Ledbury Health Partnership

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. This is the first inspection for this service since the two practices merged. This key question has been rated as good.

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 practice took park in a staff workshop to co-create 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 practice promoted a positive, compassionate, listening culture that supported trust and understanding between staff and patients using the service. Staff expressed how the practice was a friendly and supportive place to work. Staff shared a common aim to do the best they could for patients and strived to provide safe, high-quality care.

The practice 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 in the practice were approachable, responded to all concerns raised and modelled the values of the practice.

The practice fostered a positive culture where staff felt they could speak up and have their voice heard. The practice had a Freedom to Speak up policy that included relevant information about how to contact the Freedom to Speak up Guardian. Staff knew who the Freedom to Speak up Guardian was as this was a manager within the primary care network who regularly visited the practice. Staff told us they were able to raise concerns to each other and leaders at the practice, they told us their concerns were valued and acted upon appropriately.

The practice valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them. There were policies and procedures to promote equality and diversity. We reviewed staff training and found that all staff had completed their equality and diversity training. Leaders made reasonable adjustments to support staff to carry out their roles well. For example, the practice purchased an amplified stethoscope to support staff where needed.

The practice had established clear governance processes and leadership structure that were appropriate for their service to deliver quality, sustainable care, treatment and support. The practice acted on the best information about risk, performance and outcomes. Leaders and managers supported staff, and all staff we spoke with were clear on their individual roles and responsibilities. Managers met with staff regularly to complete appraisals and performance reviews. Both team and multidisciplinary meetings were held on a regular basis. Managers clearly recorded any actions arising from these meetings and ensured they were shared with staff. Policies and procedures were accessible on the shared system. Staff took patient confidentiality and information security seriously.

The practice understood their duty to collaborate and work in partnership to support care provision, enabling services to work seamlessly for patients. Staff and leaders engaged with people, communities and partners to share learning with each other and promote continuous improvement. The practice had good working relationships with other practices within their primary care network (PCN) and attended monthly PCN meetings. Leaders described the PCN as a supportive network. The practice had an active patient participation group (PPG) which was supportive of the practice in driving improvements. The PPG acted as a channel for communication between the local community and the practice. We spoke with a member of the PPG who gave positive feedback about the practice and gave examples of improvements which had been made following patient feedback.

The practice had a strong focus on continuous learning, innovation and improvement across the organisation. As a training practice, they welcomed the involvement of GP registrars. 2 previous registrars completed their training and accepted salaried roles within the practice. Staff were supported if they wanted to progress within their roles. Staff learned from significant events and complaints to continually improve the service they provided. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. For example, the practice created a diabetes group clinic to improve patient knowledge, enhance their support which therefore improved their health readings. This model of care motivated patients to manage their care. A biomedical scientist was recruited and introduced a platform that streamlined administrative tasks and improved efficiency in delivering safe patient care.Robust protocols and clinical governance processes were in place to support this. The practice took the opportunity to take part in a fully funded 6-month trial of this platform for automation of lab results and decided to fund this themselves going forwards. These examples demonstrated how the practice actively contributed to safe, effective practice and research. There was a culture of continuous improvement with staff given time and resources to try new ideas.