Dr James Lawrie

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 the service’s leadership, management and governance assured high-quality, person-centred care and promoted an open and 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, human rights, diversity, inclusion and engagement. Staff and leaders understood the challenges and the needs of people and their communities.

The service’s vision was focused on continuity of care. Staff across different roles consistently identified patient care and teamwork as core values. Strategic decisions were discussed at weekly clinical meetings and shared with administrative staff.

Staff described an open and supportive culture. They felt able to raise concerns with the duty doctor or practice manager and were aware of the Freedom to Speak Up Guardian. Practice records showed that staff contributions were recognised and areas for improvement were discussed openly.

The service used staff feedback to improve working arrangements. We saw that the anonymous staff survey had led to changes including a 4-day working week option for reception staff. Flexible and remote working arrangements were also used to help retain experienced staff, and staff described regular social events as supporting a positive team culture.

We were told that succession planning had been discussed but had not yet been formalised. We reviewed the risk register, which included succession planning and assigned responsibility to a named individual. Leaders were discussing future arrangements as the senior partner gradually stepped back.

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 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 acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

CQC register showed that the service had a single lead GP. Day-to-day responsibilities were clearly distributed across named clinical and non-clinical leads, and staff understood their roles and reporting arrangements.

We reviewed records showing that the practice had established governance systems. A weekly clinical meeting reviewed performance, audits, complaints, safeguarding, significant events and key clinical indicators, supported by separate administrative meetings and engagement with the Primary Care Network, Integrated Care Board and neighbourhood services.

Staff told us that policies were accessible through a shared platform. The policies reviewed included ownership and review dates. We saw that Information governance arrangements were effective, and the Data Security and Protection Toolkit had consistently met required standards when checking the online register. We saw that the risk register was maintained and included current operational, financial, premises and system risks. We were told that action plans arising from meetings were appropriately followed through.

Leaders described a supportive, staged approach to performance management, progressing to formal action where needed. Regular appraisals were completed across staff groups with one appraisal led directly to the introduction of Saturday phlebotomy appointments.

The service demonstrated learning from incidents and complaints. Actions from significant events were recorded and shared, including changes that were made. Complaints were reviewed for themes. Clinical audits were repeated to measure improvement.

Staff told us confidentiality was maintained through private conversation spaces and screened reception areas.

Staff told us the service is submitting patient-safety reports through Learning From Patient Safety Events and notified the ICB where appropriate.

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.