The Steven Shackman 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 in 2016, we rated this key question as good. At this assessment, the rating remains the same.

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 people and their communities.

Staff we spoke to were clear on the core objectives of the service.

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.

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. These included both internal and external arrangements. Staff were aware of how to raise concerns.

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.

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. 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. However, we found a few areas of governance requiring attention. These were the oversight of test results, staff recruitment and staff immunisations. The service took our concerns seriously in relation to the findings and immediately initiated an internal review to improve systems and processes.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The provider worked with other practices within their primary care network to offer extended access and deliver health inequalities projects. For example, the healthy lungs and the Cardio-Renal-Metabolic projects.

The service collaborated with local charities through PPG patient workshops including workshops to support independent living for older people, people with Parkinsons disease, anxiety and Multiple Sclerosis.

The service had participated in 3 neighbourhood health events. A winter wellness event, living well event and a blood pressure and cholesterol webinar.

The service had an excellent 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 contributed to safe, effective practice and research.

The service demonstrated a systematic approach to quality improvement. They provided evidence of 5 multi-cycle audits with key learning and changes implemented. The audits showed shared learning across both clinical and non-clinical staff. In addition, the service provided evidence of 11 other audits and quality improvement exercises. These included infection prevention and control, DNACPR, access, antibiotic stewardship and safeguarding audits. All these had key learning and change implemented documented.

Leaders had developed innovative aids for clinicians. For example, an aid to support clinicians with treating menopause, this had been disseminated to other GPs in the primary care network. Leaders had in collaboration with other GPs in the primary care network developed a toolkit for managing COPD and asthma flare-ups. They had also developed a range of clinical pathway documents to support clinicians. For example, to support the management of sepsis and chronic kidney disease. Leaders had developed a workbook to support patients with or at risk of hypertension, high cholesterol and diabetes.

The service was undertaking an exercise to identify and support unpaid carers which involved carer identification, a needs assessment questionnaire. So far, they had identified 154 unpaid carers who they were assessing for appropriate support. This had increased the number of patients identified with carer responsibilities to 450.

The service was participating in the healthy lungs project to reduce health inequalities in the local neighbourhood and the Cardio-Renal-Metabolic project to reduce health inequalities in the south Asian community.