to improve coordination of their service with community healthcare provision, including through recently established weekly meetings centred on the care of those at higher risk of hospital admission.

The provider had a Patient Participation Group (PPG) where patients and managers within the service could meet and discuss service deliver and other areas that concerned patients. We found that the PPG had a chairperson who was actively making sure the group met regularly to fulfil its function.

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 people. They actively contribute to safe, effective practice and research.

The provider had systems and processes in place, some of which supported new ways of working. While the service was not independently developing innovative approaches, we found they were working collaboratively with the Primary Care Network (PCN) to support the development of new ways of working, including initiatives to improve care for people living in care homes and those who were housebound

The practice had a quality improvement plan in place to help drive improvements in services. This focussed on patient access and other areas. All staff were encouraged to put forward and test out new ways of working, and we saw examples of this.