Holmside 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 outstanding.

This service scored 93 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The leadership, governance and culture were used to drive and improve the delivery of high-quality person-centred care.

The service had a very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities. Each staffing team met monthly to discuss the challenges of their roles and the practice vision. Wellness was seen by managers as a leadership responsibility, and it was a shared value for all staff.

The practice had processes and information to manage current and future performance. The information used in performance management ensured that the quality of care delivered was accurate, valid, reliable, timely and relevant.

The practice recognised that environmental responsibility was directly linked to population health, particularly in communities facing deprivation and long-term conditions. As a result, sustainability was considered routinely when services were designed.

The practice produced newsletters for staff quarterly. These were put in place following staff feedback. They gave information on the practice values, freedom to speak up guardian and staff survey results and actions.

The practice population was placed in the group with the highest levels of deprivation. They had high levels of patients compared to other practices, whose first language was not English. They had a higher proportion of patients who were elderly and had long term conditions (LTC). This led to challenges in relation to demand, longer appointments and difficulties in health screening and administering immunisations. However, the practice continually reached out to all members of their community recognising the unique needs, experiences, and challenges they face and had done so for some years. They put in place strategies to provide services to meet the needs of their population and measured these to ensure they were delivering to patient’s needs.

The service had exceptionally 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 always did so with integrity, openness and honesty.

Leaders had an inspiring shared purpose, striving to deliver and motivate staff to succeed. There were high levels of staff satisfaction. Staff were proud to work at the practice and spoke highly of the culture. There were consistently high levels of staff engagement. Staff at all levels were encouraged to raise concerns and feedback.

There was a continual development of staff skills, competence and knowledge was recognised as integral to ensuring high quality safe care, improved access and service sustainability. Staff were proactively supported to acquire new skills, develop and share best practice. There was strong feedback from staff and particularly where they had been developed. The practice could demonstrate where they had strengthened capacity for succession for the future and invested in supporting leadership competency.

Staff were encouraged to develop and gave us examples of this, healthcare assistant to practice nurse, apprenticeships completed and prescribing qualifications. As a result of linking training and development with quality and innovation the practice could give examples where they had expanded or strengthened services.

Staff retention was a high priority; there were several members of staff who had worked at the practice for 25 plus years and many staff for over 10 years.

Staff told us leaders in the practice were 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 other services 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 ICB area. Staff were aware of how to raise concerns, and we saw examples where staff had used the arrangements in place to positive effect.

Staff told us they were comfortable to raise any concerns. We gave feedback from staff questionnaires to management that the only negative comments were 2 members of staff said communication could be improved. The practice immediately put in place a communication strategy to address this. The role of the freedom to speak up guardian was set out in a recent staff newsletter. It explained the reasons for the role, who could raise concerns and the difference between whistleblowing and freedom to speak up. All staff were aware of the freedom to speak up guardian was.

The service valued diversity in their workforce. They worked 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 practice were a safe surgery practice, ensuring that lack of identification, fixed address, or immigration status is never a barrier to care. They have clear, well-understood systems to support safe access for vulnerable patients.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to drive and improve high-quality, sustainable care, treatment and support. They always act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

Governance was well-embedded into the running of the service. There was a strong framework of accountability to monitor performance and risk leading to the delivery of demonstrable quality improvements to the service. Audits we saw demonstrated this and our clinical searches showed that the governance and performance management arrangements were proactively reviewed and reflected best practice. As a result of linking training and development with quality and innovation the practice had expanded or strengthened services

Leaders and managers strongly supported staff, and all staff we spoke with were clear on their individual roles and responsibilities. They told us there was a culture where they were encouraged to develop. There was a strong open culture where safety was a top priority. The provider had strong systems to record incidents and investigate complaints. Learning from incidents and complaints resulted in changes that improved care for others.

Leaders and managers drove an awareness of positive accountability, support and sustainable improvement across the organisation. They 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. Managers clearly recorded any actions arising from these meetings and ensured they shared these with staff. Staff took patient confidentiality and information security seriously.

Staff and leaders could actively anticipate current and future performance and risks to the quality of the service. There is an informed approach to positive risk taking to support innovative ways of working.

The service worked in partnership with others to build seamless experiences for people based on good practice and people’s informed preferences. The service drove a focus on delivering care in a way that supported people’s care pathways.

This was demonstrated by the work and processes they had for patients who lived with mental health conditions. They had linked their care processes with other services who could help patients.

The service clearly understood and carried out their duty to collaborate and work in partnership, and services worked seamlessly for people. They always shared 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 practice worked in partnership and provided services for other practices ensuring inclusive and responsive care, particularly for those with the greatest barriers to healthcare.

Leaders, managers and staff strove for excellence through collaboration and shared practice. The service has a track-record of being an excellent role model for others. They were able to offer service to other practices in the area which included, providing minor surgery, Intrauterine Device (IUD) fitting and removal, contraceptive implants and pessaries for pelvic floor prolapse. Therefore improving local healthcare outcomes.

They provided daily support to a short-term rehabilitation centre, 2 bail hostels, with rapid turnover and high-risk patients with poor health, a centre for adults with complex disabilities and 3 care homes, each with its own liked GP.

The practice were veteran accredited, where veterans are proactively identified ensuring they are signposted to appropriate support and priority pathways where needed.

Leaders, managers and staff strive for excellence through collaboration and shared practice. The service has a track-record of being an excellent role model for others. For example, the practice manager had been recruited to teach other practice managers in the locality.

The service had a strong focus on continuous learning, research innovation and improvement. The leadership drove continuous improvement, and staff were accountable for delivering change. Safe innovation was celebrated. There was a clear proactive approach to seeking out and embedding new ways of providing care and treatment across the organisation and local system. For example, the home visiting service for housebound patients.

There was a continual development of staff skills, competence and knowledge was recognised as integral to ensuring high quality safe care, improved access and service sustainability. Staff were proactively supported to acquire new skills, develop and share best practice. There was strong feedback from staff and particularly where they had been developed. The practice could demonstrate where they had strengthened capacity for succession for the future. As a result of linking training and development with quality and innovation the practice could give examples where they had expanded or strengthened services because of this. For example, the fitting of pessaries for pelvic prolapse.

The practice could demonstrate where strong learning from significant events had resulted in changes in policy. Staff were encouraged to develop and gave us examples of this, healthcare assistant to practice nurse, apprenticeships completed and prescribing qualifications.

The practice manager had been recruited to teach other practice managers in the locality by the NHS transformation team, who contribute to system-wide improvement. They were sharing the key improvements the practice had made to their services.

The practice manager was highly commended by the Primary Care Awards in 2025 for recognising excellence in Health and Social Care apprenticeships.

The practice is a training practice who have GP trainees allocated to the practice (fully qualified doctors allocated to the practice as part of a three-year postgraduate general practice vocational training programme), 2 of the GPs are trainers. The practice hosts final year medical students who are not yet qualified to practice. They host student nurses via a local university.

Feedback shared with us from 4 GP student trainees was positive. The GPs said they found the practice very supportive of them, the whole team were brilliant, and the practice was patient orientated.

The practice were environmentally responsible. They had policies to include sustainability in their day-to-day systems, for example, using CFC free inhalers, arrangements in place for safe recycling of batteries and clinical and non-clinical waste.