Prospect Medical Group

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 changed to requires improvement.

This service scored 61 (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. Although staff fed back to us that they felt that they were consulted by the management at the practice, almost all of those completing a questionnaire said they did not contribute towards the practice vision or strategy of the organisation. The practice mission statement and core values were included in the practice induction pack. The practice understood the challenges faced by their patients, a high proportion of them spoke a various number of different languages and had different cultures. This could be challenging for staff in providing care, it was dealt with effectively. However, we felt they had not tried to understand how they could improve from negative feedback received via patient surveys. There was no action plan to address these issues. The practice had a business plan which discussed the development of the business to 2026. In this they recognised what was important and where they needed to improve. For example staff skill mix, feedback from patients, including patient access and PPG.

Leaders did not always demonstrate they had the experience, capacity and capability to ensure that the organisational vision could be delivered and risks were well managed.

Leaders were visible and accessible and staff told us they felt supported to deliver safe and effective care. However, leaders did not always demonstrate they understood all risks to delivering safe and effective care and they were not aware of some of the risks that we identified during the assessment.

The practice did not always manage checks on patients’ medication effectively. There was no infection control audit in place. There was no strong programme of clinical audit. The GP National Survey delivered poor scores for the practice. They recognised this, however there was no action plan in place to address this.

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, and we saw examples where staff had used the arrangements in place to positive effect. Overall staff felt their views and suggestions were actively taken on board and gave us examples of this.

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 saw senior leaders had addressed concerns related to discrimination. Adjustments had been made to ensure all staff were valued, for example we saw adjustments to support disabled staff were in place.

The service did not always act on the best information about risk, performance and outcomes.

Sometimes the governance processes in place did not ensure that patients were monitored and reviewed in line with guidelines and that staff responded to safety alerts. There were policies in place to ensure that most risk assessments related to the premises were carried out and that equipment was safe to use. However, they did not follow their infection control policy and there was no infection control audit.

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. The provider had established governance processes that were appropriate for their service. Staff could access all required policies and procedures. Managers held regular practice meetings with staff, during which they discussed clinical concerns and emerging risks. 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. Staff had made adjustments to improve coordination of their service with community healthcare services, including through recently established weekly meetings centred on the care of those at higher risk of hospital admission.

The service had a focus on learning and innovation. However, they did not learn or improve from patient feedback.

Leaders told us they supported staff development. Staff discussed and learnt from complaints, incidents and audits. Staff worked with the primary care network to deliver a wider range of services.

Staff gave us feedback of the development of services they had moved forward from their suggestions. They had worked with NHS England on a general practice improvement plan in 2023. They had put forward ideas for improvement. This included improvements to how calls were handled, more availability of medication review appointments and having an in-house diabetic specialist clinic.