The Wrythe Green 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.
Staff had contributed to the development of the practice vision and strategy, which was kept under review. The practice worked with partner agencies to address future challenges.
 

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 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.
 

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. Arrangements were in place to ensure all staff were valued, for example to make adjustments when staff needed them.
 

The service had clear responsibilities, roles, systems of accountability and good governance. Governance processes were well-documented. In general, these worked well, and the service used them, with information about risk, performance and outcomes, to manage and deliver good quality, sustainable care, treatment and support.
However, there were some areas of risk that had not been effectively addressed. Leaders were responsive to our feedback on these and shortly after the assessment sent us evidence that they had made improvements. The service reviewed the most serious issue, the system to authorise healthcare assistants to administer medicines, as a significant event to make sure the learning and actions were formally assessed and documented. The service shared our finding locally and told us that it was working with other practices who also needed to make changes to ensure that they all had legally compliant processes.
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. Staff could access all required policies and procedures. Managers held regular practice meetings with staff, during which they discussed clinical concerns and emerging risks. Managers clearly recorded any actions arising from these meetings and ensured they shared these with staff. Staff took patient confidentiality and information security seriously.
 

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 primary care network to offer extended access, and flu and covid vaccination programmes.
The service held an annual bake sale and coffee morning in support of local charities. Surgery staff and patient participation group (PPG) members donated baked goods, while PPG volunteers ran the stalls and served refreshments. The service had raised approximately £3,000 for the Royal Marsden Cancer Charity and St Raphael’s Hospice. PPG reps told us that these events had strengthened links between the practice, patients and the wider community.
 

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, outcome and quality of life for people. They actively contribute to safe, effective practice and research.
The service took part in the General Practice Improvement Programme (GPIP), an NHS England initiative designed to help primary care teams streamline operations, optimize patient access, and improve staff well-being. This required the service to commit resources for all of their teams to work with a facilitator to identify and quantity areas for improvement and test changes. We heard about many improvements that had resulted from the programme. Examples included: creation of a training skills matrix for non-clinical staff, formalising the daily GP meeting, skill-building for staff who answered phones, and reductions in the rate of appointments unused because people did not attend.
The principles from the programme were still in place. Quality improvement was a standard agenda item for meetings. All staff were encouraged to put forward and test out new ways of working. Many of the recent improvements we heard about, such as multi-morbidity consultations and the duty nurse system, had been suggested by staff. Others were made following feedback from patients.
We heard about improvements that the service was currently considering, including investment in a computer programme that might help the service better identify people who needed monitoring for their health conditions or medicines and to more efficiently manage these.