The Merton Medical Practice

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.

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. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of patients and their communities.

All staff had contributed to the development of the practice vision and strategy, which was kept under review. The practice was aware of the projected increase in the local population and was working with partner agencies to address future challenges.

The practice was working hard at coming up with strategies to improve and develop advancements in diabetes care, they were part of the diabetes 8 care processes (key annual checks recommended by the NHS for managing diabetes, focusing on preventing complications)

The practice was a veteran friendly accredited practice.

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 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 were engaged in the development of primary care services within the local area.

All staff had completed equality and diversity training. Staff fed back there was strong teamwork and a supportive inclusive culture amongst team members. They said they felt valued. Staff were happy working at the practice, and leaders were approachable and operated an open-door policy.

The service fostered a positive culture where patients felt they could speak up and their voice would be heard. Staff said there were no barriers to speaking up and their views were listened to and acted upon. This aligned with the management approach of being actively engaged with staff to seek their views.

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.

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for patients 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. Staff said they felt supported by management and worked as part of a team.

Leaders fed back they regularly conducted one to ones, appraisals, meetings, and staff surveys. The practice also had a feedback and suggestion box at the back office.

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. However we did find the clinical records review showed that MHRA alerts were not always fully implemented. This was fed back to the practice who were responsive and made timely changes.

Leaders and managers supported staff, and all staff we spoke with were clear on their individual roles and responsibilities. Staff we spoke with knew who the relevant lead person was for areas such as safeguarding, infection control and significant events monitoring.

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. 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 patients. They share information and learning with partners and collaborate for improvement.

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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 practice participated in a digital day event working with the PCN targeting patients who were recognised as having health inequalities, including limited digital skills, 28 patients from Merton Medical Practice attended this meeting. They were educated on using the NHS app including how to order repeat prescriptions, start online consultations, view medical records, seek support and book appointments.

In the summer the nurse participated in a local nurse networking opportunity, ideas and experience was shared.

The practice manager attended forums, sharing learning with other practice manager.

The practice engaged with the PPG, listened to feedback such as changing the appointment system, neatening the front of the building, reducing the number of phone options to 3 and providing signposting.

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 patients. They actively contribute to safe, effective practice and research.

The practice had a quality improvement plan in place to help drive improvements in services. This focused on the appointment system. All staff were encouraged to put forward and test out new ways of working, and we saw examples of the nursing staff.

The practice told us they would be conducting community engagement in their local population in the upcoming months to raise awareness of Type 2 Diabetes in the young.

They had signed up to further improve cancer care provision through participating in a cancer quality Improvement Scheme for 25/26. This will allow them to audit retrospective data to identify trends, liaise with patients to improve awareness of signs/symptoms suggestive of cancer and use clinical decision tools to support care/safety-net.

The practice had participated in improving diabetes care for the practice through participating in a pilot, which involved upskilling their healthcare assistant to undertake diabetes foot checks.

All 3 GP Partners had completed their GP trainer course and the practice was an accredited GP Training and Medical Student Teaching Practice.