Old Bridge 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 has remained the same.
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 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 that staff were aware of and their role in it. The vision was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities. There service had a road map to achieve their vision and some staff fed back to us that they had been involved in the development of the services vision and strategy.
Staff interviews and feedback consistently described the culture of the service being positive. Comments relating to the culture of the service included: ‘’ Friendly, caring, calm and happy’’, “This practice is warm, friendly, efficient. I enjoy coming to work”. Staff were able to articulate the service’s direction and felt that their contributions were valued.
 

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. We evidenced 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.
Staff we spoke with consistently fed back that they felt leaders treated them with care and compassion. Staff could describe how communication through meetings and emails kept them up to date about practice changes.
 

The service fostered a positive culture where people felt they could speak up and their voice would be heard.
The service had established Freedom to Speak up arrangements and staff were aware of how to raise concerns, and we saw examples where staff had used the arrangements in place to positive effect.
The service had a formal freedom to speak to guardian (FTSUG), and this was promoted within the building. Staff were aware of how to raise concerns and told us they felt confident to do so. The service had a Whistleblowing Policy which was accessible to staff. The policy outlined the process for raising concerns internally and externally.
 

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.
The service had policies and procedures to support equality and diversity, and staff had completed appropriate training. There was a policy and procedure to protect staff from bullying and harassment.
Staff reported feeling supported in managing personal responsibilities, with examples of reasonable adjustments or flexibility being given for staff with significant caring duties.
 

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.
The service had business continuity arrangements and was supported by a strategic risk register, which was reviewed monthly and reported to partners quarterly, and monitored operational risks including succession planning.
Governance oversight was coordinated from Old Bridge Surgery, with a consistent approach applied across all 3 sites. This included shared arrangements for risk assessments, fire audits and security systems. Staff rotate across sites, and an external health and safety advisor conducted regular walkarounds to ensure compliance and identify areas for improvement.
Staff demonstrated a clear understanding of their roles and responsibilities, including designated lead roles. Policies were accessible to staff, who were aware of their location. These policies were currently undergoing review as part of a wider governance project.
The practice has appointed a Data Protection Officer (DPO) and Caldicott Guardian, with links to the local Integrated Care Board (ICB). (A DPO is an expert who advises an organization on its data protection obligations under laws like the UK General Data Protection Regulation (GDPR) and a Caldicott Guardian is senior role in health and social care organisations responsible for protecting the confidentiality of people's information and ensuring it is used legally, ethically, and appropriately).
 

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.
There were active collaborations with external organisations, including contracts with GP specialists for laboratory and pathology result management. These arrangements were supported by policies and oversight mechanisms, including sample audits and weekly GP reviews of results.
The service engaged in community partnerships to support public health initiatives. For example, it worked with the Looe Lions (an organise which hosts numerous events to raise money and organise events for good causes within the local community), as well as a local school to coordinate mass vaccination clinics. The service also hosted psychiatry clinics on site.
The Patient Participation Group (PPG) was active and met regularly with the practice. Feedback from the PPG indicated that while engagement had improved, there was a desire for a more collaborative relationship and to increase the exposure of the PPG. They also highlighted challenges in reaching a broader demographic, particularly the involvement of younger patients.
 

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.
The service coordinated mass covid vaccination efforts in partnership with a local school and community organisations. This innovative initiative enabled efficient delivery of covid vaccines while strengthening relationships with external partners and improving access for the wider population
Recognising that the services’ population may be digitally excluded, they had implemented a dedicated clinic where administrative staff supported patients in setting up and navigating the NHS App. This initiative was described by people as an “education service” and people told us:
“Although you can use NHS app, they are actually available to help.”
“They showed how to navigate and use the app as needed’’
There was a focus on continuous learning and improvement. Staff were encouraged to develop their skill set to enable them to take on new roles, responsibilities and further their career. Staff told us they could access training through a training hub and that they were actively encouraged by the service to do so.