Central Medical Centre

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• 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 82 (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.

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. For example their salaried doctor was undertaking a GP Fellowship in diabetes, the practice had implemented an enhanced programme for early-onset type 2 diabetes, with targeted personalised interventions. The practice delivered diabetes group consultations in both Tamil and English to improve patient engagement and self-management. The practice had undertaken diabetes outreach sessions at the temple.

One of the partners at the practice was taking part in a pilot that involved proactive outreach to patients who had moderate or severe frailty and who were housebound. Working with them and their carers to identify their needs and create a holistic care plan including advance care planning.

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.

We saw a succession plan in place. All staff had completed equality and diversity training. Staff feedback there was strong teamwork and great support amongst team members. They were happy working at the practice, and leaders were approachable and operate an open-door policy.

The service fostered a positive culture where people 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 practice had a freedom to speak up policy reviewed in April 2025, staff we communicated with knew who the external freedom to speak up guardian was.

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.

We saw all staff (clinical and non-clinical) had completed equality and diversity training.

We saw a new staffing area built at the surgery site away from the main building that was not only a dedicated area for staff to use during breaks. Leaders informed us it had dual use in giving the practice space that could be used to accommodate group training sessions such as basic life support.

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. We did not receive any negative feedback from practice staff regarding equality, diversity and inclusion. Staff said they felt supported by management and worked as part of a team.

The practice 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 out of 10 of clinical searches undertaken 1 search identified patients on medicines used to treat cardiovascular disease of whom around 30 patients did not have a coded documented discussion or a prescription for a gastro-protective medicine recommended for their age group. Once this was raised with the practice they addressed this immediately and contacted all necessary patients.

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 clearly understood and carried out their duty to collaborate and work in partnership, and services worked seamlessly for people. They always share information and learning with partners and collaborate for improvement.

The practice had regular health visitor meeting, we saw meeting minutes documenting working relations and discussions of vulnerable patients.

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 had established fortnightly diabetes multidisciplinary meetings with a community services diabetes specialist nurse to discuss complex cases and co-create patient management plans. This was in response to the practice’s large diabetes list size.

The practice was working with the patient participation group (PPG), they met every two months alternating face to face meetings and virtual meetings. The PPG feedback the practice engaged with them regularly and listened to feedback, for example they raised concerns about the telephone problem, so the practice got more staff to answer the phones and also introduced a call back service.

The practice worked closely within Morden Primary Care Network (PCN), with the PCN one of the partners ran cooking sessions for patients with a learning disability in collaboration with local organisations with a focus on diabetes and healthy eating.

We saw joint working with the PCN, the practice implemented an enhanced programme for early-onset type 2 diabetes, with targeted personalised interventions.

The practice was involved in numerous projects including a frailty project and end of life care project.

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 practice had a quality improvement plan in place to help drive improvements in services. This focussed on the appointment system. All staff were encouraged to put forward and test out new ways of working. We saw an action plan which reviewed data from the national GP Patient survey this focussed on reviewing and improving the telephone system and looking at eConsult data to improve access. The practice had also undertaken their own patient survey and had identified themes for improvement. This included the experience of making an appointment and getting through to the practice on the phone.

We saw examples of fortnightly diabetes multidisciplinary meetings with a community services diabetes specialist nurse to discuss complex cases and co-create patient management plans, in response to the practice’s large diabetes list size.

The practice informed us they had made significant advancements in diabetes care for example, they delivered diabetes group consultations in both Tamil and English to improve patient engagement and self-management and received positive feedback.

The practice had undertaken diabetes outreach sessions at the temple and collaborated with a local community services dietician to co-create a recipe book in Tamil and English, led by the GP fellow, supporting culturally appropriate dietary advice. At the time of the inspection the practice was in discussion with diabetes UK as to whether this was something they may be able to endorse.

To improve diabetes care the practice recruited an advanced nurse practitioner (ANP)independent prescriber with a special interest in diabetes, who was able to initiate insulin in house. Since joining the practice, the ANP had been given the Queen’s nurse award, we saw the trophy on her desk, this represented and was in recognition of the nurse's commitment to ongoing learning, leadership and excellence in healthcare.

One of the GP partners had led a proactive frailty project where housebound patients were contacted by the PCN care coordinator to identify their needs and consent to participate in the project. These patients were then discussed at an MDT with community services, local PCN GP practices and Age UK, from this it was then decided who was best placed to visit the patient. The visit involved a comprehensive care plan looking to maintain independence, improve quality of life and reduce risk of hospital admission.