O'Flynn - Hampton Wick Also known as Hampton Wick Surgery

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

WELL-LED: 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 Requires Improvement. At this assessment, the rating has changed to Good.

This service scored 79 (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.

Staff we spoke to told us they felt valued and trusted and that their views were listened to and concerns acted on. Staff and patients were treated with openness, support and care.

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.

At our last inspection we found

• leaders had implemented new processes and systems to monitor patient data and drive improvements. However, these new processes and systems had not yet proven themselves to be sufficiently effective or robust. Our clinical searches showed that whilst the clinical management team had carried out audits and searches of the patient list, patients still had insufficient monitoring, follow ups or reviews completed to demonstrate that the system was effective.
• Safety alerts were not always being actioned and some patients with long-term conditions also required follow ups. Immediately following the inspection, the practice addressed all patients who required attention.

At this assessment:

• We looked at medical records for several patient groups, including those being prescribed medicines requiring regular monitoring. For the records we looked at, we found the practice was able to evidence that all patients were receiving treatment and, where necessary, monitoring in line with national guidelines.
• Our review of prescribing in accord with medicine safety alerts found no concerns. The practice had a robust system for reviewing historic safety alerts to ensure prescribing remained in line with guidance.

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. Staff told us, leaders were visible, approachable, and responsive and there was a clear structure in place.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff told us there was a freedom to speak up policy which was accessible via the computer system. The practice had established Freedom to Speak up arrangements with other practices in the primary care network. There were posters around the practice advising staff about

Staff were aware of how to raise concerns and were encouraged to speak in meetings, appraisals, 1 to 1 meetings, and within informal and formal discussions with managers.

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 promoting diversity and equality were in place. All staff felt valued. For example, staff with outside commitments were supported and encouraged in those activities. This had required the practice to agree to flexible staff rotas to accommodate those staff.

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.

At our last inspection we found some patients had not been sufficiently monitored and some safety alerts had not been actioned at the time of the inspection. There were systems and processes in place, but these were not always effective to manage and mitigate risks for patients.

At this assessment:

• We looked at medical records for several patient groups, including those being prescribed medicines requiring regular monitoring. For the records we looked at, we found the practice was able to evidence that all patients were receiving treatment and, where necessary, monitoring in line with national guidelines.
• Our review of prescribing in accord with medicine safety alerts found no concerns. The practice had a robust system for reviewing historic safety alerts to ensure prescribing remained in line with guidance.

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 via computers which were password protected with individual access.

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

The provider worked with other practices within their primary care network to share best practice, training opportunities and quality improvement projects.

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 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.

GPs at the practice had a wide range of special interests, including Minor Surgery, Mental Health problems, Women’s Health, Surgery, Urology, Men’s Health, Diabetes, dermatology, ear, nose and throat (ENT) and paediatrics.

The practice was an accredited training practice, offering places to medical students and training placements for GP trainees.

The practice was actively engaged in succession planning. The senior partner intended to retire, and a salaried GP had accepted an offer of partnership. The GP was undertaking a partnership training course.

It worked hard at building relationships, both internally, and with external organisations. For example, each year staff and leaders jointly nominated a charity to support. They then participated in activities to raise funds. Previous fund raising had included a cycle ride and camping out to raise funds for a homeless charity.

The practice had a quality improvement plan in place to help drive improvements in services. For example, following discussion with its PPG, the appointment triage system the practice had adopted a non-digital triage process. This allowed patients to phone or attend the practice in person to have their appointment needs triaged by a GP. This meant there was no early morning rush for appointments and those with computer access difficulties did not struggle to contact the practice.

The practice had recently achieved accreditation as a Veterans Surgery. Being accredited meant that a practice could better identify and treat Veterans, refer them, where appropriate, to dedicated NHS services (such as OpCOURAGE: the Veterans Mental Health and Wellbeing Service and OpRESTORE: the Veterans Physical Health and Wellbeing Service).

The practice participated in innovative medical projects being run by other institutions. For example, it had worked with a charity which supported homeless people to support and encourage homeless people to register with the practice and to attend for necessary appointments. The charity and practice recognised that this was a difficult group to engage and jointly developed bespoke arrangements for these patients.

It was actively participating in ongoing medical projects, including, working with a team from St Georges Hospital with the aim of treating patients suffering from hepatitis C. the goal of the project was to provide eligible patients with a course of treatment with the expectation of elimination of the virus.