Parkside Medical Centre

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 the practice was led effectively and in a way that was inclusive, supported improvement and innovation and made sure patients received care that was safe and effective.

At our last inspection we rated this key question Requires Improvement.
At this assessment, the rating has changed to Good.

This is because:

• There was a clear vision for the future of the practice and staff were involved in the planning and development of it.

• Staff told us leaders and managers were supportive, approachable, visible, open and honest.

• Staff were aware of how to speak up and arrangements were in place for staff to do so.

• There was effective leadership and management of the service.

• Staff were encouraged to share ideas and contribute towards work to improve the safety and effectiveness of care and treatment.

• However, the practice did not always engage with patients, the public and partners effectively.

 

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.

Most staff told us they felt there was a clear vision for the future of the practice.

All staff who provided feedback for this assessment said they had been involved in the planning and development of the vision and plans for the future of the practice.

There was a business plan and strategy which the provider reviewed and monitored progress with the delivery of the vision and values.

Staff consistently described shared values and explained how they contributed to the practice's mission statement, 'empowering you to live well'.

The GP partners and practice management team met to discuss and respond to matters relating to the running of the practice.

All staff who provided feedback for this assessment told us about a supportive and caring culture throughout the practice, where they felt valued and respected. Several staff members described going to work at the practice was “enjoyable”.

 

Leaders were aware of the challenges affecting the service, and anticipated other potential challenges. The provider had taken steps to address them safely and effectively.

All staff who provided feedback for this assessment told us they felt leaders and managers:

• listened to and acted on their views and feedback

• supported them

• were visible and approachable

• were open and transparent.

Clinical and non-clinical staff gave examples of staff feedback that had been acted on and had improved the service. For example, non-clinical staff told us about effective contributions made to improve the efficiency of the service, for example sending links to patients who completed the online triage form for them to submit a photograph, where this may help the clinician to assess their condition and offer appropriate care and treatment.

The practice had a whistleblowing and Freedom to Speak Up policy.

Staff were aware of whistleblowing and Freedom to Speak Up, and most staff were aware of the policy and where to find information.

Most staff knew who the Freedom to Speak Up Guardian was within the practice.

Freedom to Speak Up Guardians offer support to staff to raise concerns, or speak up, when they feel they cannot in other ways.

The policy also included details for Freedom to Speak Up services that worked outside the practice with whom staff could raise concerns if they felt they needed external support or advice to raise concerns, or speak up.

Staff told us they felt able to raise a concern if they needed to, and that if they were to raise a concern, especially about safe patient care, it would be welcomed.

 

Staff members were from a variety of different nationalities and backgrounds.

Staff felt they were treated with care and kindness. They also felt they were treated fairly, for example around opportunities for professional development and responsibility.

Staff told us how the practice had supported them to work flexibly to help them balance work with other responsibilities or personal matters, such as caring responsibilities, responding to unexpected situations at home, or workplace adjustments during pregnancy. Staff felt their confidentiality was maintained and they were treated in a non-judgemental way.

 

Staff were clear about their individual roles and responsibilities and the roles and responsibilities of others in the practice.

Staff knew where to find policies and guidance and knew who they could speak to if they had a question or concern.

Leaders supported staffs' development, in line with each member of staff's agreed goals and aspirations. Individual staff were supported and empowered to take responsibility for certain tasks in the practice. This helped to make sure tasks, such as regular checks of equipment or the premises, were carried out consistently.

Staff had protected time to complete training and to carry out their additional responsibilities.

There were effective governance systems in place and leaders had effective oversight of the day-to-day running of the practice. For example, the provider was aware when a member of staff was due training or immunisation against an infectious disease. The provider had identified and responded to potential risks, such as taking steps to reduce the risk of a cold chain breach or to help make sure emergency evacuation from the building would be effective if it was needed.

The provider held 'Practice Meetings' every 3 months, to which staff or a representative were invited. Notes from the meetings were recorded and made available for all staff to read.

The provider had made flowcharts to help all practice staff understand their role in improving care for patients and the efficiency of the service. These included for processing blood test results and requests from patients for ‘fit notes’. The provider created more flowcharts in response to certain scenarios that happened in the practice.

At the time of this assessment, the practice did not have an active Patient Participation Group (PPG). Practice leaders were aware of challenges contributing to this and acknowledged restarting the PPG was not a priority at this time. Attempts to relaunch the PPG had not been successful.

At the time of this assessment, the practice was not promoting a patient group. Although there was information on the practice’s website about the role of the PPG and how one could participate, including a form for people to register their interest in joining the PPG, this information was not up-to-date.

The provider had identified an intention to improve the levels of patient and public involvement, through a PPG and other means of patient participation.

The practice monitored responses to the national GP Patient Survey and the NHS 'Friends and Family Test'.

However, although the provider felt the responses to the national GP Patient Survey were not representative of the practice, except for individual staff surveys, the provider did not share with us their findings from other work they may have done, such as patient surveys.

The provider was aware generally low numbers of people provided feedback about the service, for example through links the practice shared for people to fill in a 'Friends and Family' form.

The provider contributed to discussions, including with the commissioners of the service, for example about the development of neighbourhood health services.

In response to long waiting times for mental health services, the practice was working with a mental health charity to develop an app to help people with mental health needs whilst they waited to be seen by mental health services.

Partner organisations told us it had been challenging to establish and maintain communication with the practice and had found engaging with the provider difficult at times.

The provider acknowledged there had been challenges working with the other GP practices in the South West Primary Care Network (PCN), to which Parkside Medical Centre was a member. The PCN is a group of 4 GP practices with the aim of working together to address local priorities in patient care.
 

Staff were encouraged to share ideas and contribute towards work to improve the safety and effectiveness of care and treatment.

There was a quality improvement plan and staff told us about several pieces of quality improvement work, including:

• Identifying patients who were attending the practice every 3 months for an injection of Vitamin B12. The practice carried out monitoring for all patients identified and, when it was clinically appropriate, patients were switched to Vitamin B12 tablets they could take at home. Patients whose monitoring showed this had been effective continued with tablets. For patients where monitoring showed this trial was not successful, the practice made a note on the patient's records to indicate the patient needed injections. The practice identified over 200 patients suitable for this project. As well as being more convenient for patients, another outcome of the project was that more nursing appointments became available to meet the demands on the service.

• A change of attitude toward leg ulcer care from a reactive to a more preventative approach. The nursing team had been skilled to offer patients at risk of ulcers a yearly review, including a doppler scan, education, appropriate compression garments and medicines. A practice nurse who oversaw the project told us the number of doppler scans being carried out had increased, and they had noticed significantly fewer patients were now developing leg ulcers, and there were now very few patients needing specialist compression bandaging.

• A plan to identify patients prescribed an anti-psychotic medicine who did not also have a severe mental illness, to make sure that these patients also received the monitoring needed.

The surgery was an approved training practice. At the time of this assessment, the practice were supporting GP registrars. Registrars are qualified doctors who are training to become GPs.