The Brooke 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

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 has changed.

This service scored 89 (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 very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the 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 due to a proposed building of an additional 2150 homes locally. The provider had made enquiries with regards to what GP provision had been submitted as part of the plans and was working with partner agencies to address future challenges.

The practice held the declaration of safe surgeries which ensured they were a safe surgery for everyone in the community.

There were policies and procedures in place to support and promote equality and diversity. The practice had received compliments with the theme of inclusivity and being treated fairly and equally running through. It was clear that there was a strong learning culture with the service. The no blame culture meant people felt more able to raise concerns or highlight when things had or could go wrong.

The provider fostered a workplace culture where staff are encouraged to bring personal or homelife issues that may affect their ability to perform to the best of their ability to the management team. The support given helps to keep staff psychologically safe and allows managers to help solve problems that they are facing and to put in place any proactive reasonable adjustments.

People did the right thing for patients, and this was embedded in everything that they did.

The provider supported local community projects and every Christmas all staff are involved in donating to the children’s ward at Tameside General Hospital.

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 always did so with integrity, openness and honesty.

Staff told us leaders in the practice were approachable and responded to any concerns raised and the leaders modelled the values of the practice. Staff told us that leaders were supportive and offered changes in rotas to help deal with any life challenges that staff were dealing with. They told us that any suggestions or ideas would be talked through and discussed as a whole team before being tested and implemented as normal business.

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 knew they could speak up and their voice would be heard.

The practice had established a Freedom to Speak up guardian who was independent of the management of the service. All staff were made aware of how to make contact with the guardian to report any patient safety or operational concerns.

Any matters raised with the guardian are bought to regular partnership meetings to drive forwards proactive learning and ensure patient safety remains a priority. These learning points were then bought back in house and discussed at internal staff meetings.

The service strongly valued diversity in their workforce. They had an inclusive and fair culture which had improved equality and equity for people who work for them.

Policies and procedures to promote diversity and equality were in place. Appropriate equality, diversity and inclusion training was available for all staff and had been completed at induction and yearly as part of mandatory training modules.

Reasonable adjustments and working patterns were promoted by leaders to ensure that all staff felt valued and supported within the workplace.

The service employed a range of different people with varying backgrounds and supported staff to meet their individual needs. The service actively supported staff to bring their whole true self to work and to be the best that they can be for patients.

The recruitment process ensured that there was no discrimination towards anyone applying for a role that had a protected characteristic. Applications from people with protected characteristics and were encouraged in job adverts. This helped to build a diverse workforce with a range of personal lived experience.

The provider had administrative leads and maintained a centrally monitored digital Multi-Faith Community Channel called The Water Cooler - Fun Stuff, encouraging collaboration for all staff. The channel shared multi-faith cultural milestones (such as practice-wide Iftar events and Eid celebrations) alongside localised inclusive social outings.

The provider fostered a workplace culture where staff are actively encouraged to bring personal or home-life problems affecting their work to management, allowing for collaborative problem-solving and proactive pastoral adjustments.

The providers undertook, anonymous staff-to-staff feedback campaigns, compiled qualitative peer reviews that were distributed directly to individuals to combat burnout and build team morale.

The provider encouraged staff development and regularly promoted staff into triage and care navigation positions following enhanced training.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment and support. They always acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The provider had a wide range of quality improvement initiatives in place which were used to drive improvements across all areas within the service. These were driven by the partners with the whole team buying into these initiatives to help make improvements for service users. The provider undertook a range number of audits to monitor performance and risk.

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.

Practice meetings took place on a regular basis, there were all staff meetings, clinical meetings and non-clinical staff meetings. Learning from significant events and emerging risks were shared at meetings alongside any learning that had been shared with managers from the local Primary Care Network (PCN). Managers clearly recorded any actions arising from these meetings and ensured they shared these with staff. Managers would highlight, using staff members names, specific areas within the minutes for any staff that were unable to attend the meetings.

Staff took patient confidentiality and information security seriously and undertook regular mandatory training.

Managers put in place a peer-to-peer anonymous feedback campaign for all staff. This allowed team members to submit feedback regarding their colleague’s leadership, clinical support and work ethic. This kept the information anonymous and helps to keep the integrity and importance of the statement within. Staff told us that they felt it was important to receive feedback, so they were aware of any changes they needed to make, and they felt that it helped during appraisals and 1-2-1 meetings.

The service 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 provider worked with other practices within their primary care network and shared learning to ensure people were kept safe and reduce the risk of harm.

Staff worked closely with community services and communicated well the needs of people using the service. they ensured that patient records were kept up to date to ensure that patients only needed to tell their story once. They worked closely with district nurses to ensure that patients received the right care at the right time.

The service worked closely with community groups and engaged with them to help reduce health inequalities being experienced by people from minority backgrounds.

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.

The practice had several quality improvement plans in place to help drive improvements in services. One example of this was the way in which they governed digital innovation safely. The provider had a Social Media Governance Framework procedure ensuring digital videos to be published to the practice YouTube channel underwent documented dual-clinician vetting and sign-off before public distribution.

All staff that we spoke to told us that they were encouraged to put forward new ideas and ways to improve the service.

The provider operated a Point of Care bus which was setup outside of the practice and allowed people to come in for screening and allowed some patients to be started on medications required to help manage long term conditions. This helped encourage people to come to the practice for screening that had become disengaged with the service for whatever reason.

The service ran automated diagnostic, and medication checks on patient records to identify risks to patients. Once risks had been identified patients were invited in for reviews at either a routine appointment or by a targeted approach using the Point of Care Testing bus which was set up outside of the practice.

The provider had worked closely with the community and reduced the use of ‘Z’ drugs down to zero prescriptions. ‘Z’ drugs are medications which have a high rate of dependency and are a class of sedative-hypnotic medications primarily prescribed for insomnia.